Department of Nursing, University of Massachusetts Boston, Boston, MA, United States.
Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States.
Front Public Health. 2022 May 2;10:871104. doi: 10.3389/fpubh.2022.871104. eCollection 2022.
Prior research has shown that environmental hazards, such as limited green space, air pollution, and harmful weather, have the strong adverse impact on older adults' cognitive function; however, most of the studies were conducted in developed countries and limited to cross-sectional analyses. China has the largest aging population in the world so the research evidence from it can offer an insight to the study in other developing countries facing similar issues and inform future public health policy and disease control. This study examined the long-term impact of environmental factors, namely, green space coverage, air pollution, and weather conditions on cognitive function using a nationally representative sample consisting of adults aged 45 years and older selected from the China Health and Retirement Longitudinal Study (CHARLS 2011-2018), the China City Statistical Yearbook, and other sources. Multilevel growth curve models were utilized for analysis and the mediator effects of physical activity and social engagement on the relationship between environmental factors and cognitive function were examined. Findings of this study showed that after controlling for sociodemographic characteristics, annual precipitation of 80 cm or more, living in areas with July temperature of 28°C or higher, urban community, and green space coverage were positively associated with cognition score at the baseline and lower precipitation, urban community, and greater green space coverage were associated with slower cognitive decline over a 7-year period. The impact of gross domestic product (GDP) seemed to take into effect more and more over time. These effects did not substantially change after weekly total hours of physical activities and levels of social engagement were added. More research on the mechanisms of the effect of environmental factors on cognition is needed such as the subgroup analyses and/or with more aspects of environmental measures.
先前的研究表明，环境危害，如有限的绿地、空气污染和恶劣天气，对老年人的认知功能有强烈的不利影响；然而，大多数研究都是在发达国家进行的，仅限于横断面分析。中国是世界上老龄化人口最多的国家，因此，来自中国的研究证据可以为其他面临类似问题的发展中国家提供深入了解，并为未来的公共卫生政策和疾病控制提供信息。本研究利用中国健康与退休纵向研究（CHARLS2011-2018）、中国城市统计年鉴和其他来源中选择的 45 岁及以上成年人的全国代表性样本，使用多层次增长曲线模型，考察了环境因素（即绿地覆盖率、空气污染和天气条件）对认知功能的长期影响，并检验了身体活动和社会参与对环境因素与认知功能之间关系的中介效应。本研究的结果表明，在控制了社会人口特征后，年降水量在 80 厘米以上、7 月温度在 28°C 以上、居住在城市社区以及绿地覆盖率较高与认知评分基线较高有关，而降水量较低、居住在城市社区以及绿地覆盖率较高与 7 年内认知能力下降较慢有关。国内生产总值（GDP）的影响似乎随着时间的推移越来越明显。在加入每周总身体活动时间和社会参与水平后，这些影响并没有实质性变化。需要更多关于环境因素对认知影响机制的研究，如亚组分析和/或更多方面的环境措施。
