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Pescador Jimenez M, Wagner M, Laden F, Hart JE, Grodstein F, James P. Midlife Residential Greenness and Late-Life Cognitive Decline among Nurses' Health Study Participants. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:77003. [PMID: 39016600 PMCID: PMC11253812 DOI: 10.1289/ehp13588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Midlife residential exposure to greenspace may slow cognitive decline by increasing opportunities for physical activity and social connection, restoring attention, or reducing stress or adverse environmental exposures. However, prospective studies on the association between greenness and cognitive decline are sparse. OBJECTIVE We investigated the prospective association between greenness at midlife and cognitive decline later in life. We explored effect measure modification by apolipoprotein E (APOE)-ɛ4 carrier status, neighborhood socioeconomic status (NSES), and rural/urban regions. METHODS The Nurses' Health Study (N = 121,700 ) started in 1976 with married female nurses, 30-55 years of age, located across 11 US states. We examined 16,962 nurses who were enrolled in a substudy starting in 1995-2001 (mean age = 74 y ) through 2008. We assessed average summer residential greenness in a 270 -m buffer using Landsat Normalized Difference Vegetation Index data from 1986-1994. Starting in 1995-2001, participants underwent up to four repeated measures of five cognitive tests. A global composite score was calculated as the average of all z -scores for each task to evaluate overall cognition. We used linear mixed models to evaluate the association of average greenness exposure at midlife with cognitive decline in later life, adjusted for age, education, NSES, and depression. RESULTS In adjusted models, higher midlife greenness exposure [per interquartile range (IQR): 0.18] was associated with a 0.004-unit (95% CI: 0.001, 0.006) slower annual rate of cognitive decline. For comparison, we found that 1 year of age is related to a - 0.006 mean annual difference for global cognition in the full sample; thus, higher midlife greenness appeared equivalent to slowing cognitive decline by ∼ 8 months. In analysis exploring gene-environment interactions, we found that among APOE-ɛ4 carriers, an IQR increase in greenness was associated with a rate of decline that was slower by 0.01 units of global composite score (95% CI: 0.0004, 0.02). This association was attenuated among APOE-ɛ4 noncarriers. We did not observe associations between greenness and baseline or annual rate of cognitive decline of verbal memory. DISCUSSION Higher midlife greenness exposure is associated with slower cognitive decline later in life. Future research is necessary to confirm these findings. https://doi.org/10.1289/EHP13588.
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Affiliation(s)
- Marcia Pescador Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Maude Wagner
- Department of Internal Medicine, Rush Medical College and Rush Alzheimer’s Disease Center, Chicago, Illinois, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Francine Grodstein
- Department of Internal Medicine, Rush Medical College and Rush Alzheimer’s Disease Center, Chicago, Illinois, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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Thierry AD, Sherman-Wilkins K, Armendariz M, Sullivan A, Farmer HR. Perceived Neighborhood Characteristics and Cognitive Functioning among Diverse Older Adults: An Intersectional Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2661. [PMID: 33800952 PMCID: PMC7967341 DOI: 10.3390/ijerph18052661] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022]
Abstract
Unfavorable neighborhood conditions are linked to health disparities. Yet, a dearth of literature examines how neighborhood characteristics contribute to cognitive health in diverse samples of older adults. The present study uses an intersectional approach to examine how race/ethnicity, gender, and education moderate the association between neighborhood perceptions and cognitive functioning in later life. We used data from adults ≥65 years old (n = 8023) in the 2010-2016 waves of the nationally representative Health and Retirement Study (HRS). We conducted race/ethnicity-stratified linear regression models where cognitive functioning, measured using the 35-point Telephone Interview Cognitive Screen (TICS), was regressed on three neighborhood characteristics-cleanliness, safety, and social cohesion. We examine whether there is heterogeneity within race/ethnicity by testing if and how the relationship between neighborhood characteristics and cognitive functioning differs by gender and education. Among White adults, worse neighborhood characteristics were associated with lower cognitive functioning among those with less education. However, for Black adults, poor perceived quality of one's neighborhood was associated with worse cognitive functioning among those with more years of education compared to those with fewer years of education. Among Mexicans, perceived neighborhood uncleanliness was associated with lower cognitive functioning among those with less education, but higher cognitive functioning for those with higher levels of education. Thus, this study contributes to the literature on racial/ethnic disparities in cognitive aging disparities by examining neighborhood contextual factors as determinants of cognitive functioning. In particular, we find that higher education in the context of less favorable neighborhood environments does not confer the same benefits to cognitive functioning among all older adults.
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Affiliation(s)
- Amy D. Thierry
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA;
| | - Kyler Sherman-Wilkins
- Department of Sociology and Anthropology, Missouri State University, Springfield, MO 65897, USA;
| | - Marina Armendariz
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA;
| | - Allison Sullivan
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA;
| | - Heather R. Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE 19716, USA;
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Koehly LM, Persky S, Shaw P, Bonham VL, Marcum CS, Sudre GP, Lea DE, Davis SK. Social and behavioral science at the forefront of genomics: Discovery, translation, and health equity. Soc Sci Med 2021; 271:112450. [PMID: 31558303 PMCID: PMC9745643 DOI: 10.1016/j.socscimed.2019.112450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/25/2019] [Indexed: 12/15/2022]
Abstract
This special issue highlights the unique role that social and behavioral science has to play at the forefront of genomics. Through the introduction of papers comprising this special issue, we outline priority research areas at the nexus of genomics and the social and behavioral sciences. These include: Discovery science; clinical and community translation, and equity, including engagement and inclusion of diverse populations in genomic science. We advocate for genomic discovery that considers social context, neural, cognitive, and behavioral endophenotypes, and that is grounded in social and behavioral science research and theory. Further, the social and behavioral sciences should play a leadership role in identifying best practices for effective clinical and community translation of genomic discoveries. Finally, inclusive research that engages diverse populations is necessary for genomic discovery and translation to benefit all. We also highlight ways that genomics can be a fruitful testbed for the development and refinement of social and behavioral science theory. Indeed, an expanded ecological lens that runs from genomes to society will be required to fully understand human behavior.
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Affiliation(s)
- Laura M. Koehly
- Corresponding author. 31 Center Drive, Rm B1B54, Bethesda, MD, 20892-2073, USA. (L.M. Koehly)
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Chhetri JK, Ma L, Zheng Z, Liu FY, Zhao J, Gu ZQ, Chan P. Apolipoprotein E Polymorphism and Frailty: Apolipoprotein ε4 Allele Is Associated with Fatigue but Not Frailty Syndrome in a Community-Dwelling Older Population Cohort. J Nutr Health Aging 2021; 25:410-415. [PMID: 33786555 DOI: 10.1007/s12603-020-1522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Frailty is known to be influenced by genetics, however, little evidence on the association of Apolipoprotein E (ApoE) genotype and frailty exists which we aim to investigate. DESIGN This study is a cross-sectional analysis from a prospective longitudinal study cohort. SETTING AND PARTICIPANTS Community-dwelling individuals aged 55 years and older from Beijing region in China. MEASUREMENTS A total of 3,569 older adults with a mean age of 75.06(±6.79) years were included. We investigated the association between ApoE polymorphism and frailty syndrome using the frailty index (FI) and frailty phenotype (including association with individual components of the frailty phenotype). Logistic regressions were performed to investigate the relation between ApoE variants and frailty. RESULTS There was no significant association between ApoE variants and frailty as assessed by the FI. In the age and sex-adjusted model, compared to the ApoE e3/e3 carriers ApoE e4 carriers had almost 1.5 times higher odds of being frail as assessed by the frailty phenotype. However, the significance was lost on the model with adjustment for cognitive impairment. Compared to the ApoE e3/e3 carriers ApoE e4 carriers had almost two times higher odds of fatigue. ApoE e4 heterozygotes had higher odds of fatigue compared to ApoE e4 non-carriers. No significant association was found between ApoE variants and other components of frailty phenotype. CONCLUSIONS Our findings do not support an association between ApoE genotype and frailty irrespective of the frailty assessment tools. Fatigue in older adults is the only component of frailty phenotype influenced by ApoE genotype.
