Yang Hui-Wen, Wu Yun-Hsuan, Lin Mei-Chen, Liao Shu-Fen, Fan Chun-Chieh, Wu Chi-Shin, Wang Shi-Heng
Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
Prev Med. 2023 Oct;175:107669. doi: 10.1016/j.ypmed.2023.107669. Epub 2023 Aug 16.
The existing evidence on the contextual influence of the availability of local facilities for physical activity on the cognitive health of elderly residents is sparse. This study examined the association between neighborhood physical activity facilities and cognitive health in older individuals. A cohort study of community-dwelling older adults was performed using baseline data and follow-up data from the Taiwan Biobank. Cognitive health was measured in 32,396 individuals aged 60-70 years using the Mini-Mental State Examination (MMSE) with follow-up information on 8025 participants. The district was used as the proxy for local neighborhood. To determine neighborhood physical activity facilities, school campuses, parks, activity centers, gyms, swimming pools, and stadiums were included. Multilevel linear regression models were applied to examine the associations of neighborhood physical activity facilities with baseline MMSE and MMSE decline during follow-up, with adjustment for individual factors and neighborhood socioeconomic characteristics. Multilevel analyses revealed that there was a neighborhood-level effect on cognitive health among older adults. After adjusting for compositional and neighborhood socioeconomic characteristics, baseline MMSE was higher in individuals living in the middle- (beta = 0.12, p-value = 0.140) and high-density facility (beta = 0.22, p-value = 0.025) groups than in the low-density group (p-value for trend-test = 0.031). MMSE decline during follow-up was slower in the middle- (beta = 0.15, p-value = 0.114) and high-density facility (beta = 0.27, p-value = 0.052) groups than in the low-density group (p-value for trend-test = 0.032). Greater neighborhood availability of physical activity facilities was associated with better cognitive health among older residents. These findings have implications for designing communities and developing strategies to support cognitive health of an aging population.
关于当地体育活动设施的可及性对老年居民认知健康的背景影响，现有证据稀少。本研究调查了邻里体育活动设施与老年人认知健康之间的关联。利用台湾生物银行的基线数据和随访数据，对社区居住的老年人进行了一项队列研究。使用简易精神状态检查表（MMSE）对32396名60 - 70岁个体的认知健康进行测量，并对8025名参与者进行随访。以行政区作为当地邻里的代表。为确定邻里体育活动设施，纳入了校园、公园、活动中心、健身房、游泳池和体育场。应用多水平线性回归模型，在调整个体因素和邻里社会经济特征后，研究邻里体育活动设施与基线MMSE以及随访期间MMSE下降之间的关联。多水平分析显示，老年人的认知健康存在邻里层面的影响。在调整了构成因素和邻里社会经济特征后，居住在中等密度设施组（β = 0.12，p值 = 0.140）和高密度设施组（β = 0.22，p值 = 0.025）的个体的基线MMSE高于低密度组（趋势检验p值 = 0.031）。随访期间，中等密度设施组（β = 0.15，p值 = 0.114）和高密度设施组（β = 0.27，p值 = 0.052）的MMSE下降比低密度组慢（趋势检验p值 = 0.032）。邻里体育活动设施的可及性越高，老年居民的认知健康状况越好。这些发现对于设计社区和制定支持老年人口认知健康的策略具有启示意义。
