Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis

Lilah M. Besser, Lun-Ching Chang, Jana A. Hirsch, Daniel A. Rodriguez, John Renne, Stephen R. Rapp, Annette L. Fitzpatrick, Susan R. Heckbert, Joel D. Kaufman and Timothy M. Hughes
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Lilah M. Besser: Department of Urban and Regional Planning and Institute for Human Health and Disease Intervention, Florida Atlantic University, Boca Raton, FL 33431, USA
Lun-Ching Chang: Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL 33431, USA
Jana A. Hirsch: Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
Daniel A. Rodriguez: Department of City and Regional Planning, Institute for Transportation Studies, University of California Berkeley, Berkeley, CA 94720, USA
John Renne: Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA
Stephen R. Rapp: Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA
Annette L. Fitzpatrick: Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, WA 98105, USA
Susan R. Heckbert: Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA 98105, USA
Joel D. Kaufman: Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, WA 98105, USA
Timothy M. Hughes: Department of Internal Medicine, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA

IJERPH, 2021, vol. 18, issue 15, 1-12

Abstract: Few studies have examined associations between neighborhood built environments (BE) and longitudinally measured cognition. We examined whether four BE characteristics were associated with six-year change in global cognition and processing speed. We obtained data on 1816 participants without dementia from the Multi-Ethnic Study of Atherosclerosis. BE measures included social destination density, walking destination density, proportion of land dedicated to retail, and network ratio (street connectivity). Global cognition was measured with the Cognitive Abilities Screening Instrument (CASI) and processing speed with the Digit Symbol Coding test (DSC). Multivariable random intercept logistic models tested associations between neighborhood BE at 2010–2012 and maintained/improved cognition (versus decline) from 2010–2018, and mediation by minutes of physical activity (PA)/week. The sample was an average of 67 years old (standard deviation = 8.2) (first cognitive measurement) and racially/ethnically diverse (29% African American, 11% Chinese, 17% Hispanic, 44% White). Compared to individuals with no walking destinations in the 1-mile surrounding their residence, those with 716 walking destinations (maximum observed) were 1.24 times more likely to have maintain/improved DSC score (Odds ratio: 1.24; 95% confidence interval: 1.03–1.45). No other associations were observed between BE and cognition, and PA minutes/week did not mediate the association between walking destination density and DSC change. This study provides limited evidence for an association between greater neighborhood walking destinations and maintained/improved processing speed in older age and no evidence for associations between the other BE characteristics and cognition. Future studies with finer grained BE and cognitive measures and longer-term follow up may be required.

Keywords: built environment; residence characteristics; city planning; cognition; Alzheimer disease; preventive medicine; public health; walking destination; land use; older adult (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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