scholarly journals CAN NEIGHBORHOOD AND LOCAL ENVIRONMENTS MODIFY COGNITIVE DECLINE? FINDINGS FROM THE REGARDS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S26-S26
Author(s):  
Philippa J Clarke ◽  
Jessica M Finlay

Abstract Environmental factors may significantly increase the risk of, or buffer against, age-related cognitive decline, yet policies and practices to improve cognitive health outcomes to date largely overlook the role of neighborhoods and socio-physical environmental contexts. Residence in socioeconomically advantaged neighborhoods may promote cognitive function through greater density of physical and social resources (e.g., libraries, parks, coffee shops, air conditioning, community centers) that promote physical activity, facilitate mental stimulation, and encourage social engagement. This symposium will identify natural, built, and social environmental factors linked to changes in cognitive function over time (assessed by animal naming and world list learning tests) based on secondary data analyses of a national, racially diverse (42% Black), population-based sample of over 30,000 Americans aged 45+ in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study followed annually since 2003. The first two papers investigate the roles of racial residential segregation and education on cognitive function disparities at the neighborhood and city scale. The third paper explores fast-food restaurants as socially interactive community spaces for older adults that may help buffer against cognitive decline. The fourth paper investigates effects of local air temperature on cognitive testing performance, and discusses how regional differences and seasonality may buffer or exacerbate temperature-cognition associations. Altogether, the symposium elucidates how cognitive health is impacted by a complex interplay of individual and geographic factors. The papers inform policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the well-being of older adults aging in place.

Author(s):  
Joy Bohyun Jang ◽  
Margaret T Hicken ◽  
Megan Mullins ◽  
Michael Esposito ◽  
Ketlyne Sol ◽  
...  

Abstract Objectives Residential segregation is one of the fundamental features of health disparities in the United States. Yet little research has examined how living in segregated metropolitan areas is related to cognitive function and cognitive decline with age. We examined the association between segregation at the Metropolitan Statistical Area (MSA) level and trajectories of age-related cognitive function. Method Using data from Black and White older adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=18,913), we employed linear growth curve models to examine how living in racially segregated MSAs at baseline, measured by the degree of Non-Hispanic Black [NHB] isolation and NHB dissimilarity, was associated with trajectories of age-related cognitive function and how the associations varied by race and education. Results Living in MSAs with greater levels of isolation was associated with lower cognitive function (b=-0.093, p<0.05) but was not associated with rates of change in cognitive decline with age. No effects of living in isolated MSAs were found for those with at least a high school education, but older adults with less than a high school education had lower cognitive function in MSAs with greater isolation (b=-0.274, p<0.05). The degree of dissimilarity was not associated with cognitive function. The association between segregation and cognitive function did not vary by race. Discussion Metropolitan segregation was associated with lower cognitive function among older adults, especially for those with lower education living in racially isolated MSAs. This suggests complex associations between individual socioeconomic status, place, and cognitive health.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 703-703
Author(s):  
Jessica Finlay ◽  
Philippa Clarke ◽  
Lisa Barnes

Abstract Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.


Author(s):  
Jessica Finlay ◽  
Anam Khan ◽  
Carina Gronlund ◽  
Ketlyne Sol ◽  
Joy Jang ◽  
...  

Rain, snow, or ice may discourage older adults from leaving their homes with potential consequences for social isolation, decreased physical activity, and cognitive decline. This study is the first to examine potential links between annual precipitation exposure and cognitive function in a large population-based cohort of older Americans. We examined the association between precipitation (percent of days with snow or rain in the past year) and cognitive function in 25,320 individuals aged 45+ from the Reasons for Geographic and Racial Differences in Stroke Study. Linear mixed models assessed the relationship between precipitation and cognitive function, as well as rates of change in cognitive function with age. We found a non-linear relationship between precipitation and cognitive function. Compared to those exposed to infrequent precipitation (less than 20% of days with rain/snow in the past year), cognitive function was higher among older adults experiencing moderately frequent precipitation (20–40% of annual days with precipitation). However, beyond more than about 45% of days with precipitation in the past year, there was a negative association between precipitation and cognitive function, with faster rates of cognitive decline with age. These exploratory findings motivate further research to better understand the complex role of precipitation for late-life cognitive function.


Author(s):  
Jongnam Hwang ◽  
Sangmin Park ◽  
Sujin Kim

Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006–2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.


