Abstract
BackgroundPhysical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This study aims to explore the influence of physical and social environments on the incidence of dementia through a population-based case-control design in Taiwan.MethodsWe identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level.ResultsWe observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81–0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87–0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04–1.25), such a significant relationship did not appear in the full model.ConclusionsOur study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.
Highlights
Physical and social environments may influence cognition health in older adults
One study from Japan used a cohort design with a 3-year follow-up period and found Geographic Information System (GIS)-based and self-reported living in neighborhoods with lower availability of food stores were associated with increased dementia incidence in older adults after controlling for individual features and other environmental factors, with an adjusted hazard ratio (HR) of 1.51 and 1.65, respectively [22]
The results showed older adults living in areas in the second-highest quintile of multiple deprivation was associated with an increased risk of dementia (HR = 1.62, 95%confidence intervals (CI) 1.06–2.46) compared to those living in areas in the least deprived quintile after adjustment of individual factors [20]
Summary
Physical and social environments may influence cognition health in older adults. evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. Some previous studies have suggested that certain features of both physical and social environments on a small scale, including the presence of community resources [6, 7], public open spaces [6, 7], green environments [7,8,9], neighborhood social cohesion [10], and socioeconomic composition of residential population [11,12,13], were associated with individual-level cognition function among elderly adults Those features of physical and social environments may change the risk of dementia by moderating individual risk factors such as lifestyle [14, 15], chronic diseases [16,17,18], and by playing a potential role to enable or obstruct cognition stimulation [4] and cognition reserve [19]. This makes it difficult to interpret the study findings and precludes any firm conclusions
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