Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
Department of Epidemiology and Biostatistics, Drexel University, 3215 Market Street, 2nd Floor, Philadelphia, PA, 19104, USA.
BMC Geriatr. 2024 Jun 25;24(1):551. doi: 10.1186/s12877-024-05068-0.
Although a growing body of literature documents the importance of neighborhood effects on late-life cognition, little is known about the relative strength of objective and subjective neighborhood measures on late-life cognitive changes. This study examined effects of objective and subjective neighborhood measures in three neighborhood domains (neighborhood safety, physical disorder, food environments) on longitudinal changes in processing speed, an early marker of cognitive aging and impairment.
The analysis sample included 306 community-dwelling older adults enrolled in the Einstein Aging Study (mean age = 77, age range = 70 to 91; female = 67.7%; non-Hispanic White: 45.1%, non-Hispanic Black: 40.9%). Objective and subjective measures of neighborhood included three neighborhood domains (i.e., neighborhood safety, physical disorder, food environments). Processing speed was assessed using a brief Symbol Match task (unit: second), administered on a smartphone device six times a day for 16 days and repeated annually for up to five years. Years from baseline was used as the within-person time index.
Results from mixed effects models showed that subjective neighborhood safety (β= -0.028) and subjective availability of healthy foods (β= -0.028) were significantly associated with less cognitive slowing over time. When objective and subjective neighborhood measures were simultaneously examined, subjective availability of healthy foods remained significant (β= -0.028) after controlling for objective availability of healthy foods. Associations of objective neighborhood crime and physical disorder with processing speed seemed to be confounded by individual-level race and socioeconomic status; after controlling for these confounders, none of objective neighborhood measures showed significant associations with processing speed.
Subjective neighborhood safety and subjective availability of healthy foods, rather than objective measures, were associated with less cognitive slowing over time over a five-year period. Perception of one's neighborhood may be a more proximal predictor of cognitive health outcomes as it may reflect one's experiences in the environment. It would be important to improve our understanding of both objective and subjective neighborhood factors to improve cognitive health among older adults.
尽管越来越多的文献证明了邻里效应对老年人认知的重要性，但对于客观和主观邻里措施对老年人认知变化的相对强度知之甚少。本研究考察了三个邻里领域（邻里安全、物理无序、食品环境）的客观和主观邻里措施对加工速度（认知老化和障碍的早期标志物）的纵向变化的影响。
分析样本包括参加爱因斯坦老龄化研究的 306 名居住在社区的老年人（平均年龄 77 岁，年龄范围为 70 至 91 岁；女性占 67.7%；非西班牙裔白人：45.1%，非西班牙裔黑人：40.9%）。客观和主观邻里措施包括三个邻里领域（即邻里安全、物理无序、食品环境）。使用简短的符号匹配任务（单位：秒）评估加工速度，该任务在智能手机设备上每天六次进行，为期 16 天，并每年重复一次，最多可重复五年。从基线开始的年数用作个体内时间指数。
混合效应模型的结果表明，主观邻里安全（β= -0.028）和主观健康食品供应（β= -0.028）与随时间推移认知速度较慢显著相关。当同时检查客观和主观邻里措施时，在控制了客观健康食品供应后，主观健康食品供应仍然具有显著意义（β= -0.028）。客观邻里犯罪和物理无序与加工速度之间的关联似乎受到个体水平种族和社会经济地位的混淆；在控制了这些混杂因素后，客观邻里措施与加工速度均无显著关联。
在五年的时间里，与客观测量相比，主观邻里安全和主观健康食品供应与认知速度较慢有关。对自己所在社区的看法可能是认知健康结果的更直接预测因素，因为它可能反映了一个人在环境中的体验。了解客观和主观邻里因素都很重要，这对于改善老年人的认知健康至关重要。