Author(s):  
Jessica R. Andrews-Hanna ◽  
Matthew D. Grilli ◽  
Muireann Irish

The brain’s default network (DN) has received considerable interest in the context of so-called “normal” and pathological aging. Findings have generally been couched in support of a pessimistic view of brain aging, marked by substantial loss of structural brain integrity accompanied by a host of impairments in brain and cognitive function. A critical look at the literature, however, reveals that the standard loss of integrity, loss of function (LILF) view in normal aging may not necessarily hold with respect to the DN and the internally guided functions it supports. Many internally guided processes subserved by the DN are preserved or enhanced in cognitively healthy older adults. Moreover, differences in motivational, contextual, and physiological factors between young and older adults likely influence the extant neuroimaging and cognitive findings. Accordingly, normal aging can be viewed as a series of possibly adaptive cognitive and DN-related alterations that bolster cognitive function and promote socioemotional well-being and stability in a stage of life noted for change. On the other hand, the available evidence reveals strong support for the LILF view of the DN in neurodegenerative disorders, whereby syndromes such as Alzheimer’s disease (AD) and semantic dementia (SD), characterized by progressive atrophy to distinct DN subsystems, display distinct aberrations in autobiographical and semantic cognition. Taken together, these findings call for more naturalistic, age-appropriate, and longitudinal paradigms when investigating neurocognitive changes in aging and to adequately assess and control for differences in non-neural factors that may obscure “true” effects of normal and pathological aging. A shift in the framework with which age-related alterations in internally guided cognition are interpreted may shed important light on the neurocognitive mechanisms differentiating healthy and pathological aging, leading to a more complete picture of the aging brain in all its complexity.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Gail A Laughlin ◽  
Linda K McEvoy ◽  
Elizabeth Barrett-Connor ◽  
Lori B Daniels ◽  
Joachim H Ix

Objectives: The contribution of vascular disease to neurocognitive decline is now widely recognized. Fetuin-A is an abundant plasma protein known to predict vascular disease. Prior studies have shown that fetuin-A levels are lower in patients with Alzheimer’s disease in direct proportion to the severity of cognitive impairment; however, their association with normal cognitive aging is unknown. We evaluated the association of serum fetuin-A levels with cognitive function in relatively high-functioning, community-dwelling older adults from the Rancho Bernardo Study. Methods: This is a population-based study of 1382 older adults (median age 75) who had plasma fetuin-A levels and cognitive function evaluated in 1992-96; 855 had repeat cognitive function assessment a median of 4 years later. Results: Adjusting for age, sex, education, and depression, higher levels of fetuin-A were associated with better baseline performance on the Mini-Mental Status Exam (MMSE) (P=0.012) and a tendency for better Trails Making B scores (P=0.066). In longitudinal analyses, the likelihood of a major decline (highest decile of change) in Trails B was 29% lower (P=0.010) for each SD higher baseline fetuin-A level; odds of major decline in MMSE was 42% lower (P=0.005) per SD higher fetuin-A for individuals with no known CVD, but were not related to fetuin-A in those with CVD (P=0.33). Fetuin-A was not related to Category Fluency performance. Results did not vary by sex and were not explained by numerous vascular risk factors and comorbidities. Conclusions: Higher plasma fetuin-A concentrations are associated with better performance on tests of global cognitive function and executive function and with reduced likelihood of major decline in these cognitive abilities over a 4-year period. These observations are consistent with the hypothesis that higher fetuin-A protects against cognitive decline in relatively high functioning older adults, although this may be less apparent in those with established vascular disease. Fetuin-A may serve as a biological link between vascular disease and normal age-related cognitive decline.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S414-S414
Author(s):  
Jessica M Finlay ◽  
Philippa Clarke ◽  
Anam Khan ◽  
Carina Gronlund ◽  
Robert Melendez ◽  
...  

