Researchers from Edinburgh University found that people who were born and brought up in rural areas were at greater risk of the condition than those from towns and cities.
Although the cause of the trend is unclear, the scientists suggested factors like access to health care, or exposure to certain substances in either the countryside or in cities, could have played a role.
Alzheimer's, a form of dementia, affects more than 800,000 in Britain and the number of sufferers is expected to double by 2050 due to the ageing population.
The researchers studied 51 academic papers containing data on the medical records of 12,580 people from around the world, published over several decades.
The countries studied included the UK, USA and Canada as well as less developed nations like Nigeria and Peru.
Rates of dementia as a whole did not differ greatly between rural and urban dwellers, but for Alzheimer's specifically there was a marked difference, according to the results published in the International Journal of Epidemiology.
Dr Tom Russ, who led the study, emphasised the difference between the two groups could be down to benefits associated with living with cities, rather than harmful factors linked to the countryside.
He said: "We don't really know the mechanism. It could be to do with access to health care, exposure to some unknown substance, socioeconomic factors, or a number of other factors. We're currently looking into this question in more detail."
A priority for researchers will be to identify what causes the difference, so that more can be done earlier in life to prevent people developing the incurable condition, he added.
Dr Simon Ridley, of Alzheimer’s Research UK, said: “This data review observes a link between rural living and increased Alzheimer’s incidence and prevalence, but the complicated evidence is insufficient to prompt an exodus to the city.
"We should remember this is an amalgamation of global data that may not hold true for the UK. Big questions remain over whether particular exposures in early rural life or duration of rural living are at play."