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Affiliation(s)
- J K Chhetri
- Piu Chan, MD, PhD, Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China, E-mail: , Tel: +86-10-83198677
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Park S, Kim B, Kwon E, Kown G. Influence of senior housing types on cognitive decline and nursing home admission among lower-income older adults. Aging Ment Health 2020; 24:1579-1588. [PMID: 31389268 DOI: 10.1080/13607863.2019.1650888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: Focusing on unique ageing populations in subsidized senior housing for lower-income older adults, this study contributes to literature on housing and aging; provides initial understanding of existing housing types; and explores the extent to which living in different housing types may influence changes in cognitive function and likelihood of nursing home admission.Method: Data came from seven waves (2002-2014) of the Health and Retirement Study. A latent-class clustering approach was used to identify senior-housing types among lower-income older people;Results: We identified four discernible housing types among lower-income older adults: (1) High physical & Low service, (2) Low physical & Low service, (3) High physical & High service, and (4) Medium physical & High service. Individuals in Medium physical & High service and High physical & Low service types were likely to have higher cognitive-function levels at baseline (B = 0.58, p < .001; 0.58, p < .001) and slower rates of decline over time (B = 0.42, p < .001; B = 0.32, p < .01). Older adults in High physical & High service are significantly less likely to be admitted to a nursing home (OR = 0.55, p < .00).Conclusion: The mismatch between health needs and lack of service and support suggests that current residents in each housing type relocate, based on knowledge of subsidized housing or availability. Future studies should examine possible mismatches between health needs and housing environment.
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Affiliation(s)
- Sojung Park
- George Warren Brown School of Social Work, Washington University in Saint Louis, Saint Louis, MO, USA
| | - BoRin Kim
- College of Health and Human Services, University of New Hampshire, Durham, NH, USA
| | - Eunsun Kwon
- Department of Social Work, St. Cloud State University, St. Cloud, MN, USA
| | - Goeun Kown
- George Warren Brown School of Social Work, Washington University in Saint Louis, Saint Louis, MO, USA
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Letellier N, Carrière I, Cadot E, Berkman L, Goldberg M, Zins M, Berr C. Individual and neighbourhood socioeconomic inequalities in cognitive impairment: cross-sectional findings from the French CONSTANCES cohort. BMJ Open 2020; 10:e033751. [PMID: 32193263 PMCID: PMC7150592 DOI: 10.1136/bmjopen-2019-033751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Despite the recent awareness of the environment impact on brain ageing, the influence of the neighbourhood socioeconomic status on cognitive impairment remains unclear. Here, we investigated the effects of individual and neighbourhood deprivation on cognitive impairment in middle-aged and young-old people. DESIGN Cross-sectional study. SETTINGS 21 Health Screening Centres in the entire French metropolitan territory. PARTICIPANTS A total of 44 648 participants (age range: 45 to 69 years) from the French CONSTANCES cohort were included in the analyses. MAIN OUTCOMES Associations between the overall cognitive score (based on a standardised battery of cognitive tests administered by neuropsychologists) and individual deprivation (Evaluation of Deprivation and Inequalities in Health Screening Centres; EPICES score) and geographical deprivation (French Deprivation Index; FDep index). RESULTS Based on the EPICES score (validated cut-off ≥30.17), 12% of participants were considered to be deprived. After mutual adjustment, individual and geographical deprivation were associated with higher cognitive impairment in a multilevel logistic regression analysis that was also adjusted for sociodemographic, lifestyle and health factors. Specifically, individual deprivation was associated with an odds increase of 55% (OR=1.55, 95% CI: 1.45 to 1.66). The risk of global cognitive impairment progressively increased with the neighbourhood deprivation level, evaluated by the FDep index (reference Q1; Q2: OR=1.09, 95% CI: 0.98 to 1.20; Q3: OR=1.15, 95% CI: 1.04 to 1.27; Q4: OR=1.15, 95% CI: 1.04 to 1.28; Q5: OR=1.25, 95% CI: 1.13 to 1.39). CONCLUSION Our results suggest that the neighbourhood socioeconomic deprivation level is associated with cognitive impairment, independently of the individual deprivation level. A better understanding of this association could help to define new prevention strategies to target high-risk residents and high-risk geographical areas in order to reduce social health inequalities.
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Affiliation(s)
- Noémie Letellier
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Isabelle Carrière
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, Montpellier, France
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Marcel Goldberg
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
| | - Marie Zins
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
- UVSQ, INSERM, VIMA; Aging and chronic diseases, U1168, Villejuif, France
| | - Claudine Berr
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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Cerin E, Barnett A, Chaix B, Nieuwenhuijsen MJ, Caeyenberghs K, Jalaludin B, Sugiyama T, Sallis JF, Lautenschlager NT, Ni MY, Poudel G, Donaire-Gonzalez D, Tham R, Wheeler AJ, Knibbs L, Tian L, Chan YK, Dunstan DW, Carver A, Anstey KJ. International Mind, Activities and Urban Places (iMAP) study: methods of a cohort study on environmental and lifestyle influences on brain and cognitive health. BMJ Open 2020; 10:e036607. [PMID: 32193278 PMCID: PMC7202706 DOI: 10.1136/bmjopen-2019-036607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents. METHODS AND ANALYSIS Participants aged 50-79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total; 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants' visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants' characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures. ETHICS AND DISSEMINATION The study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website. TRIAL REGISTRATION NUMBER ACTRN12619000817145.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Anthony Barnett
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - Basile Chaix
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, Paris, Île-de-France, France
| | | | - Karen Caeyenberghs
- Cognitive Neurosciences Unit, Deakin University, Burwood, Victoria, Australia
| | - Bin Jalaludin
- Population Health Intelligence, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Takemi Sugiyama
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - James F Sallis
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | | | - Michael Y Ni
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Govinda Poudel
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Donaire-Gonzalez
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - Rachel Tham
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - Amanda J Wheeler
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - Luke Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Linwei Tian
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yih-Kai Chan
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Alison Carver
- Mary MacKillop Inst Health Res, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute and School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
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Cerin E. Building the evidence for an ecological model of cognitive health. Health Place 2019; 60:102206. [PMID: 31797770 DOI: 10.1016/j.healthplace.2019.102206] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
This is a commentary on Besser and colleagues' article "Associations between neighbourhood built environment and cognition vary by apolipoprotein E genotype: Multi-Ethnic Study on Atherosclerosis" published in Health & Place. Unlike previous studies, the authors found significant environment-cognition associations in apolipoprotein E (APOE) ε2 carriers and no significant associations in ε4 carriers. This commentary discusses the possible reasons for these findings and, in doing so, proposes an ecological model of cognitive health. The model highlights the importance of accounting for multiple environmental influences including the built and natural environment and air and noise pollution indicators. It also stresses the importance of studying the underlying biological mechanisms explaining differences in environment-cognition associations across APOE genotype categories.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Public Health, The University of Hong Kong, Hong Kong, China.
