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Settels J, Leist AK. Changes in neighborhood-level socioeconomic disadvantage and older Americans' cognitive functioning. Health Place 2021; 68:102510. [PMID: 33493963 DOI: 10.1016/j.healthplace.2021.102510] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/22/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND While associations of neighborhood conditions with cognitive functioning at older ages have been established, few studies have investigated with a dynamic perspective if changing neighborhood socioeconomic conditions affect older residents' cognitive declines, and which putative factors mediate this relationship. METHOD Using data from waves 2 (2010-2011) and 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) survey (n = 1837), ordinary least squares regressions and mediation analyses were conducted, adjusting for multiple confounders and testing eight putative mediators. RESULTS Worsening neighborhood socioeconomic circumstances were associated with cognitive declines. Changes in depressive symptoms, sizes of close social networks, and physical activity substantially mediated this relationship. DISCUSSION While 18.10% of the total effect occurred through these mechanisms, further pathways may work through contextual- and individual-level variables not assessed in the NSHAP.
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Affiliation(s)
- Jason Settels
- University of Luxembourg, Department of Social Sciences, Institute for Research on Socio-Economic Inequality, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
| | - Anja K Leist
- University of Luxembourg, Department of Social Sciences, Institute for Research on Socio-Economic Inequality, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg.
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2
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Kuchibhatla M, Hunter JC, Plassman BL, Lutz MW, Casanova R, Saldana S, Hayden KM. The association between neighborhood socioeconomic status, cardiovascular and cerebrovascular risk factors, and cognitive decline in the Health and Retirement Study (HRS). Aging Ment Health 2020; 24:1479-1486. [PMID: 31018653 DOI: 10.1080/13607863.2019.1594169] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: A small but growing body of evidence supports a relationship between neighborhood socioeconomic status (NSES) and cognitive decline. Additional work is needed to characterize this relationship controlling for risk factors such as cardiovascular, cerebrovascular, and genetic risk factors.Methods: Cognitive decline was assessed in association with NSES, and cardiovascular and cerebrovascular risk factors (heart disease, diabetes, hypertension, and stroke) in 8,198 individuals from the 1992-2010 waves of the Health and Retirement Study (HRS). Latent class trajectory analysis determined the number of cognitive trajectory classes that best fit the data, and a multinomial logistic regression model in the latent class framework assessed the risk for cognitive classes conferred by NSES index score and heart disease, diabetes, hypertension, and stroke across three trajectory classes of cognitive function. The analyses controlled for genetic risk for cognitive decline (including APOE genotype) and demographic variables, including education.Results: The HRS sample was 57.6% female and 85.5% White, with a mean age of 67.5(3.5) years at baseline. The three-quadratic-class model best fit the data, where higher classes represented better cognitive function. Those with better cognitive function were mainly younger white females. Those in the highest quartile of NSES had 57% higher odds of being in the high cognitive function class. Heart disease, diabetes, hypertension, and stroke each increased the odds having of lower cognitive function.Conclusions: In examining the relationship of cognitive status with various variables, neighborhood socioeconomic status, cardiovascular risk, and cerebrovascular risk persisted across the cognitive trajectory classes.
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Affiliation(s)
- Maragatha Kuchibhatla
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Jaimie C Hunter
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Brenda L Plassman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Michael W Lutz
- Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Ramon Casanova
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Santiago Saldana
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M Hayden
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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3
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Lau H, Shahar S, Hussin N, Kamarudin MZ, Hamid TA, Mukari SZM, Rajab NF, Din NC, Omar A, Singh DK, Haron H, Sharif R, Yahya HM, Fitri A, Manaf ZA, Mohammed Z, Ishak WS. Methodology approaches and challenges in population-based longitudinal study of a neuroprotective model for healthy longevity. Geriatr Gerontol Int 2019; 19:233-239. [PMID: 30618211 DOI: 10.1111/ggi.13598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 11/09/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022]
Abstract
AIM The 36-month Long-Term Research Grant Scheme project: Towards Usual Aging - Neuroprotective Model for Healthy Longevity among Malaysian Elderly was designed to address multidimensional aspects including psychosocial, biophysical health, nutrition and dietary pattern, and auditory and visual function to highlight the magnitude of these associations in a single study. METHODS A total of 2322 respondents aged ≥60 years were recruited at baseline using the multistage sampling method, followed up at 18 months and 36 months. RESULTS Response rates at baseline, 18 months and 36 months were 87.8%, 77.3% and 67.1%, respectively. At baseline, the prevalence of successful aging, usual aging and mild cognitive impairment was 11%, 73% and 16%, respectively. The prevalence of single and multimorbidity at baseline were 25.9% and 50.3%, respectively. The incidence rates of mild cognitive impairment at 18 months and 36 months were 6.5 and 5.6 per 100 person-years. The incidence rates of multimorbidity at 18 months and 36 months were 23.7 and 21.5 per 100 person-years, respectively. CONCLUSIONS The Long-Term Research Grant Scheme project: Towards Usual Aging study provides an opportunity to investigate the interactions between wide ranges of aspects of the older population in a nationally representative sample of the older population. Geriatr Gerontol Int 2019; 19: 233-239.
