Department of Neurology, University of California Davis, Sacramento, CA 95817, USA.
Department of Psychology, University of California Davis, Davis, CA 95616, USA.
Int J Environ Res Public Health. 2021 Jul 4;18(13):7166. doi: 10.3390/ijerph18137166.
Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia.
A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels.
Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level.
Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
社会环境是影响健康和健康差异的一个决定因素。本范围综述详细介绍了社会环境在认知衰老和痴呆的观察性研究中是如何被操作化的。
在 PubMed 和 Web of Science 中进行系统搜索，确定了社会环境暴露与晚年认知/痴呆结局相关的研究。提取的数据包括：（1）研究设计；（2）人群；（3）社会环境；（4）认知结局；（5）分析方法；以及（6）理论上的因果途径。研究使用人际、社区或政策层面的三级社会生态模型进行组织。
在 7802 篇非重复文章中，有 123 篇符合纳入标准。84 项研究为纵向研究（范围为 1-28 年），16 项研究检查了随时间变化的社会环境。按照社会生态层次分类，91 项研究检查了人际层面；37 项研究检查了社区/邻里层面；3 项研究检查了政策层面的社会环境；7 项研究检查了多个层面。
大多数关于社会环境与认知衰老和痴呆的研究都考察了在单一时间点测量的人际因素。很少有研究评估随时间变化的社会环境因素，也很少考虑多个社会生态层次。未来的研究可以通过描述社会环境如何影响晚年认知衰老和痴呆的结局，来帮助阐明干预的机会，如果、何时以及如何影响。
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