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Besser L, Galvin JE, Rodriguez D, Seeman T, Kukull W, Rapp SR, Smith J. Associations between neighborhood built environment and cognition vary by apolipoprotein E genotype: Multi-Ethnic Study of Atherosclerosis. Health Place 2019; 60:102188. [PMID: 31797769 PMCID: PMC6901106 DOI: 10.1016/j.healthplace.2019.102188] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/26/2019] [Accepted: 08/07/2019] [Indexed: 01/02/2023]
Abstract
We examined whether neighborhood built environment (BE) and cognition associations in older adults vary by apolipoprotein E (APOE) genotype, a genetic risk factor for Alzheimer's disease (AD). We conducted a cross-sectional analysis of 4091 participants. Neighborhood characteristics included social and walking destination density (SDD, WDD), intersection density, and proportion of land dedicated to retail. Individuals were categorized as APOE ε2 (lower AD risk), APOE ε4 (higher AD risk), or APOE ε3 carriers. Among APOE ε2 carriers, greater proportion of land dedicated to retail was associated with better global cognition, and greater SDD, WDD, intersection density, and proportion of land dedicated to retail was associated with better processing speed. These associations were not observed in APOE ε3 or ε4 carriers. APOE ε2 carriers may be more susceptible to the potentially beneficial effects of denser neighborhood BEs on cognition; however, longitudinal studies are needed.
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Affiliation(s)
- Lilah Besser
- School of Urban and Regional Planning, Institute for Human Health and Disease Intervention, Florida Atlantic University, 777 Glades Rd, SO-284H, Boca Raton, FL, 33431, USA.
| | - James E Galvin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, ME-104, First Floor, Boca Raton, FL, 33431, USA.
| | - Daniel Rodriguez
- Department of City and Regional Planning, College of Environmental Design, Office 313B, Wurster Hall #1820, University of California, Berkeley, CA, 94720-1820, USA.
| | - Teresa Seeman
- David Geffen School of Medicine, University of California Los Angeles, 10945 Le Conte Avenue, Suite 2339 (PVUB Uberroth Building), Los Angeles, CA, 90095, USA.
| | - Walter Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Avenue NE, Suite 300, Seattle, WA, 98105, USA.
| | - Stephen R Rapp
- Departments of Psychiatry and Behavioral Medicine & Public Health Sciences, Wake Forest School of Medicine, 791 Jonestown Road, Winston-Salem, NC, 27103, USA.
| | - Jennifer Smith
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Room 2631, Ann Arbor, MI, 48109-2029, USA.
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Rovner BW, Casten RJ, Hegel MT, Leiby B. Preventing Cognitive Decline in Black Individuals With Mild Cognitive Impairment: A Randomized Clinical Trial. JAMA Neurol 2019; 75:1487-1493. [PMID: 30208380 DOI: 10.1001/jamaneurol.2018.2513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Mild cognitive impairment (MCI) is a transition state between normal cognitive aging and dementia that increases the risk for progressive cognitive decline. Preventing cognitive decline is a public health priority. Objective To determine whether behavioral activation prevents cognitive and functional decline over 2 years in black individuals with MCI. Design, Setting, and Participants Single-center, single-masked, attention-controlled randomized clinical trial. Participants were enrolled from June 21, 2011, to October 3, 2014, and follow-up ended December 13, 2016. Community-based recruitment and treatment of black individuals older than 65 years with amnestic MCI. Volunteer sample of 1390 persons with memory complaints were screened. Overall, 536 individuals had baseline assessment, and 315 (58.8%) were ineligible, most often owing to normal cognition (205 of 315 [65%]) or dementia (59 of 315 [18.7%]); 221 fully eligible participants were randomized. Analyses were intention to treat. Interventions Participants were randomized to behavioral activation, which aimed to increase cognitive, physical, and social activity (111 [50.2%]), or supportive therapy, an attention control treatment (110 [49.8%]). Main Outcomes and Measures The prespecified primary outcome was a decline of 6 or more recalled words on the total recall score of the Hopkins Verbal Learning Test-Revised assessed at 6, 12, 18, and 24 months. The secondary outcome was functional decline. Results Of 221 randomized participants (mean [SD] age, 75.8 [7.0] years, 175 women [79%]), 77 behavioral activation participants (69.4%) and 87 supportive therapy participants (79.1%) had 2-year outcome assessments. After baseline, behavioral activation participants engaged in significantly more cognitive activities than supportive therapy participants. The 2-year incidence of memory decline was 1.2% (95% CI, 0.2-6.4) for behavioral activation vs 9.3% (95% CI, 5.30-16.4) for supportive therapy (relative risk, 0.12; 95% CI, 0.02-0.74; P = .02). Behavioral activation was associated with stable everyday function, whereas supportive therapy was associated with decline (difference in slopes, 2.71; 95% CI, 0.12-5.30; P = .04). Rates of serious adverse events for behavioral activation and supportive therapy, respectively, were: falls (14 [13%] vs 28 [25%]), emergency department visits (24 [22%] vs 24 [22%]), hospitalizations (36 [32%] vs 31 [28%]), and deaths (7 [5%] vs 3 [4%]). Conclusions and Relevance Behavioral activation prevented cognitive and functional decline, but this finding requires further investigation. Black individuals have almost twice the rate of dementia as white individuals; behavioral activation may reduce this health disparity. Trial Registration ClinicalTrials.gov Identifier: NCT01299766.
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Affiliation(s)
- Barry W Rovner
- Department of Neurology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.,Department Psychiatry, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.,Department Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Robin J Casten
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mark T Hegel
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Benjamin Leiby
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
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Park S, Kwon E, Kim B, Han Y. Person-Environment Fit Approach to Trajectories of Cognitive Function Among Older Adults Who Live Alone: Intersection of Life-Course SES Disadvantage and Senior Housing. J Gerontol B Psychol Sci Soc Sci 2019; 74:e1-e12. [PMID: 31038160 PMCID: PMC6703233 DOI: 10.1093/geronb/gbz025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Drawing from life course and environmental perspectives, we examined the trajectory of cognitive function and how senior housing moderates the effects of life-course socioeconomic status (SES) disadvantage among older people living alone over time. METHOD Six waves of the Health and Retirement Study (HRS) were used with multilevel growth modeling to analyze developmental patterns of cognitive function over time and how various forms of life-course SES disadvantage affect cognitive function depending on senior housing residency status. RESULTS At baseline, we found a positive role of senior housing in four subgroups: SES disadvantage in childhood only, unstable mobility pattern (disadvantage in childhood and old age only), downward mobility (no disadvantage in childhood, but in later two life stages), and cumulative disadvantage (all three life stages). Over time, the positive role of senior housing for the unstable and the most vulnerable group persisted. DISCUSSION Our findings provide a much-needed practical and theoretical underpinning for environmental policy-making efforts regarding vulnerable elders who live alone.
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Affiliation(s)
- Sojung Park
- Brown School of Social Work, Washington University in Saint Louis, Missouri
| | - Eunsun Kwon
- Department of Social Work, St. Cloud State University, Minnesota
| | - BoRin Kim
- Department of Social Work, University of New Hampshire, Durham
| | - Yoonsun Han
- Department of Social Welfare, Seoul National University, Seoul, Korea
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Xiang Y, Zare H, Guan C, Gaskin D. The impact of rural-urban community settings on cognitive decline: results from a nationally-representative sample of seniors in China. BMC Geriatr 2018; 18:323. [PMID: 30594142 PMCID: PMC6311043 DOI: 10.1186/s12877-018-1003-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/03/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Aging and rural-urban disparities are two major social problems in today's ever-developing China. Much of the existing literature has supported a negative association between adverse community setting with the cognitive functioning of seniors, but very few studies have empirically investigated the impact of rural-urban community settings on cognitive decline in the late life course of the population in developing countries. METHODS Data of seniors aged 65 or above (n = 1709) within CHARLS (The China Health and Retirement Longitudinal Study, a sister study of HRS), a nationally representative longitudinal cohort (2011-2015) in China, were analyzed using a multilevel modeling (MLM) of time within individuals, and individual within communities. Cognitive impairment was assessed with an adapted Chinese version of Mini-Mental State Examination. RESULTS Urban community setting showed a significant protective effect (β = - 1.978, p < .000) on cognitive impairment in simple linear regression, and the MLM results showed it also had a significant lower cognitive impairment baseline (β = - 2.278, p < .000). However, the curvature rate of cognitive decline was faster in urban community setting indicated by a positive interaction between the quadratic time term and urban community setting on cognitive impairment (β = 0.320, p < .05). A full model adjusting other individual SES factors was built after model fitness comparison, and the education factor accounted for most of the within and between community setting variance. CONCLUSIONS The findings suggest that urban community setting in one's late-life course has a better initial cognitive status but a potentially faster decline rate in China, and this particular pattern of senior cognitive decline emphasize the importance of more specific preventive measures. Meanwhile, a more holistic perspective should be adopted while construct a risk factor model of community environment on cognitive function, and the influence at society level needs to be further explored in future research.
