中国老年人的生活环境、建筑环境与认知功能：一项横断面研究的结果

Living Environment, Built Environment and Cognitive Function among Older Chinese Adults: Results from a Cross-Sectional Study.

作者信息

Fangfang H, Xiao H, Shuai Z, Qiong W, Jingya Z, Guodong S, Yan Z

机构信息

Prof. Shen Guodong, Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 17-Lujiang Road, Hefei, Anhui 230001, P.R. China, E-mail:

出版信息

J Prev Alzheimers Dis. 2022;9(1):126-135. doi: 10.14283/jpad.2021.59.

DOI:10.14283/jpad.2021.59

PMID:35098983

Abstract

BACKGROUND

Many studies have addressed the relationship between environmental factors and cognitive function; however, evidence from China is very rare.

OBJECTIVES

To discuss the relationship between the living and built environment and cognitive function among older Chinese adults.

DESIGN

The Anhui Healthy Longevity Survey (AHLS) was used to investigate the ability to control major non-communicable diseases through behavioural techniques among adults aged 60 or older dwelling in Anhui Province. A multistage sampling strategy was used to obtain a representative sample. Cross-sectional data were collected for the analyses.

SETTING

The included participants were recruited from four selected cities in Anhui Province, China.

PARTICIPANTS

The participants were adults aged 60 or older and resided in the selected urban or rural communities.

MEASUREMENTS

The Mini Mental State Examination was used to measure the cognitive status of the participants. Mild cognitive impairment (MCI) was defined as illiteracy with MMSE scores lower than 18, MMSE scores lower than 21 among those educated for 0-6 years, or MMSE scores lower than 25 among those with 6 or more years of education. The living environment was assessed by asking the participants about their daily living conditions. The distances between the participants' dwellings and the nearest facilities and the proportions of green/blue spaces within 800 m buffers were calculated based on the textural address to indicate the built environment.

RESULTS

The male participants who lived in a non-dusty environment had higher MMSE scores (β=0.828, 95% CI: 0.240, 1.416, p=0.006) and lower risks of mild cognitive impairment (MCI) (OR=0.651, 95% CI: 0.488, 0.868, p=0.003), and the male participants with no access to recreation spaces had lower MMSE scores (β=-1.107, 95% CI: -1.531, -0.684, p<0.001) and higher risks of MCI (OR=1.403, 95% CI: 1.134, 1.737, p=0.002). The female participants who lived far from a supermarket had significantly lower MMSE scores (Q3:β=-0.750, 95% CI: -1.266, -0.233, p adjusted=0.036; Q4: β=-1.184, 95% CI: -1.745, -0.624, p adjusted<0.001) than those who lived near a supermarket (Q1).

CONCLUSIONS

The living environment and built environment might have sex-specific associations with cognitive function among older adults.

摘要

背景

许多研究探讨了环境因素与认知功能之间的关系；然而，来自中国的证据非常罕见。

目的

探讨中国老年人的生活环境和建成环境与认知功能之间的关系。

设计

安徽健康长寿调查（AHLS）用于调查安徽省60岁及以上成年人通过行为技术控制主要非传染性疾病的能力。采用多阶段抽样策略获取具有代表性的样本。收集横断面数据进行分析。

地点

纳入的参与者来自中国安徽省的四个选定城市。

参与者

参与者为60岁及以上的成年人，居住在选定的城市或农村社区。

测量

采用简易精神状态检查表（MMSE）测量参与者的认知状态。轻度认知障碍（MCI）的定义为：文盲且MMSE得分低于18分；受教育0 - 6年者MMSE得分低于21分；受教育6年及以上者MMSE得分低于25分。通过询问参与者的日常生活条件来评估生活环境。根据纹理地址计算参与者住所与最近设施之间的距离以及800米缓冲区内绿地/蓝地的比例，以表明建成环境。

结果

生活在无扬尘环境中的男性参与者MMSE得分较高（β = 0.828，95%置信区间：0.240，1.416，p = 0.006），轻度认知障碍（MCI）风险较低（OR = 0.651，95%置信区间：0.488，0.868，p = 0.003）；无法使用娱乐空间的男性参与者MMSE得分较低（β = -1.107，95%置信区间：-1.531，-0.684，p < 0.001），MCI风险较高（OR = 1.403，95%置信区间：1.134，1.737，p = 0.002）。居住在远离超市地方的女性参与者MMSE得分显著低于居住在超市附近的女性参与者（Q3：β = -0.750，95%置信区间：-1.266，-0.233，校正p = 0.036；Q4：β = -1.184，95%置信区间：-1.745，-0.624，校正p < 0.001）。