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Affiliation(s)
- Huijin Lau
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Norlela Hussin
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Za Kamarudin
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tengku At Hamid
- Institute of Gerontology, University Putra Malaysia, Serdang, Malaysia
| | - Siti Z-Ms Mukari
- Institute of Ear, Hearing and Speech, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nor F Rajab
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Center of Diagnostic and Applied Science, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Normah C Din
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia.,Faculty of Health Sciences, Center of Healthcare Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Azahadi Omar
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Devinder Ka Singh
- Faculty of Health Sciences, Center for Rehabilitation and Special Needs, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Faculty of Health Sciences, Center of Healthcare Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Faculty of Health Sciences, Center of Healthcare Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hanis M Yahya
- Faculty of Health Sciences, Center for Healthy Aging and Wellness, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri
- Faculty of Health Sciences, Center of Diagnostic and Applied Science, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Zahara A Manaf
- Faculty of Health Sciences, Center of Healthcare Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Zainora Mohammed
- Faculty of Health Sciences, Center of Healthcare Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Wan S Ishak
- Institute of Ear, Hearing and Speech, National University of Malaysia, Kuala Lumpur, Malaysia
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O'Shea DM, Dotson VM, Woods AJ, Porges EC, Williamson JB, O'Shea A, Cohen R. Depressive Symptom Dimensions and Their Association with Hippocampal and Entorhinal Cortex Volumes in Community Dwelling Older Adults. Front Aging Neurosci 2018. [PMID: 29515435 PMCID: PMC5826180 DOI: 10.3389/fnagi.2018.00040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: Research has shown that depression is a risk factor for Alzheimer’s disease (AD) and subsequent cognitive decline. This is compounded by evidence showing an association between depression and reduced hippocampal volumes; a primary structure implicated in the pathogenesis of the disease. Less is known about the relationship between depression and other AD vulnerable regions such as the entorhinal cortex. Given the heterogeneity of depressive symptom presentation, we examined whether symptom dimensions were associated with hippocampal and entorhinal cortex volumes in community dwelling older adults. Methods: Eighty-one community dwelling adults completed the Beck Depression Inventory – second edition and underwent structural neuroimaging. Measures of hippocampal and entorhinal cortex volumes were obtained using FreeSurfer software. Linear regression models included regions of interest as dependent variables, with depressive symptom dimensions, as independent variables, controlling for total intracranial volumes, age, education, and gender. Results: Somatic symptoms were negatively associated with total, right, and left hippocampal volumes. Affective symptoms were negatively associated with total entorhinal cortex volumes, with a marginal main effect on left entorhinal cortex volumes. Conclusion: Our findings provide support for examining depressive symptoms and their association with AD vulnerable regions along subdimensions of affective, cognitive, and somatic symptoms to better understand profiles of symptoms most associated with these regions. Conceptualizing depressive symptoms in this way may also better inform treatment approaches in terms of targeting types of symptoms that may be more closely linked to poorer brain and cognitive health outcomes.
