Would be interesting to see whether spatial reasoning from gaming shows the same association.

This is indeed interesting because rotating 2D screen is not necessarily the same type of brain processing as experiencing things fly around you. Even VR is not necessarily the same, because knowing you're safe may be different from taking the situation seriously. Could be same, could be completely different.

But the first massively popular 3D games started end of 90s which means Alzheimer cases for them will pop up only around 2060 or later (average onset year 75 minus being 15 years kid during 90s).

Besides safety, there is also the cognitive complexity angle.

Plus, digital environments are explicitly designed to be engaging: authors are putting intentional thought into making the virtual space easy to navigate so that the player doesn't get frustrated and go do something else.

Meanwhile, the physical world is something we're pretty much stuck in, and material spaces tend to be optimized not so much to be engaging to navigate and explore - more to be comfortable to inhabit, etc.

Besides, physical spaces - e.g. cities - tend to be iteratively developed over generations, bearing the hallmarks of many different thinking minds, and not optimized for any one particular user flow.