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Affiliation(s)
- Yuanxi Xiang
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Hampton House Rm 441, 624 N. Broadway, Baltimore, Maryland 21205 USA
- University of Maryland- University College, Adelphi, USA
| | - Cuiling Guan
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Darrell Gaskin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Hampton House Rm 441, 624 N. Broadway, Baltimore, Maryland 21205 USA
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Lee H, Waite LJ. Cognition in Context: The Role of Objective and Subjective Measures of Neighborhood and Household in Cognitive Functioning in Later Life. THE GERONTOLOGIST 2018; 58:159-169. [PMID: 28666359 PMCID: PMC5881741 DOI: 10.1093/geront/gnx050] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/04/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although the role of place on health is not new, less is known about how place matters for cognition. By investigating both neighborhood and home as the sociospatial realms of older adults, we explore associations between health and place across multiple contexts. We also distinguish objective and subjective measures of place and disentangle their differential associations with cognition. RESEARCH DESIGN AND METHODS We analyzed place effects on cognition from the National Social Life, Health, and Aging Project (N = 2,260) linked to neighborhood characteristics and crime data. We measured place in four ways: (a) objective indicators of neighborhood such as police-reported crime rates and interviewer-reported on presence of disordered conditions on the streets; (b) perceptions of neighborhood by respondents (perceived danger and social cohesion); (c) objective conditions of home (interviewer's report on presence of clutters, odor, and messiness); (4) perceived social support, strain, and threat by household members. The MoCA-SA was used to assess cognitive functioning. RESULTS Subjective interpretations appeared to have more direct effects on cognition than did objective indicators of neighborhood or home. When examining these living environments together, we found the association between neighborhood and cognition is partially explained by characteristics of home environment, especially perceived social support. We found a buffering effect of social support on cognition for women, not for men. DISCUSSION AND IMPLICATIONS Late life living environments are important contexts for aging. Aging-in-Place interventions should address subjective interpretations of place to reduce future risks of cognitive decline.
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Affiliation(s)
- Haena Lee
- Department of Sociology, University of Chicago, Illinois
- Address correspondence to Haena Lee, MA, Department of Sociology, University of Chicago, 1126 E. 59 Street, Chicago, IL 60637. E-mail:
| | - Linda J Waite
- Department of Sociology, University of Chicago, Illinois
- Center on Aging, NORC at the University of Chicago, Illinois
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Letellier N, Gutierrez LA, Carrière I, Gabelle A, Dartigues JF, Dufouil C, Helmer C, Cadot E, Berr C. Sex-specific association between neighborhood characteristics and dementia: The Three-City cohort. Alzheimers Dement 2017; 14:473-482. [PMID: 29102501 DOI: 10.1016/j.jalz.2017.09.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/04/2017] [Accepted: 09/06/2017] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The living environment affects general health and may influence cognitive aging; however, the relationships between neighborhood characteristics and dementia are still poorly understood. METHODS We used data from a French population-based prospective study (the Three-City cohort) that included 7016 participants aged 65 years and older with a 12-year follow-up. We used principal components analysis of neighborhood composition indicators to construct the Three-City deprivation score. To study its impact on dementia incidence, we performed survival analyses using a marginal Cox model to take into account intraneighborhood correlations. As interaction with sex was significant, analyses were stratified by sex. RESULTS Even after controlling on individual factors, women living in deprived neighborhoods were at higher risk of dementia (hazard ratio = 1.29, 95% confidence interval 1.00-1.67) and Alzheimer's disease (hazard ratio = 1.42, 95% confidence interval 1.09-1.84). No association was found for men. DISCUSSION Living in a deprived neighborhood is associated with higher risk of dementia in women.
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Affiliation(s)
- Noémie Letellier
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Laure-Anne Gutierrez
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Isabelle Carrière
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Audrey Gabelle
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Jean-François Dartigues
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, UMR 1219, Bordeaux, France; CHU Bordeaux, Department of Public Health, Bordeaux, France
| | - Carole Dufouil
- CHU Bordeaux, Department of Public Health, Bordeaux, France; University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, UMR 1219, Bordeaux, France; CHU Bordeaux, Department of Public Health, Bordeaux, France
| | - Emmanuelle Cadot
- IRD-Hydrosciences UMR 5569, Montpellier University, Montpellier, France
| | - Claudine Berr
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
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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: 125] [Impact Index Per Article: 17.9] [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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Smith RJ, Lehning AJ, Kim K. Aging in Place in Gentrifying Neighborhoods: Implications for Physical and Mental Health. THE GERONTOLOGIST 2017; 58:26-35. [DOI: 10.1093/geront/gnx105] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Indexed: 11/14/2022] Open
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Wörn J, Ellwardt L, Aartsen M, Huisman M. Cognitive functioning among Dutch older adults: Do neighborhood socioeconomic status and urbanity matter? Soc Sci Med 2017. [PMID: 28647643 DOI: 10.1016/j.socscimed.2017.05.052] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Positive associations of neighborhood socioeconomic characteristics and older adults' cognitive functioning have been demonstrated in previous studies, but overall results have been mixed and evidence from European countries and particularly the Netherlands is scarce. We investigated the effects of socioeconomic status (SES) and urbanity of neighborhoods on four domains of cognitive functioning in a sample of 985 Dutch older adults aged 65-88 years from the Longitudinal Aging Study Amsterdam. Besides cross-sectional level differences in general cognitive functioning, processing speed, problem solving and memory, we examined cognitive decline over a period of six years. Growth models in a multilevel framework were used to simultaneously assess levels and decline of cognitive functioning. In models not adjusting for individual SES, we found some evidence of higher levels of cognitive functioning in neighborhoods with a higher SES. In the same models, urbanity generally showed positive or inversely U-shaped associations with levels of cognitive functioning. Overall, effects of neighborhood urbanity remained significant when adjusting for individual SES. In contrast, level differences by neighborhood SES were largely explained by the respondents' individual SES. This suggests that neighborhood SES does not influence levels of cognitive functioning beyond the fact that individuals with a similar SES tend to self-select into neighborhoods with a corresponding SES. No evidence of systematically faster decline in neighborhoods with lower SES or lower degrees of urbanity was found. The findings suggest that neighborhood SES has no independent effect on older adults cognitive functioning in the Netherlands. Furthermore, the study reveals that neighborhood urbanity should be considered a determinant of cognitive functioning. This finding is in line with theoretical approaches that assume beneficial effects of exposure to complex environments on cognitive functioning. We encourage further investigations into the effect of urbanity in other contexts before drawing firm conclusions.
