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The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II.

Accepted version
Peer-reviewed

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Authors

Wu, Y-T 
Prina, AM 
Jones, A 
Matthews, FE 

Abstract

Introduction

Built environment features have been related to behavior modification and might stimulate cognitive activity with a potential impact on cognitive health in later life. This study investigated cross-sectional associations between features of land use and cognitive impairment and dementia, and also explored urban and rural differences in these associations.

Methods

Postcodes of the 7,505 community-based participants (aged ≥65 years) in the Cognitive Function and Ageing Study II (collected in 2008–2011) were linked to environmental data from government statistics. Multilevel logistic regression investigated associations between cognitive impairment (defined as Mini-Mental State Examination score ≤25) and dementia (Geriatric Mental Status and Automatic Geriatric Examination for Computer-Assisted Taxonomy organicity level ≥3) and land use features, including natural environment availability and land use mix, fitting interaction terms with three rural/urban categories. Data were analyzed in 2015.

Results

Associations between features of land use and cognitive impairment were not linear. After adjusting for individual-level factors and area deprivation, living in areas with high land use mix was associated with a nearly 30% decreased odds of cognitive impairment (OR=0.72, 95% CI=0.58, 0.89). This was similar, yet non-significant, for dementia (OR=0.70, 95% CI=0.46, 1.06). In conurbations, living in areas with high natural environment availability was associated with 30% reduced odds of cognitive impairment (OR=0.70, 95% CI=0.50, 0.97).

Conclusions

Non-linear associations between features of land use and cognitive impairment were confirmed in this new cohort of older people in England. Both lack of and overload of environmental stimulation may be detrimental to cognition in later life.

Description

Keywords

Aged, Aged, 80 and over, Aging, Cognition, Cognition Disorders, Cross-Sectional Studies, Dementia, England, Environment Design, Female, Humans, Incidence, Logistic Models, Male, Prevalence, Rural Health, Urban Health

Journal Title

American Journal of Preventive Medicine

Conference Name

Journal ISSN

0749-3797
1873-2607

Volume Title

53

Publisher

Elsevier
Sponsorship
ESRC (via Bangor University) (RES-060-25-0060)
Medical Research Council (G0601022)
Economic and Social Research Council (ES/G007462/1)
Medical Research Council (MR/K023187/1)
The Cognitive Function and Ageing Study II was funded by the Medical Research Council (grant number G0601022); FEM and AMP were supported by the Medical Research Council (grant numbers U105292687 and MR/K021907/1).