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Community environment, cognitive impairment and dementia in later life: results from the Cognitive Function and Ageing Study.

Published version
Peer-reviewed

Repository DOI


Type

Article

Change log

Authors

Wu, Yu-Tzu 
Prina, A Matthew 
Jones, Andrew P 
Barnes, Linda E 
Matthews, Fiona E 

Abstract

BACKGROUND: Few studies have investigated the impact of the community environment, as distinct from area deprivation, on cognition in later life. This study explores cross-sectional associations between cognitive impairment and dementia and environmental features at the community level in older people. METHOD: The postcodes of the 2,424 participants in the year-10 interview of the Cognitive Function and Ageing Study in England were mapped into small area level geographical units (Lower-layer Super Output Areas) and linked to environmental data in government statistics. Multilevel logistic regression was conducted to investigate associations between cognitive impairment (defined as MMSE ≤ 25), dementia (organicity level ≥3 in GMS-AGECAT) and community level measurements including area deprivation, natural environment, land use mix and crime. Sensitivity analyses tested the impact of people moving residence within the last two years. RESULTS: Higher levels of area deprivation and crime were not significantly associated with cognitive impairment and dementia after accounting for individual level factors. Living in areas with high land use mix was significantly associated with a nearly 60% reduced odds of dementia (OR: 0.4; 95% CI: 0.2, 0.8) after adjusting for individual level factors and area deprivation, but there was no linear trend for cognitive impairment. Increased odds of dementia (OR: 2.2, 95% CI: 1.2, 4.2) and cognitive impairment (OR: 1.4, 95% CI: 1.0, 2.0) were found in the highest quartile of natural environment availability. Findings were robust to exclusion of the recently relocated. CONCLUSION: Features of land use have complex associations with cognitive impairment and dementia. Further investigations should focus on environmental influences on cognition to inform health and social policies.

Description

Keywords

cognitive impairment, dementia, neighbourhood/community environment, older people, Aged, Aged, 80 and over, Cognition Disorders, Dementia, England, Environment, Female, Humans, Independent Living, Logistic Models, Male, Residence Characteristics, Risk Factors, Social Environment

Journal Title

Age Ageing

Conference Name

Journal ISSN

0002-0729
1468-2834

Volume Title

44

Publisher

Oxford University Press (OUP)
Sponsorship
Medical Research Council (G9901400)
Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) was funded by the Department of health and the Medical Research Council, [Grant number G9901400]; Fiona E Matthews and A. Matthew Prina were supported by the Medical Research Council [Grant number U105292687 and MR/K021907/1]; Yu-Tzu Wu received a PhD scholarship from Cambridge Trust, University of Cambridge.