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
Authors | Bagheri, Nasser, Mavoa, Suzanne, Tabatabaei-Jafari, Hossein, Knibbs, Luke D., Coffee, Neil T., Salvador-Carulla, Luis and Anstey, Kaarin J. |
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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. |
Keywords | dementia; green spaces; social fragmentation; spatial analysis; walkability |
Year | 2021 |
Journal | Journal of Alzheimer's Disease |
Journal citation | 84 (2), pp. 621-632 |
Publisher | IOS Press |
ISSN | 1387-2877 |
Digital Object Identifier (DOI) | https://doi.org/10.3233/JAD-210208 |
Scopus EID | 2-s2.0-85119201752 |
Funder | Dementia 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 status | Published |
Publication dates | |
Online | 09 Nov 2021 |
Publication process dates | |
Accepted | 20 Aug 2021 |
Deposited | 28 Nov 2022 |
ARC Funded Research | This output has been funded, wholly or partially, under the Australian Research Council Act 2001 |
Grant ID | 1121035 |
FL190100011 |
https://acuresearchbank.acu.edu.au/item/8y7v8/the-impact-of-built-social-environmental-characteristics-on-diagnosed-and-estimated-future-risk-of-dementia
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