Abstract
BackgroundResearch suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults.MethodsGreenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer’s disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics—Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park—were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD.ResultsCompared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies.ConclusionsThis study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
Highlights
IntroductionThis study examines whether residential greenspace is associated with risk of dementia among older adults
Research suggests that greenspace may confer neurocognitive benefits
Residential greenspace exposure was found to be associated with moderate cognitive health benefit for older U.S adults
Summary
This study examines whether residential greenspace is associated with risk of dementia among older adults. There has been increasing interest in exposure to greenspace as a possible modifiable protective factor because it may improve cognitive domains [4,5,6], reduce stress [7,8,9], increase physical exercise [10], improve social ties [11, 12] and mitigate air pollution [13,14,15]. Greenspace as an exposure may play a role in preventing or mitigating such risk factors for dementia [19,20,21]. Examination of subtypes may aid in elucidating possible mechanisms of action (i.e. physical activity, pollution mitigation, stress reduction, social contact) for the greenspace-dementia relationship. Some research has already noted inverse associations between elevated greenspace exposure and AD using an ecological design [32]
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