Repository logo
 

Neighbourhood environment and dementia in older people from high-, middle- and low-income countries: results from two population-based cohort studies.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Brayne, Carol 
Liu, Zhaorui 
Huang, Yueqin 
Sosa, Ana Luisa 

Abstract

BACKGROUND: A growing number of studies have explored how features of the neighbourhood environment can be related to cognitive health in later life. Yet few have focused on low- and middle-income countries and compared the results across different settings. The aim of this study is to investigate the cross-sectional associations between neighbourhood amenities and dementia in older people from high-, middle- and low-income countries. METHODS: This study was based on two population-based cohort studies of people aged≥65: the Cognitive Function and Ageing Study II (CFAS II) in UK (N = 4955) and a subset of the 10/66 study in China, Dominican Republic and Mexico (N = 3386). In both cohorts, dementia was assessed using the Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm. The 10/66 dementia diagnostic algorithm was also used as an additional criterion in the 10/66 study. Publicly accessible databases, Google Maps and Open Street Map, were used to obtain geographic information system data on distance to neighbourhood amenities, including lifestyle (cafés, libraries, movie theatres, parks), daily life (post offices, convenience stores), healthcare (hospitals, pharmacies) and percentages of local green and blue spaces within 400 and 800 m of participants' residences. Multilevel logistic regression was used to investigate the associations between these environmental features and dementia adjusting for sociodemographic factors and self-rated health. RESULTS: Living far from daily life amenities was associated with higher odds of dementia in both CFAS II (1.47; 95% CI: 0.96, 2.24) and the 10/66 study (1.53; 95% CI: 1.15, 2.04), while living far from lifestyle (1.50; 95% CI: 1.13, 1.99) and healthcare amenities (1.32; 95% CI: 0.93, 1.87) was associated with higher odds of dementia only in the 10/66 study. A high availability of local green and blue spaces was not associated with dementia in either cohort yet living far from public parks was associated with lower odds of dementia in CFAS II (0.64; 95% CI: 0.41, 1.00). CONCLUSIONS: The different relationships across cohorts may indicate a varying role for local amenities in diverse settings. Future research may investigate mechanisms related to these differences and social, cultural and historical influences on the interaction between neighbourhood amenities and older people.

Description

Keywords

Built environment, Dementia, Epidemiological cohorts, Geographic information system, Green and blue spaces, Local amenities, Older people, Aged, Aged, 80 and over, China, Cognition, Cohort Studies, Cross-Sectional Studies, Dementia, Developed Countries, Developing Countries, Dominican Republic, Female, Geriatric Assessment, Humans, Logistic Models, Male, Mental Status and Dementia Tests, Mexico, Residence Characteristics, Social Environment, United Kingdom

Journal Title

BMC Public Health

Conference Name

Journal ISSN

1471-2458
1471-2458

Volume Title

20

Publisher

Springer Science and Business Media LLC
Sponsorship
Medical Research Council (G0601022)
Medical Research Council (G9901400)
Medical Research Council (MR/L023784/2)
Alzheimer's Society (294)
Medical Research Council (G0601022/1)