Abstract Snowfall, sleet and rain can adversely affect the mobility of older adults, with negative consequences for engagement in daily activities and socializing. This can lead to isolation and loneliness, which can negatively impact cognitive functioning. We tested whether long-term exposure to precipitation – particularly snow and cold rain (precipitation at ambient temperatures between 0°C and 10°C) – negatively impacts age-related cognitive function trajectories among a national sample of over 30,000 Americans (aged 45+) in the Reasons for Geographic and Racial Differences in Stroke study followed since 2003. Linear growth mixture models showed that living in an area with a 25% greater proportion of days with snow/rain in the past year was associated with a 0.6 unit decrease in cognitive function score (p<.001). Effects were stronger among those aged 75+, who experienced faster rates of cognitive decline. The findings motivate further research on the role of cold-season precipitation for cognitive decline.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 704-704
Author(s):  
Philippa Clarke ◽  
Michael Esposito ◽  
Joy Bohyun Jang ◽  
Sandra Tang ◽  
Anam Khan ◽  
...  

Abstract Older adults’ perceptions of the presence and quality of neighborhood resources provide important information about the potential benefit of those resources but are not necessarily concordant with the actual physical resources available in that environment. There is debate about whether subjective perceptions of local context are more important for individual behavior and well-being than objective indicators of resources. However, little research has examined how cognitive function is related to differences in the perceived availability and quality of neighborhood resources among older adults. We found that subjective reports of neighborhood safety and adequacy of parks were positively associated with objective measures of property crime and park density. Cognitive function was associated with higher subjective neighborhood evaluations, but adults with lower cognitive function reported more discordance between objective and subjective measures of neighborhood resources. These findings inform how neighborhood resources may have different consequences for older adults experiencing cognitive decline.


Author(s):  
Atsushi Motohiro ◽  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Keiichi Onoda ◽  
Tomoko Ito ◽  
...  

Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect on older adults living in rural areas. This longitudinal study aimed to investigate the role of neighborhood environmental factors in cognitive decline among rural older adults. The data of 485 older adults aged ≥60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were determined using geographic information system. We applied a generalized estimating equation with odds ratios (OR) and 95% confidence intervals (CIs) of cognitive decline in the quartiles of neighborhood environmental factors. A total of 56 (11.6%) participants demonstrated a decrease in cognitive function at follow up. Elevation (adjusted OR 2.58, 95% CI (1.39, 4.77) for Q4 vs. Q1) and hilliness (adjusted OR 1.93, 95% CI (1.03, 3.63) for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. The second quartiles of residential density showed significantly lower likelihoods of cognitive decline compared with the first quartiles (adjusted OR 0.36, 95% CI (0.19, 0.71) for Q2 vs. Q1). Thus, an elevated hilly environment and residential density predicted cognitive decline among rural older adults.


2020 ◽  
Vol 4 (s1) ◽  
pp. 4-4
Author(s):  
Jessica Finlay ◽  
Michael Esposito ◽  
Sandra Tang ◽  
Iris Gomez-Lopez ◽  
Dominique Sylvers ◽  
...  

OBJECTIVES/GOALS: Environmental factors may significantly increase the risk of or buffer against Alzheimer’s disease and related dementias, yet strategies to address cognitive decline and impairment to date largely overlook the role of neighborhoods. This mixed-methods study is the first to examine potential links between access to eateries and cognitive function. The goal is to inform place-specific interventions to help aging individuals reduce risk for cognitive impairment through neighborhood community and design. METHODS/STUDY POPULATION: Following an exploratory sequential mixed-methods design, seated and mobile interviews with 125 adults aged 55-92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggest that eateries, including coffee shops and fast-food restaurants, represent popular neighborhood destinations for older adults and sources of wellbeing. To test the hypothesis that these sites, and the benefits they confer, are associated with cognitive welfare, we analyzed data from urban and suburban dwelling participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national racially diverse sample of older Americans followed since 2003 (n = 16,404, average age at assessment 72 years). RESULTS/ANTICIPATED RESULTS: Qualitative thematic analysis of how older adults perceived and utilized local eateries include sites of familiarity and comfort; physical and economic accessibility; sociability with friends, family, staff, and customers; and entertainment (e.g., destinations for outings and walks, free newspapers to read). Quantitative results from multilevel linear regression models demonstrate a positive association between density of eateries and cognitive functioning. Taken together, these results complicate our understanding of fast-food settings as possible sites of wellbeing through social interaction and leisure activities. DISCUSSION/SIGNIFICANCE OF IMPACT: The results contribute new evidence towards an emerging ecological model of cognitive health. Understanding whether and how retail food environments can help buffer against cognitive decline among older adults provides novel opportunities to promote wellbeing in later life through community interventions and neighborhood design.


Sign in / Sign up

Export Citation Format

Share Document