Abstract
Little is known about the association between environmental features and the risk of Alzheimer’s dementia (AD). This study aims to investigate the association of physical and social environments with the incidence of AD. We identified 12,401 newly diagnosed AD cases aged ≥65 years in 2010, with the same no. of matched controls from National Health Insurance claims in Taiwan. Environmental data were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was conducted to calculate the odds ratios (OR) of AD in association with environmental features at the township level. Results showed that living in the areas with higher availability of playgrounds and sport venues was associated with a 3% decreased odds of AD (95% CI = 0.96–0.99), while higher density of elderly living alone was associated with a 5% increased odds of AD (95% CI = 1.01–1.11), after controlling for individual and other environmental factors. In further examination by urbanization level, the above relationships were found only in rural areas but not in urban areas. This study provides evidence that specific physical and social environmental features have different impacts on the risk of AD.
Highlights
Alzheimer’s dementia (AD), accounting for approximately 50–70% of overall dementia in the world, has been noted as an increasingly serious health problem [1]
AD from an overall aspect or by urbanization level. In this large-scale case-control study, we found that older adults living in areas with higher density of playgrounds and sport venues were independently associated with a 3% decreased odds of AD
Living in townships with high availability of playgrounds and sport venues may reduce the risk of developing AD, while living in areas with high density of elderly living alone has the opposite effect
Summary
Alzheimer’s dementia (AD), accounting for approximately 50–70% of overall dementia in the world, has been noted as an increasingly serious health problem [1]. Numerous studies have reported a range of individual factors such as smoking, lack of physical activities, lack of social engagement, and chronic disease (vascular disease, diabetes mellitus, and depression) would contribute to the risk of AD [1,2]. Environmental factors, such as social interaction and physical activity, might be related to the risk of AD [3,4,5] and other health outcomes (vascular disease, diabetes mellitus, and depression) [6,7,8]. Public Health 2019, 16, 2828; doi:10.3390/ijerph16162828 www.mdpi.com/journal/ijerph
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