Cavuoto Marina G, Davies Liam, Rowsthorn Ella, Cribb Lachlan G, Yiallourou Stephanie R, Yassi Nawaf, Maruff Paul, Lim Yen Ying, Pase Matthew P
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
National Ageing Research Institute, Royal Melbourne Hospital, VIC, Australia.
Prev Med Rep. 2024 Mar 19;41:102696. doi: 10.1016/j.pmedr.2024.102696. eCollection 2024 May.
Dementia disproportionately affects individuals from disadvantaged backgrounds, including those living in areas of lower neighborhood-level socioeconomic status. It is important to understand whether there are specific neighborhood characteristics associated with dementia risk factors and cognition which may inform dementia risk reduction interventions. We sought to examine whether greenspace, walkability, and crime associated with the cumulative burden of modifiable dementia risk factors and cognition. This was a cross-sectional analysis of 2016-2020 data from the Healthy Brain Project, a population-based cohort of community-dwelling individuals across Australia. Participants were aged 40-70 and free of dementia. Measures included greenspace (greenspace % in the local area, and distance to greenspace, n = 2,181); and intersection density (n = 1,159), and crime (rate of recorded offences; n = 1,159). Outcomes included a modified Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score to index the burden of modifiable vascular dementia risk factors; and composite scores of both memory and attention, derived from the Cogstate Brief Battery. Linear regressions adjusted for age, sex, education, and personal socio-economic status, demonstrated distance to greenspace ( ± per 2-fold increase = 0.09 ± 0.03, =.005) and crime rate ( ± per 2-fold increase = 0.07 ± 0.03, =.018) were associated with higher modified CAIDE. Higher crime was associated with lower memory performance ( ± = -0.03 ± 0.01, =.018). The association between distance to greenspace and modified CAIDE was only present in low-moderate socioeconomic status neighborhoods (p interaction = 0.004). Dementia prevention programs that address modifiable risk factors in midlife should consider the possible role of neighborhood characteristics.
痴呆症对弱势群体的影响尤为严重，包括那些生活在社区层面社会经济地位较低地区的人群。了解是否存在与痴呆症风险因素及认知相关的特定社区特征，对于降低痴呆症风险的干预措施具有重要意义。我们试图研究绿地空间、步行便利性和犯罪率是否与可改变的痴呆症风险因素及认知的累积负担相关。这是一项对2016年至2020年来自“健康大脑项目”数据的横断面分析，该项目是一项基于澳大利亚社区居住人群的队列研究。参与者年龄在40至70岁之间，且无痴呆症。测量指标包括绿地空间（当地绿地空间百分比以及到绿地空间的距离，n = 2181）、交叉路口密度（n = 1159）以及犯罪率（记录在案的犯罪率；n = 1159）。研究结果包括一个经过修正的心血管风险因素、衰老与痴呆症发病率（CAIDE）痴呆症风险评分，用于衡量可改变的血管性痴呆症风险因素的负担；以及源自Cogstate简短电池测试的记忆和注意力综合评分。经年龄、性别、教育程度和个人社会经济地位调整后的线性回归分析表明，到绿地空间的距离（每增加2倍± = 0.09 ± 0.03，p = 0.005）和犯罪率（每增加2倍± = 0.07 ± 0.03，p = 0.018）与更高的修正后CAIDE评分相关。更高的犯罪率与更低的记忆表现相关（± = -0.03 ± 0.01，p = 0.018）。到绿地空间的距离与修正后CAIDE评分之间的关联仅在社会经济地位低至中等的社区中存在（p交互作用 = 0.004）。针对中年可改变风险因素的痴呆症预防项目应考虑社区特征可能发挥的作用。