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Affiliation(s)
- Jonathan Wörn
- University of Cologne, Research Training Group SOCLIFE, Albertus-Magnus-Platz, 50923 Cologne, Germany; University of Cologne, Institute of Sociology and Social Psychology, Albertus-Magnus-Platz, 50923 Cologne, Germany.
| | - Lea Ellwardt
- University of Cologne, Institute of Sociology and Social Psychology, Albertus-Magnus-Platz, 50923 Cologne, Germany.
| | - Marja Aartsen
- Oslo and Akershus University College of Applied Sciences, Norwegian Social Research, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Martijn Huisman
- VU University Amsterdam, Medical Center, Department of Epidemiology and Biostatistics, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; VU University Amsterdam, Department of Sociology, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
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Does Apolipoprotein e4 Status Moderate the Association of Family Environment with Long-Term Child Functioning following Early Moderate to Severe Traumatic Brain Injury? A Preliminary Study. J Int Neuropsychol Soc 2016; 22:859-64. [PMID: 27480909 PMCID: PMC5476473 DOI: 10.1017/s1355617716000631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To examine whether apolipoprotein e4 (APOE) status moderates the association of family environment with child functioning following early traumatic brain injury (TBI). METHODS Sixty-five children with moderate to severe TBI and 70 children with orthopedic injury (OI) completed assessments 6, 12, 18 months, and 3.5 and 6.8 years post injury. DNA was extracted from saliva samples and genotyped for APOE e4 status. Linear mixed models examined moderating effects of APOE e4 status on associations between two family environment factors (parenting style, home environment) and three child outcomes (executive functioning, behavioral adjustment, adaptive functioning). RESULTS Children with TBI who were carriers of the e4 allele showed poorer adaptive functioning relative to non-carriers with TBI and children with OI in the context of low authoritarianism. At high levels of authoritarianism, non-carriers with TBI showed the poorest adaptive functioning among groups. There were no main effects or interactions involving APOE and executive functioning or behavioral adjustment. CONCLUSIONS The APOE e4 allele was detrimental for long-term adaptive functioning in the context of positive parenting, whereas in less optimal parenting contexts, being a non-carrier was detrimental. We provide preliminary evidence for an interaction of APOE e4 status and parenting style in predicting long-term outcomes following early TBI. (JINS, 2016, 22, 859-864).
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Cerin E, Rainey-Smith SR, Ames D, Lautenschlager NT, Macaulay SL, Fowler C, Robertson JS, Rowe CC, Maruff P, Martins RN, Masters CL, Ellis KA. Associations of neighborhood environment with brain imaging outcomes in the Australian Imaging, Biomarkers and Lifestyle cohort. Alzheimers Dement 2016; 13:388-398. [PMID: 27546307 DOI: 10.1016/j.jalz.2016.06.2364] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 06/10/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION "Walkable" neighborhoods offer older adults opportunities for activities that may benefit cognition-related biological mechanisms. These have not previously been examined in this context. METHODS We objectively assessed neighborhood walkability for participants (n = 146) from the Australian Imaging, Biomarkers and Lifestyle study with apolipoprotein E (APOE) genotype and two 18-month-apart brain volumetric and/or amyloid β burden assessments. Linear mixed models estimated associations of neighborhood walkability with levels and changes in brain imaging outcomes, the moderating effect of APOE ε4 status, and the extent to which associations were explained by physical activity. RESULTS Cross-sectionally, neighborhood walkability was predictive of better neuroimaging outcomes except for left hippocampal volume. These associations were to a small extent explained by physical activity. APOE ε4 carriers showed slower worsening of outcomes if living in walkable neighborhoods. DISCUSSION These findings indicate associations between neighborhood walkability and brain imaging measures (especially in APOE ε4 carriers) minimally attributable to physical activity.
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Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia; School of Public Health, The University of Hong Kong, Hong Kong, China; School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
| | - Stephanie R Rainey-Smith
- Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia; National Ageing Research Institute, Parkville, Victoria, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Joanne S Robertson
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Cogstate Ltd., Melbourne, Victoria, Australia
| | - Ralph N Martins
- Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, Western Australia, Australia; Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
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Kats D, Patel MD, Palta P, Meyer ML, Gross AL, Whitsel EA, Knopman D, Alonso A, Mosley TH, Heiss G. Social support and cognition in a community-based cohort: the Atherosclerosis Risk in Communities (ARIC) study. Age Ageing 2016; 45:475-80. [PMID: 27107128 DOI: 10.1093/ageing/afw060] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/20/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE social support has demonstrated cross-sectional associations with greater cognitive function and a protective effect against cognitive decline in older adults, but exploration of its temporal role in cognitive ageing from mid-life to older adulthood has been limited. We aimed to quantify the associations of social support, assessed at mid-life, with cognitive function in mid-life and with cognitive decline into late life among African Americans and Caucasians. METHODS data from the community-based, prospective Atherosclerosis Risk in Communities (ARIC) cohort of 15,792 biracial participants were examined for baseline and longitudinal associations of mid-life social support with global cognition at mid-life and with 20-year change in global cognition, respectively, stratified by race. Interactions with sociodemographic and cardiometabolic covariates were additionally explored within each race group. Social support was ascertained using two metrics: interpersonal support and social network. RESULTS interpersonal support was directly associated with greater global cognition at baseline in both race groups. Social network was directly associated with greater global cognition at baseline among Caucasians and African American females, but it was not significantly associated with global cognition in African American males. Neither mid-life social support measure was associated with 20-year change in global cognition. CONCLUSIONS higher levels of social support were moderately associated with greater multi-dimensional cognitive function at mid-life, but mid-life social support was not associated with temporal change in global cognitive function over 20 years into late life. Prospective studies with time-dependent measures of social support and cognition are needed to better understand the role of social engagement in ageing-related cognitive functioning.
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Affiliation(s)
- Dmitry Kats
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Mehul D Patel
- Center for Observational and Real World Evidence, Merck & Co., Inc., North Wales, PA, USA
| | - Priya Palta
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Michelle L Meyer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric A Whitsel
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA Department of Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
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Smith-Ray RL, Makowski-Woidan B, Hughes SL. A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact Black older adults. HEALTH EDUCATION & BEHAVIOR 2015; 41:62S-9S. [PMID: 25274713 DOI: 10.1177/1090198114537068] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest declines in executive function experience more falls. The purpose of this study was twofold: to demonstrate the feasibility of a community-based cognitive training program for cognitively intact Black older adults and to analyze its impact on gait and balance in this population. METHOD This pilot study used a pretest/posttest randomized trial design with assignment to an intervention or control group. Participants assigned to the intervention completed a computer-based cognitive training class that met 2 days a week for 60 min over 10 weeks. Classes were held at senior/community centers. Primary outcomes included balance as measured by the Berg Balance Scale (BBS), 10-meter gait speed, and 10-meter gait speed under visuospatial dual-task condition. All measures were assessed at baseline and immediately post-intervention. RESULTS Participants were community-dwelling Black adults with a mean age of 72.5 and history of falls (N = 45). Compared to controls, intervention participants experienced statistically significant improvements in BBS and gait speed. Mean performance on distracted gait speed also improved more for intervention participants compared to controls. CONCLUSION Findings from this pilot randomized trial demonstrate the feasibility of a community-based cognitive training intervention. They provide initial evidence that cognitive training may be an efficacious approach toward improving balance and gait in older adults known to have a history of falls.
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Weaver SM, Portelli JN, Chau A, Cristofori I, Moretti L, Grafman J. Genetic polymorphisms and traumatic brain injury: the contribution of individual differences to recovery. Brain Imaging Behav 2015; 8:420-34. [PMID: 22878895 DOI: 10.1007/s11682-012-9197-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Recovery after Traumatic Brain Injury (TBI) is variable, even for patients with similar severity of brain injury. Recent research has highlighted the contribution that genetic predisposition plays in determining TBI outcome. This review considers the potential for genetic polymorphisms to influence recovery of cognitive and social processes following TBI. Limitations and considerations that researchers should make when assessing the potential impact of polymorphisms on TBI outcome are also discussed. Understanding the genetic factors that support neuroplasticity will contribute to an understanding of the variation in outcome following injury and help to identify potential targets for rehabilitation.