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Affiliation(s)
- Deirdre M O'Shea
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Vonetta M Dotson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Adam J Woods
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Eric C Porges
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - John B Williamson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Brain Rehabilitation Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, United States
| | - Andrew O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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Hatzinger M, Hemmeter U, Hirsbrunner T, Holsboer-Trachsler E, Leyhe T, Mall JF, Mosimann U, Rach N, Trächsel N, Savaskan E. [Not Available]. PRAXIS 2018; 107:127-144. [PMID: 29382263 DOI: 10.1024/1661-8157/a002883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Diese Empfehlungen sollen dazu dienen, Fachpersonen das Wissen über die aktuelle Evidenz von Diagnostik und Therapie der Depression im Alter zur Verfügung zu stellen und damit zur frühzeitigen Erkennung und evidenzbasierten Behandlung beizutragen. Da für einige Behandlungsansätze nur rudimentär kontrollierte Studien vorliegen, wird auch das klinische Expertenwissen in die Beurteilung einbezogen. Im diagnostischen Vorgehen wird die besondere Symptomatik der Depression im Alter beleuchtet, auf die Suizidalität eingegangen und werden die häufig vorkommenden somatischen Komorbiditäten hervorgehoben. Auch Hypothesen zur Pathogenese, wie Neuroendokrinologie, Neurodegeneration und vaskuläre Faktoren, werden erläutert. In der Behandlung gilt heute ein integrierter biopsychosozialer Ansatz mit gezielten psychosozialen Interventionen, spezifischer Psychotherapie und einer antidepressiven Pharmakotherapie bei schweren Depressionen als sinnvoll. Daneben kommen auch chronobiologische oder Neurostimulationsverfahren zum Einsatz.
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Affiliation(s)
- Martin Hatzinger
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
- 2 Schweizerische Gesellschaft für Biologische Psychiatrie (SGBP)
| | - Ulrich Hemmeter
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
| | - Therese Hirsbrunner
- 4 Schweizerischer Berufsverband der Pflegefachfrauen und Pflegefachmänner (SBK)
| | | | - Thomas Leyhe
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
| | - Jean-Frédéric Mall
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
| | - Urs Mosimann
- 2 Schweizerische Gesellschaft für Biologische Psychiatrie (SGBP)
| | - Nicole Rach
- 5 Schweizerische Fachgesellschaft für Gerontopsychologie (SFGP)
| | - Nathalie Trächsel
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
| | - Egemen Savaskan
- 1 Schweizerische Gesellschaft für Alterspsychiatrie und Alterspsychotherapie (SGAP)
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6
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Campanholo KR, Boa INF, Hodroj FCDSA, Guerra GRB, Miotto EC, de Lucia MCS. Impact of sociodemographic variables on executive functions. Dement Neuropsychol 2017; 11:62-68. [PMID: 29213495 PMCID: PMC5619216 DOI: 10.1590/1980-57642016dn11-010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Executive functions (EFs) regulate human behavior and allow individuals to
interact and act in the world. EFs are sensitive to sociodemographic variables
such as age, which promotes their decline, and to others that can exert a
neuroprotective effect.
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Affiliation(s)
- Kenia Repiso Campanholo
- Division of Psychology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
| | - Izadora Nogueira Fonte Boa
- Division of Psychology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
| | | | - Glaucia Rosana Benute Guerra
- Division of Psychology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
| | - Eliane Correa Miotto
- Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
| | - Mara Cristina Souza de Lucia
- Division of Psychology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil
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7
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O'Shea DM, Dotson VM, Fieo RA. Aging perceptions and self-efficacy mediate the association between personality traits and depressive symptoms in older adults. Int J Geriatr Psychiatry 2017; 32:1217-1225. [PMID: 27653811 DOI: 10.1002/gps.4584] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Personality traits have been shown to be predictors of depressive symptoms in late life. Thus, we examined whether other more modifiable sources of individual differences such as self-efficacy and self-perceptions of aging would mediate the association between personality traits and depressive symptoms in older adults. METHOD Data were obtained from 3,507 older adult participants who took part in the 2012 Health and Retirement Study. The "Big Five" personality traits, self-efficacy, aging perceptions, and depressive symptoms were assessed. Mediation analyses tested the hypothesis that self-efficacy and aging perceptions would mediate the relationship between personality traits and depressive symptoms. RESULTS All five personality traits were significant predictors of depressive symptoms. Neuroticism was positively associated with depressive symptoms and had the greatest effect compared with the other personality traits. There was a significant indirect effect of neuroticism, extraversion, and conscientiousness on depressive symptoms (including both mediators). The mediating effect of aging perceptions on the relationship between neuroticism and depressive symptoms was the strongest compared with self-efficacy, accounting for approximately 80% of the total indirect effect. CONCLUSION Our results provide support for interventions aimed at improving self-perceptions related to efficacy and aging in order to reduce depressive symptoms in older adults. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- D M O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - V M Dotson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - R A Fieo
