Department of Sociology, University of Chicago, Illinois.
Center on Aging, NORC at the University of Chicago, Illinois.
Gerontologist. 2018 Jan 18;58(1):159-169. doi: 10.1093/geront/gnx050.
Although the role of place on health is not new, less is known about how place matters for cognition. By investigating both neighborhood and home as the sociospatial realms of older adults, we explore associations between health and place across multiple contexts. We also distinguish objective and subjective measures of place and disentangle their differential associations with cognition.
We analyzed place effects on cognition from the National Social Life, Health, and Aging Project (N = 2,260) linked to neighborhood characteristics and crime data. We measured place in four ways: (a) objective indicators of neighborhood such as police-reported crime rates and interviewer-reported on presence of disordered conditions on the streets; (b) perceptions of neighborhood by respondents (perceived danger and social cohesion); (c) objective conditions of home (interviewer's report on presence of clutters, odor, and messiness); (4) perceived social support, strain, and threat by household members. The MoCA-SA was used to assess cognitive functioning.
Subjective interpretations appeared to have more direct effects on cognition than did objective indicators of neighborhood or home. When examining these living environments together, we found the association between neighborhood and cognition is partially explained by characteristics of home environment, especially perceived social support. We found a buffering effect of social support on cognition for women, not for men.
Late life living environments are important contexts for aging. Aging-in-Place interventions should address subjective interpretations of place to reduce future risks of cognitive decline.
尽管场所对健康的作用并不新鲜,但对于场所对认知的影响知之甚少。通过调查邻里和家庭作为老年人的社会空间领域,我们探索了健康与场所之间在多个背景下的关联。我们还区分了场所的客观和主观测量,并厘清了它们与认知的不同关联。
我们分析了来自国家社会生活、健康和老龄化项目(N=2260)的数据,这些数据与邻里特征和犯罪数据相关联,以探讨场所对认知的影响。我们通过以下四种方式测量场所:(a)邻里的客观指标,如警方报告的犯罪率和访谈者报告的街道上无序状况的存在;(b)受访者对邻里的看法(感知危险和社会凝聚力);(c)家庭的客观条件(访谈者报告存在杂物、异味和混乱);(4)家庭成员感知到的社会支持、压力和威胁。使用 MoCA-SA 评估认知功能。
主观解释似乎比邻里或家庭的客观指标对认知有更直接的影响。当一起检查这些生活环境时,我们发现邻里与认知之间的关联部分被家庭环境的特征所解释,特别是感知到的社会支持。我们发现社会支持对女性的认知有缓冲作用,但对男性没有。
晚年的生活环境是衰老的重要背景。“就地养老”干预措施应解决对场所的主观解释,以降低未来认知能力下降的风险。