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Affiliation(s)
- Starla M Weaver
- Traumatic Brain Injury Research Laboratory, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA,
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Kimbrel NA, Hauser MA, Garrett M, Ashley-Koch A, Liu Y, Dennis MF, Klein RC, Beckham JC. EFFECT OF THE APOE ε4 ALLELE AND COMBAT EXPOSURE ON PTSD AMONG IRAQ/AFGHANISTAN-ERA VETERANS. Depress Anxiety 2015; 32:307-15. [PMID: 25709077 PMCID: PMC4697754 DOI: 10.1002/da.22348] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/12/2014] [Accepted: 12/11/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The apolipoprotein E (APOE) ε4 allele has been implicated in a range of neuropsychiatric conditions. The present research examined if the ε4 allele of the APOE gene moderated the effect of combat exposure on posttraumatic stress disorder (PTSD) among Iraq/Afghanistan-era veterans. METHOD Participants included 765 non-Hispanic White (NHW) and 859 non-Hispanic Black (NHB) Iraq/Afghanistan-era veterans. A structured interview established psychiatric diagnoses. Combat exposure and PTSD symptom severity were assessed via self-report. RESULTS The most common lifetime diagnoses were depression (39.2%), PTSD (38.4%), and alcohol dependence (24.38%). After correcting for multiple comparisons, no significant effects were observed on any of the outcomes among the NHW sample; however, within the NHB sample, significant gene × environment (G × E) interactions were observed for lifetime PTSD (P = .0029) and PTSD symptom severity (P = .0009). In each case, the APOE ε4 allele had no effect on the outcomes when combat exposure was low; however, when combat exposure was high, an additive effect was observed such that ε4 homozygotes exposed to high levels of combat reported the highest rates of PTSD (92%) and the worst symptom severity scores on the Davidson Trauma Scale (M = 79.5). CONCLUSIONS Although preliminary, these findings suggest that the APOE ε4 allele, in conjunction with exposure to high levels of combat exposure, may increase veterans' risk for developing PTSD.
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Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC,Correspondence concerning this article should be sent to: Dr. Nathan A. Kimbrel, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705. Phone: (919) 286-0411, ext. 6759.
| | - Michael A. Hauser
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Melanie Garrett
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Allison Ashley-Koch
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Yutao Liu
- Department of Medicine, Duke University Medical Center, Durham, NC,Duke Center for Human Genetics, Durham, NC
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Rebecca C. Klein
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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Wu YT, Prina AM, Brayne C. The association between community environment and cognitive function: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2015; 50:351-62. [PMID: 25087013 PMCID: PMC4322216 DOI: 10.1007/s00127-014-0945-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/28/2014] [Indexed: 12/05/2022]
Abstract
PURPOSES The aim of this study is to review the published evidence on the association between community environment and cognitive function in older people, focusing on the findings and a critique of the existing studies. METHODS A literature search was conducted to identify studies linking the community environment and cognitive function in older people. The results and methodological factors, including the definition of community, individual level characteristics and the measurements of cognitive function and community environment were extracted from each study. The measurements of community environment were mainly categorized into two types: compositional, generated by aggregating individual and household data (community-level socioeconomic status, deprivation index) and contextual, targeting at the features of built or social environment in local areas (green space, street conditions, crime rate). RESULTS Fourteen of the fifteen studies used compositional measurements such as community-level socioeconomic status and deprivation index and significant associations were found in eleven studies. Some individual level factors (ethnicity, genotype and socioeconomic status) were found to modify the association between community environment and cognitive function. Few contextual measurements were included in the existing studies. A conceptual framework for the pathway from community environment to cognitive function of older people is provided in this review. CONCLUSIONS To disentangle the additional effect of place from individual risk factors and investigate the casual direction of community environment and cognition in later life, longitudinal studies with measurements targeting built and social environments of community and change of cognitive functions over time need to be included in future studies.
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Affiliation(s)
- Yu-Tzu Wu
- Department of Public Health and Primary Care, Institute of Public Health, Forvie Site, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK,
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Park S, Nam YY, Sim Y, Hong JP. Interactions between the apolipoprotein E ε4 allele status and adverse childhood experiences on depressive symptoms in older adults. Eur J Psychotraumatol 2015; 6:25178. [PMID: 25630472 PMCID: PMC4309830 DOI: 10.3402/ejpt.v6.25178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The influence of childhood adversity on depression is modulated by genetic vulnerability. The apolipoprotein E ε4 (APOE-ε4) allele is a strong genetic risk factor for Alzheimer's disease (AD). Because late-life depressive symptoms could be a part of the preclinical course of AD, the APOE-ε4 allele may contribute to depression in old age. OBJECTIVE The aim of this study was to evaluate whether an APOE-ε4 carrier status was associated with depressive symptoms in older adults and to detect the gene-environment interaction between APOE-ε4 status and childhood adversity in relation to depressive symptoms in old age. METHOD The participants consisted of 137 older adults (age range 50-70) without any psychiatric history or clinically significant cognitive impairment. APOE genotypes and measures of childhood adversity and depressive symptoms were obtained. RESULTS There was a significant positive association between adverse childhood experiences (ACE) scores and depressive symptoms (B=0.60; 95% CI=0.26, 0.93 for a 1 score increase in ACE scores; p=0.001). Although APOE-ε4 status per se was not associated with depressive symptoms, there was a significant interaction of the ACE scores with the APOE genotype in relation to depressive symptoms (B=0.78; 95% CI=0.02, 1.55; p=0.044). There was a significantly higher effect of childhood adversity on depressive symptoms in APOE-ε4 carriers than non-carriers (t=2.13, p=0.035). CONCLUSIONS Our results suggest that the APOE-ε4 may modulate the association between childhood adversity and depressive symptoms in older adults. However, more research in a larger sample is needed to gain a better understanding of the relationship between the APOE-ε4, childhood adversity, and depression.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Yoon-Young Nam
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Yoojin Sim
- Department of Psychiatry, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Seoul, South Korea;
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27
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Krishan S, Bakeman R, Broussard B, Cristofaro SL, Hankerson-Dyson D, Husbands L, Watson AC, Compton MT. The influence of neighborhood characteristics on police officers' encounters with persons suspected to have a serious mental illness. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:359-369. [PMID: 24636571 PMCID: PMC4929689 DOI: 10.1016/j.ijlp.2014.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Police officers' decisions and behaviors are impacted by the neighborhood context in which police encounters occur. For example, officers may use greater force and be more likely to make arrests in disadvantaged neighborhoods. We examined whether neighborhood characteristics influence police encounters with individuals suspected to have a serious mental illness, addictive disorder, or developmental disability. METHOD We obtained data on 916 encounters from 166 officers in six jurisdictions in Georgia, USA and abstracted geographical data pertaining to the location of these encounters from United States Decennial Census data. Encounters were nested within 163 census tracts. Officer-reported data covered general encounter characteristics, the officer's perception of the subject's condition, subject demographics, use of force, and disposition of the encounter (e.g., arrest v. referral or transport to treatment services). Geographical data included 17 variables representing population and housing characteristics of the census tracts, from which three indices pertaining to neighborhood income, stability, and immigration status were derived using factor-analytic techniques. We then examined associations of these indices with various encounter-related variables using multi-level analysis. RESULTS Encounters taking place in higher-income and higher-stability census tracts were more likely to be dispatch-initiated and take place in a private home compared to those in lower-income and lower-stability neighborhoods. In higher-income neighborhoods, encounters were more likely to involve a subject suspected to have a mental illness (as opposed to an addictive disorder or developmental disability) and less likely to involve a subject suspected to have alcohol problems. The officer's level of force used was not associated with neighborhood factors. Regarding disposition, although the likelihood of arrest was unrelated to neighborhood characteristics, encounters taking place in higher-immigrant neighborhoods were more likely to result in referral or transport to services than those in lower-immigrant neighborhoods. CONCLUSION Neighborhood characteristics are important to consider in research on police interactions with individuals with serious mental illnesses, addictive disorders, or developmental disabilities. Such research could inform departmental training policies and procedures based on the needs of the jurisdictions served.
