The impact of built social environmental characteristics on diagnosed and estimated future risk of dementia

Journal article


Bagheri, Nasser, Mavoa, Suzanne, Tabatabaei-Jafari, Hossein, Knibbs, Luke D., Coffee, Neil T., Salvador-Carulla, Luis and Anstey, Kaarin J.. (2021). The impact of built social environmental characteristics on diagnosed and estimated future risk of dementia. Journal of Alzheimer's Disease. 84(2), pp. 621-632. https://doi.org/10.3233/JAD-210208
AuthorsBagheri, Nasser, Mavoa, Suzanne, Tabatabaei-Jafari, Hossein, Knibbs, Luke D., Coffee, Neil T., Salvador-Carulla, Luis and Anstey, Kaarin J.
Abstract

Background:Dementia is a major global health challenge and the impact of built and social environments’ characteristics on dementia risk have not yet been fully evaluated. Objective:To investigate associations between built and social environmental characteristics and diagnosed dementia cases and estimated dementia risk. Methods:We recruited 25,511 patients aged 65 and older from family physicians’ practices. We calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. Our exposure variables were estimated for each statistical area level 1: social fragmentation, nitrogen dioxide, public open spaces, walkability, socio-economic status, and the length of main roads. We performed a multilevel mixed effect linear regression analysis to allow for the hierarchical nature of the data. Results:We found that a one standard deviation (1-SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% CI: 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1-SD increase in social fragmentation and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1-SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of diagnosed dementia and the estimated future risk of dementia. Conclusion:Associations of neighborhood NO2 level, walkability, public open space, and social fragmentation with diagnosed dementia cases and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments.

Keywordsdementia; green spaces; social fragmentation; spatial analysis; walkability
Year2021
JournalJournal of Alzheimer's Disease
Journal citation84 (2), pp. 621-632
PublisherIOS Press
ISSN1387-2877
Digital Object Identifier (DOI)https://doi.org/10.3233/JAD-210208
Scopus EID2-s2.0-85119201752
FunderDementia Australia Research Foundation
National Health and Medical Research Council (NHMRC)
Australian Research Council (ARC)
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online09 Nov 2021
Publication process dates
Accepted20 Aug 2021
Deposited28 Nov 2022
ARC Funded ResearchThis output has been funded, wholly or partially, under the Australian Research Council Act 2001
Grant ID1121035
FL190100011
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