National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA 98105, USA.
Department of City and Regional Planning, Institute for Transportation Studies, University of California, Berkeley, Office 313B, Wurster Hall #1820, Berkeley, CA, 94720, USA.
Soc Sci Med. 2018 Mar;200:27-35. doi: 10.1016/j.socscimed.2018.01.007. Epub 2018 Jan 9.
Preliminary studies suggest that neighborhood social and built environment (BE) characteristics may affect cognition in older adults. Older adults are particularly vulnerable to the neighborhood environment due to a decreasing range of routine travel with increasing age. We examined if multiple neighborhood BE characteristics are cross-sectionally associated with cognition in a diverse sample of older adults, and if the BE-cognition associations vary by individual-level demographics. The sample included 4539 participants from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine the associations between five BE measures and four cognitive measures, and effect modification by individual-level education and race/ethnicity. In the overall sample, increasing social destination density, walking destination density, and intersection density were associated with worse overall cognition, whereas increasing proportion of land dedicated to retail was associated with better processing speed. Effect modification results suggest that the association between urban density and worse cognition may be limited to or strongest in those of non-white race/ethnicity. Although an increase in neighborhood retail destinations was associated with better cognition in the overall sample, these results suggest that certain BE characteristics in dense urban environments may have a disproportionately negative association with cognition in vulnerable populations. However, our findings must be replicated in longitudinal studies and other regional samples.
初步研究表明，邻里社会和建筑环境（BE）特征可能会影响老年人的认知能力。由于随着年龄的增长，日常出行范围缩小，老年人特别容易受到邻里环境的影响。我们研究了在一个多样化的老年人群体中，多个邻里 BE 特征是否与认知能力存在横断面关联，以及 BE-认知关联是否因个体层面的人口统计学特征而异。该样本包括来自动脉粥样硬化多民族研究的 4539 名参与者。多变量线性回归用于检验五种 BE 测量指标与四种认知测量指标之间的关联，以及个体层面的教育程度和种族/民族的修饰作用。在总体样本中，社会目的地密度、步行目的地密度和交叉口密度的增加与整体认知能力下降有关，而用于零售的土地比例的增加与处理速度的提高有关。修饰作用的结果表明，城市密度与认知能力下降之间的关联可能仅限于或在非白种人种族/民族中最强。尽管增加邻里零售目的地与整体认知能力的提高有关，但这些结果表明，在脆弱人群中，密集城市环境中的某些 BE 特征可能与认知能力存在不成比例的负面关联。然而，我们的发现必须在纵向研究和其他区域样本中得到复制。