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Affiliation(s)
- Shaily Krishan
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Roger Bakeman
- Georgia State University, Department of Psychology, Atlanta, GA, USA
| | - Beth Broussard
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA
| | - Sarah L Cristofaro
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Dana Hankerson-Dyson
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Letheshia Husbands
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Amy C Watson
- University of Illinois at Chicago, Jane Addams College of Social Work, Chicago, IL, USA
| | - Michael T Compton
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Hofstra North Shore - LIJ School of Medicine at Hofstra University, Department of Psychiatry, Hempstead, NY, USA.
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Sheffler J, Moxley J, Sachs-Ericsson N. Stress, race, and APOE: understanding the interplay of risk factors for changes in cognitive functioning. Aging Ment Health 2014; 18:784-91. [PMID: 24521139 DOI: 10.1080/13607863.2014.880403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Biological and environmental factors are thought to contribute to the development of cognitive decline (CD). The Apolipoprotein E (APOE) ϵ4 allele is the greatest known genetic risk factor. The current study focused on the extent to which environmental factors, specifically stress, influence the relationship between the APOE allele and cognitive functioning and whether this relationship is stronger for African-Americans compared to Caucasians. METHODS Participants consisted of community-dwelling older adults from the Duke Established Populations for Epidemiologic Studies of the Elderly (N = 4,162). Data were drawn from two waves, which were three years apart. Cognitive functioning was assessed at both waves using the Short Portable Mental Status (SPMSQ). RESULTS Whereas there was no main effect of stress, there was a significant interaction between APOE status and stressful life events, such that increased stress in individuals with an ϵ4 allele lead to more errors on the SPMSQ than individuals with no allele. Inconsistent with predictions, there was a significant interaction between stress and race such that increased stressful events predicted CD in Caucasians but not African-Americans. CONCLUSIONS Recent stressful late-life events have a greater impact on the cognitive status of individuals with an ϵ4 allele. While Caucasians appear to be less vulnerable to cognitive losses at lower levels of stress, as the number of stressful life events increases that advantage disappears for Caucasians.
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Affiliation(s)
- Julia Sheffler
- a Department of Psychology , Florida State University , Tallahassee , USA
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29
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Panizzon MS, Hauger R, Xian H, Vuoksimaa E, Spoon KM, Mendoza SP, Jacobson KC, Vasilopoulos T, Rana BK, McKenzie R, McCaffery JM, Lyons MJ, Kremen WS, Franz CE. Interaction of APOE genotype and testosterone on episodic memory in middle-aged men. Neurobiol Aging 2013; 35:1778.e1-8. [PMID: 24444806 DOI: 10.1016/j.neurobiolaging.2013.12.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/19/2013] [Accepted: 12/21/2013] [Indexed: 01/12/2023]
Abstract
Age-related changes in testosterone are believed to be a key component of the processes that contribute to cognitive aging in men. The APOE-ε4 allele may interact with testosterone and moderate the hormone's association with cognition. The goals of the present study were to examine the degree to which free testosterone is associated with episodic memory in a community-based sample of middle-aged men, and examine the potential interaction between free testosterone and the APOE-ε4 allele. Data were used from 717 participants in the Vietnam Era Twin Study of Aging. Average age was 55.4 years (standard deviation = 2.5). Significant positive associations were observed between free testosterone level and verbal episodic memory, as well as a significant interaction between free testosterone and APOE-ε4 status. In ε4 carriers free testosterone was positively associated with verbal episodic memory performance (story recall), whereas no association was observed in ε4 noncarriers. Results support the hypothesis that APOE-ε4 status increases susceptibility to other risk factors, such as low testosterone, which may ultimately contribute to cognitive decline or dementia.
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Affiliation(s)
- Matthew S Panizzon
- Department of Psychiatry, University of California, San Diego, CA, USA; Twin Research Laboratory, Center for Behavioral Genomics, University of California, San Diego, CA, USA.
| | - Richard Hauger
- Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Hong Xian
- Department of Biostatistics, St. Louis University, College for Public Health & Social Justice, St. Louis, MO, USA; Research Service, St. Louis Veterans Affairs Medical Center, St. Louis, MO
| | - Eero Vuoksimaa
- Department of Psychiatry, University of California, San Diego, CA, USA; Twin Research Laboratory, Center for Behavioral Genomics, University of California, San Diego, CA, USA; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kelly M Spoon
- Computational Science Research Center, San Diego State University, San Diego, CA, USA
| | - Sally P Mendoza
- Department of Psychology, University of California, Davis, CA, USA
| | | | | | - Brinda K Rana
- Department of Psychiatry, University of California, San Diego, CA, USA; Twin Research Laboratory, Center for Behavioral Genomics, University of California, San Diego, CA, USA
| | - Ruth McKenzie
- Department of Psychology, Boston University, Boston, MA, USA
| | - Jeanne M McCaffery
- Department of Psychiatry and Human Behavior, The Miriam Hospital and Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Michael J Lyons
- Department of Psychology, Boston University, Boston, MA, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, CA, USA; Twin Research Laboratory, Center for Behavioral Genomics, University of California, San Diego, CA, USA; VA San Diego Healthcare System, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, CA, USA; Twin Research Laboratory, Center for Behavioral Genomics, University of California, San Diego, CA, USA
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Abstract
Cultural constructs prevalent in older African Americans may influence their risk perceptions and knowledge of Alzheimer disease (AD). To examine this issue, we administered 3 sociocultural scales, the AD Knowledge Scale, and a Risk Perception questionnaire to 271 older African Americans who were recruited from a large community senior center and local churches. Higher Present Time Orientation was significantly related to perceptions of having little control over risks to health (P=0.004), God's Will in determining AD (P=0.001), and lower AD knowledge (P<0.0001) and marginally related to having little control over developing AD (P=0.052). Religiosity was marginally related to having little control over risks to health (P=0.055) and getting AD (P=0.057). Post hoc intergroup comparisons found significant differences in the highest versus lowest scoring Religiosity groups. There were no significant differences by Future Time Orientation. Most subjects (57.6%) were unaware that African Americans were at higher risk for AD than whites. These data indicate that cultural diversity within older African Americans may shape health perceptions and knowledge of AD. This diversity may contribute to disparities in the detection and treatment of AD in this high-risk population.
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Lyons MJ, Genderson M, Grant MD, Logue M, Zink T, McKenzie R, Franz CE, Panizzon M, Lohr JB, Jerskey B, Kremen WS. Gene-environment interaction of ApoE genotype and combat exposure on PTSD. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:762-9. [PMID: 24132908 PMCID: PMC4745646 DOI: 10.1002/ajmg.b.32154] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/06/2013] [Indexed: 01/14/2023]
Abstract
Factors determining who develops PTSD following trauma are not well understood. The €4 allele of the apolipoprotein E (apoE) gene is associated with dementia and unfavorable outcome following brain insult. PTSD is also associated with dementia. Given evidence that psychological trauma adversely affects the brain, we hypothesized that the apoE genotype moderates effects of psychological trauma on PTSD pathogenesis. To investigate the moderation of the relationship between PTSD symptoms and combat exposure, we used 172 participants with combat trauma sustained during the Vietnam War. PTSD symptoms were the dependent variable and number of combat experiences, apoE genotype, and the combat experiences × apoE genotype interaction were predictors. We also examined the outcome of a diagnosis of PTSD (n = 39) versus no PTSD diagnosis (n = 131). The combat × apoE genotype interaction was significant for both PTSD symptoms (P = .014) and PTSD diagnosis (P = .009). ApoE genotype moderates the relationship between combat exposure and PTSD symptoms. Although the pathophysiology of PTSD is not well understood, the €4 allele is related to reduced resilience of the brain to insult. Our results are consistent with the €4 allele influencing the effects of psychological trauma on the brain, thereby affecting the risk of PTSD.