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.,Center for Cognitive Aging and Memory, Institute on Aging, University of Florida, Gainesville, FL, USA
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8
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Wang W, Wu Q, Yang X, He X, An X. Migrant elders in Hainan, China, report better health and lower depression than local-born elderly residents. Ann Hum Biol 2017; 44:622-627. [PMID: 28952360 DOI: 10.1080/03014460.2017.1377289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The number of migrant elders is increasing due to ageing of the global population and increasing life expectancy. There is accumulating evidence of the impact of internal or international migration on health. AIM To compare the health and depression of local and migrant elders in Hainan province. SUBJECTS AND METHODS Health and depression were assessed by the Self-Rated Health Measurement Scale Version 1.0 (SRHMS V1.0) and the Geriatric Depression Scale (GDS), respectively. The relationship between health and depression was investigated, along with the three sub-scales of SRHMS and the potential independent variables. RESULTS In total, 564 valid questionnaires were returned. Migrant elders were younger, had higher education levels and monthly income, and lower prevalence rates of chronic diseases than the local elders. The SRHMS scores were significantly higher, while the GDS scores were statistically lower in the migrant elders than the locals. Depression was negatively correlated with health (r = -0.674, p = 0.0000). Moreover, the three sub-scales of SRHMS were correlated with age, birth place, marital status, chronic diseases, GDS and/or educational level. CONCLUSION Migrant elders self-reported better health and lower depression compared to the local elders. Differences in age, education, monthly income and chronic diseases might be influencing factors.
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Affiliation(s)
- Wei Wang
- a Department of Nursing , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Qingxia Wu
- a Department of Nursing , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Xiaoyang Yang
- b Department of Hematology , Haikou People's Hospital, Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Xin He
- c Department of Nursing , Qionghai People's Hospital , Qionghai , PR China
| | - Xuefang An
- d Department of Neurology , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
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9
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Besser LM, McDonald NC, Song Y, Kukull WA, Rodriguez DA. Neighborhood Environment and Cognition in Older Adults: A Systematic Review. Am J Prev Med 2017; 53:241-251. [PMID: 28455123 PMCID: PMC5522645 DOI: 10.1016/j.amepre.2017.02.013] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/10/2017] [Accepted: 02/16/2017] [Indexed: 01/14/2023]
Abstract
CONTEXT Some evidence suggests that treating vascular risk factors and performing mentally stimulating activities may delay cognitive impairment onset in older adults. Exposure to a complex neighborhood environment may be one mechanism to help delay cognitive decline. EVIDENCE ACQUISITION PubMed, Web of Science, and ProQuest Dissertation and Theses Global database were systematically reviewed, identifying 25 studies published from February 1, 1989 to March 5, 2016 (data synthesized, May 3, 2015 to October 7, 2016). The review was restricted to quantitative studies focused on: (1) neighborhood social and built environment and cognition; and (2) community-dwelling adults aged ≥45 years. EVIDENCE SYNTHESIS The majority of studies were cross-sectional, U.S.-based, and found at least one significant association. The diversity of measures and neighborhood definitions limited the synthesis of findings in many instances. Evidence was moderately strong for an association between neighborhood SES and cognition, and modest for associations between neighborhood demographics, design, and destination accessibility and cognition. Most studies examining effect modification found significant associations, with some evidence for effect modification of the neighborhood SES-cognition association by individual-level SES. No studies had low risk of bias and many tested multiple associations that increased the chance of a statistically significant finding. Considering the studies to date, the evidence for an association between neighborhood characteristics and cognition is modest. CONCLUSIONS Future studies should include longitudinal measures of neighborhood characteristics and cognition; examine potential effect modifiers, such as sex and disability; and study mediators that may help elucidate the biological mechanisms linking neighborhood environment and cognition.
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Affiliation(s)
- Lilah M Besser
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington.
| | - Noreen C McDonald
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yan Song
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Walter A Kukull
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington
| | - Daniel A Rodriguez
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of City and Regional Planning, University of California, Berkeley, Berkeley, California
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10
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Madden K, Rapoport M, Maxwell C. Summer Issue 2015. Can Geriatr J 2015; 18:42. [PMID: 26180558 PMCID: PMC4487734 DOI: 10.5770/cgj.18.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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