Lebanon faces a growing challenge as its population ages now with nearly one in ten adults aged 65 years or older. The contrast between urban and rural living conditions offers a unique lens to study how geography, education, and lifestyle shape cognitive health. This study aimed at estimating dementia prevalence and identifying associated sociodemographic and cardiovascular risk factors among older adults across urban and rural Lebanon. We conducted a secondary analysis of two cross sectional, community based surveys from 2013 and 2018, including 716 adults aged 65 years from Beirut, Aley, Chouf, and Beqaa. Dementia was diagnosed using the validated Arabic 10 66 protocol. Participants were classified as urban n is equal to 374 or rural n is equal to 342. Multivariable logistic regressions were used to identify determinants of dementia, adjusting for demographic and vascular covariates