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Affiliation(s)
- Michael J. Lyons
- Boston University, Boston, Massachusetts,Correspondence to: Michael J. Lyons, Ph.D., Department of Psychology, Boston University, 64 Cummington Mall, Boston, MA 02215,
| | | | | | - Mark Logue
- Boston University, Boston, Massachusetts
| | - Tyler Zink
- Boston University, Boston, Massachusetts
| | | | - Carol E. Franz
- School of Medicine, University of California, San Diego, California
| | - Matthew Panizzon
- School of Medicine, University of California, San Diego, California
| | - James B. Lohr
- School of Medicine, University of California, San Diego and VA San Diego Healthcare System, San Diego, California
| | - Beth Jerskey
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - William S. Kremen
- School of Medicine, University of California, San Diego and VA San Diego Healthcare System, San Diego, California
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Binbay T, Drukker M, Alptekin K, Elbi H, Aksu Tanık F, Özkınay F, Onay H, Zağlı N, van Os J. Evidence that the wider social environment moderates the association between familial liability and psychosis spectrum outcome. Psychol Med 2012; 42:2499-2510. [PMID: 22717152 DOI: 10.1017/s0033291712000700] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Familial liability to both severe and common mental disorder predicts psychotic disorder and psychotic symptoms, and may be used as a proxy in models examining interaction between genetic risk and the environment at individual and contextual levels. METHOD In a representative general population sample (n=4011) in Izmir, Turkey, the full spectrum of expression of psychosis representing (0) no symptoms, (1) subclinical psychotic experiences, (2) low-impact psychotic symptoms, (3) high-impact psychotic symptoms and (4) full-blown clinical psychotic disorder was assessed in relation to mental health problems in the family (proxy for familial liability) and the wider social environment. Quality of the wider social environment was assessed in an independent sample using contextual measures of informal social control, social disorganization, unemployment and low income, aggregated to the neighbourhood level. RESULTS The association between familial liability to severe mental illness and expression of psychosis spectrum was stronger in more deprived neighbourhoods [e.g. this association increased from β=0.33 (p=0.01) in low-unemployment neighbourhoods to β=0.92 (p<0.001) in high-unemployment neighbourhoods] and in neighbourhoods high in social control, while neighbourhood variables did not modify the association between familial liability to common mental disorder and the psychosis outcome. Neighbourhood variables mediated urbanicity effects. CONCLUSIONS Contextual effects may be important in moderating the expression of psychosis liability in populations, representing a specific pathway independent of the link between common mental disorder and psychosis.
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Affiliation(s)
- T Binbay
- Department of Psychiatry, Atatürk State Hospital, Sinop, Turkey
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Dar-Nimrod I, Chapman BP, Robbins JA, Porsteinsson A, Mapstone M, Duberstein PR. Gene by neuroticism interaction and cognitive function among older adults. Int J Geriatr Psychiatry 2012; 27:1147-54. [PMID: 23042108 PMCID: PMC3466473 DOI: 10.1002/gps.3759] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/17/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Both apolipoprotein E (ApoE) ε-4 allele(s) and elevated trait neuroticism, the tendency to experience distress, are associated with cognitive function among older adults. We predicted that neuroticism moderates the association between ApoE and cognitive function and also explored whether other personality dimensions (openness to experience, agreeableness, extraversion, and conscientiousness) affect the association between ApoE status and cognitive function. METHOD Five-hundred and ninety-seven older adults (mean age of 78 years) enrolled in the Ginkgo Evaluation of Memory study completed the NEO five-factor inventory of personality. Cognitive function was assessed via the cognitive portion of the Alzheimer's Disease Assessment Scale, and a blood sample for ApoE genotyping was drawn. RESULTS As hypothesized, regression analysis indicated that neuroticism moderated the relationship between the presence of ApoE ε-4 and cognitive function. Individuals with high neuroticism scores had significantly lower scores on the cognitive portion of the Alzheimer's Disease Assessment Scale compared with individuals with low neuroticism scores, but this was true only among carriers of ApoE ε-4 (interaction effect β = 0.124, p = 0.028). There was scant evidence that other personality dimensions moderate the association between ApoE ε-4 and cognitive function. CONCLUSIONS Cognitive function may be affected by ApoE and neuroticism acting in tandem. Research on the underlying physiological mechanisms by which neuroticism amplifies the effect of ApoE ε-4 is warranted. The study of genotype by phenotype interactions provides an important and useful direction for the study of cognitive function among older adults and for the development of novel prevention programs.
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Affiliation(s)
- Ilan Dar-Nimrod
- Department of Psychiatry and Laboratory of Personality and Development, University of Rochester Medical Center, Rochester, NY, USA.
| | - Benjamin P. Chapman
- Department of Psychiatry and Laboratory of Personality and Development, University of Rochester Medical Center, Rochester, NY, USA
| | - John A. Robbins
- Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Anton Porsteinsson
- Department of Psychiatry and Alzheimer’s Disease Care, Research and Education Program, University of Rochester Medical Center, Rochester, NY, USA
| | - Mark Mapstone
- Department of Neurology and Alzheimer’s Disease Care, Research and Education Program, University of Rochester Medical Center, Rochester, NY, USA
| | - Paul R. Duberstein
- Department of Psychiatry and Laboratory of Personality and Development, University of Rochester Medical Center, Rochester, NY, USA
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Neighborhood Influences on Late Life Cognition in the ACTIVE Study. J Aging Res 2012; 2012:435826. [PMID: 22966458 PMCID: PMC3433144 DOI: 10.1155/2012/435826] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 06/10/2012] [Accepted: 06/30/2012] [Indexed: 11/23/2022] Open
Abstract
Low neighborhood-level socioeconomic status has been associated with poorer health, reduced physical activity, increased psychological stress, and less neighborhood-based social support. These outcomes are correlates of late life cognition, but few studies have specifically investigated the neighborhood as a unique source of explanatory variance in cognitive aging. This study supplemented baseline cognitive data from the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study with neighborhood-level data to investigate (1) whether neighborhood socioeconomic position (SEP) predicts cognitive level, and if so, whether it differentially predicts performance in general and specific domains of cognition and (2) whether neighborhood SEP predicts differences in response to short-term cognitive intervention for memory, reasoning, or processing speed. Neighborhood SEP positively predicted vocabulary, but did not predict other general or specific measures of cognitive level, and did not predict individual differences in response to cognitive intervention.
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Boardman JD, Barnes LL, Wilson RS, Evans DA, Mendes de Leon CF. Social disorder, APOE-E4 genotype, and change in cognitive function among older adults living in Chicago. Soc Sci Med 2012; 74:1584-90. [PMID: 22465377 DOI: 10.1016/j.socscimed.2012.02.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 12/21/2011] [Accepted: 02/07/2012] [Indexed: 01/20/2023]
Abstract
The goal of this paper is to describe the simultaneous influence of social and genetic risk factors on declines in cognitive functioning among older American adults. We use detailed information about the social characteristics of older adults' neighborhoods from the Chicago Health and Aging Project (n = 1655; ages 65+) in conjunction with information about respondent's APOE genotype to predict changes in cognitive function over time. Results indicate that the presence of the ε4 allele is associated with a significantly lower cognitive function score at baseline and greater declines in cognitive function compared to those without this risk allele. Importantly, we also show significant variation in the effect of the ε4 allele across neighborhoods and our results indicate that this genotype is more strongly associated with cognitive function for residents of neighborhoods with the lowest levels of social disorder. Our findings support the non-causal social push gene-environment interaction model.
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Affiliation(s)
- Jason D Boardman
- Institute of Behavioral Science, University of Colorado, 1440 15th St., Boulder, CO 80303, USA.
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