Social Epidemiology Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE4 5PL, UK.
Soc Psychiatry Psychiatr Epidemiol. 2021 Sep;56(9):1601-1610. doi: 10.1007/s00127-021-02030-y. Epub 2021 Jan 23.
The aim of this study was to investigate the associations between quality of life and both perceived and objective availability of local green and blue spaces in people with dementia, including potential variation across rural/urban settings and those with/without opportunities to go outdoors.
This study was based on 1540 community-dwelling people with dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Quality of life was measured by the Quality of Life in Alzheimer's Disease (QoL-AD) scale. A list of 12 types of green and blue spaces was used to measure perceived availability while objective availability was estimated using geographic information system data. Regression modelling was employed to investigate the associations of quality of life with perceived and objective availability of green and blue spaces, adjusting for individual factors and deprivation level. Interaction terms with rural/urban areas or opportunities to go outdoors were fitted to test whether the associations differed across these subgroups.
Higher QoL-AD scores were associated with higher perceived availability of local green and blue spaces (0.82; 95% CI 0.06, 1.58) but not objective availability. The positive association between perceived availability and quality of life was stronger for urban (1.50; 95% CI 0.52, 2.48) than rural residents but did not differ between participants with and without opportunities to go outdoors.
Only perceived availability was related to quality of life in people with dementia. Future research may investigate how people with dementia utilise green and blue spaces and improve dementia-friendliness of these spaces.
本研究旨在探讨生活质量与痴呆患者感知到的和客观存在的当地绿色和蓝色空间之间的关联,包括在农村/城市环境以及有/无户外活动机会的人群中的潜在差异。
本研究基于 IDEAL 计划中 1540 名居住在社区中的痴呆症患者。生活质量通过阿尔茨海默病生活质量量表(QoL-AD)进行测量。使用了一份包含 12 种绿色和蓝色空间类型的清单来衡量感知到的可达性,而客观可达性则使用地理信息系统数据进行估计。回归模型用于研究生活质量与绿色和蓝色空间的感知和客观可达性之间的关联,同时调整了个体因素和贫困水平。与农村/城市地区或户外活动机会的交互项被拟合,以检验这些亚组之间的关联是否存在差异。
更高的 QoL-AD 评分与更高的感知到的当地绿色和蓝色空间可达性相关(0.82;95%CI 0.06, 1.58),但与客观可达性无关。感知可达性与生活质量之间的正相关关系在城市居民中更强(1.50;95%CI 0.52, 2.48),而在有和没有户外活动机会的参与者之间没有差异。
只有感知到的可达性与痴呆患者的生活质量有关。未来的研究可以调查痴呆症患者如何利用绿色和蓝色空间,并改善这些空间对痴呆症患者的友好程度。