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Song Y, Liu Y, Bai X, Yu H. Effects of neighborhood built environment on cognitive function in older adults: a systematic review. BMC Geriatr 2024; 24:194. [PMID: 38408919 PMCID: PMC10898015 DOI: 10.1186/s12877-024-04776-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/03/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND In the background of an aging population, the risk of cognitive impairment in the older population is prominent. Exposure to complex neighborhood built environments may be beneficial to the cognitive health of older adults, and the purpose of this study was to systematically review the scientific evidence on the effects of neighborhood built environments on cognitive function in older adults. METHODS Keywords and references were searched in Web of Science, Pubmed, PsycINFO, and MEDLINE. Studies examining the relationship between the built environment and cognitive function in older adults were included. The neighborhood built environment as an independent variable was classified according to seven aspects: density, design, diversity, destination accessibility, public transportation distance, blue/green space, and built environment quality. The cognitive function as the dependent variable was classified according to overall cognitive function, domain-specific cognitive function, and incidence of dementia. The quality of the included literature was assessed using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool. RESULTS A total of 56 studies were included that met the inclusion criteria, including 31 cross-sectional studies, 23 longitudinal studies, 1 cross-sectional study design combined with a case-control design, and 1 longitudinal study design combined with a case-control design. Most of the studies reviewed indicate that the built environment factors that were positively associated with cognitive function in older adults were population density, street connectivity, walkability, number of public transportation stops around the residence, land use mix, neighborhood resources, green space, and quality of the neighborhood built environment. Built environment factors that were negatively associated with cognitive function in older adults were street integration, distance from residence to main road. The relationship between residential density, destination accessibility, and blue space with cognitive function in older adults needs to be further explored. CONCLUSION Preliminary evidence suggests an association between the neighborhood built environment and cognitive function in older adults. The causal relationship between the built environment and cognitive function can be further explored in the future using standardized and combined subjective and objective assessment methods, and longitudinal or quasi-experimental study designs. For public health interventions on the cognitive health of older adults, it is recommended that relevant authorities include the neighborhood built environment in their intervention programs.
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Affiliation(s)
- Yiling Song
- Department of Physical Education, Tsinghua University, Beijing, 100084, China
| | - Yunxi Liu
- Graduate School of Commerce, Waseda University, Tokyo, 169-8050, Japan
| | - Xiaotian Bai
- Department of Physical Education, Tsinghua University, Beijing, 100084, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, 100084, China.
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Ye Z, Li X, Lang H, Xin J, Xu H, Fang Y. Long-term effect of extreme temperature on cognitive function of middle-aged and older adults in China. Int J Geriatr Psychiatry 2024; 39:e6063. [PMID: 38400786 DOI: 10.1002/gps.6063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/27/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Several studies have explored the association between temperature and cognitive function. However, few studies have examined the effect of extreme temperature on cognitive function. In this study, we aimed to quantify the long-term effect of extreme temperature (e.g., heat waves, cold spells, and hot night excess (HNE)) on cognitive performance in middle-aged and older people in China. METHOD We investigated 7915 aged >45 years people from the China Health and Retirement Longitudinal Study (CHARLS), surveyed in 2011 and 2015. A structured questionnaire was utilized to assess cognitive function, including four dimensions: episodic memory, attention, orientation, and visuo-construction. Hourly ambient temperature from the ERA5-Land datasets were used to calculate variables indicating extreme temperature. We performed difference-in-difference (DID) models to assess the potential causal relationship between extreme temperature and cognitive function. RESULTS Non-linear analyses suggested that both sustained increases in temperature and excessive variability in temperature increased the risk of cognitive decline. Meanwhile, we observed the extra risk of global cognitive function decline was 2.3% (95% Confidence interval (95% CI): 0.2%, 4.4%) for heat waves (one unit increase) and 5.9% (95% CI: 0.6%, 11.6%) for HNE (one unit increase), while the association for cold spells was insignificant. Two cognitive dimensions, episodic memory and visuo-construction, were sensitive to these two heat-related factors. CONCLUSION Extreme temperature was inversely related to cognitive performance in middle-aged and older adults, which was substantial for heat waves and HNE particularly. The effect size varied by cognitive dimensions.
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Affiliation(s)
- Zirong Ye
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Xueru Li
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Haoxiang Lang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Jiawei Xin
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Haibin Xu
- Fujian Medical University, Fuzhou, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
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Pozzi FE, Remoli G, Tremolizzo L, Appollonio I, Ferrarese C, Cuffaro L. Brain Health and Cognition in Older Adults: Roadmap and Milestones towards the Implementation of Preventive Strategies. Brain Sci 2024; 14:55. [PMID: 38248270 PMCID: PMC10813413 DOI: 10.3390/brainsci14010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
In this narrative review, we delve into the evolving concept of brain health, as recognized by the WHO, focusing on its intersection with cognitive decline. We emphasize the imperative need for preventive strategies, particularly in older adults. We describe the target population that might benefit the most from risk-based approaches-namely, people with subjective cognitive decline. Additionally, we consider universal prevention in cognitively unimpaired middle-aged and older adults. Delving into multidomain personalized preventive strategies, we report on empirical evidence surrounding modifiable risk factors and interventions crucial in mitigating cognitive decline. Next, we highlight the emergence of brain health services (BHS). We explain their proposed role in risk assessment, risk communication, and tailored interventions to reduce the risk of dementia. Commenting on ongoing BHS pilot experiences, we present the inception and framework of our own BHS in Monza, Italy, outlining its operational structure and care pathways. We emphasize the need for global collaboration and intensified research efforts to address the intricate determinants of brain health and their potential impact on healthcare systems worldwide.
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Affiliation(s)
- Federico Emanuele Pozzi
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Giulia Remoli
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Lucio Tremolizzo
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Ildebrando Appollonio
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Carlo Ferrarese
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
| | - Luca Cuffaro
- School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy; (G.R.); (L.T.); (I.A.); (C.F.); (L.C.)
- Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
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Oeser P, Bruckmann N, Gellert P, Herrmann WJ. Older adults' suggestions of research topics on ageing well in urban environments - A participatory study. PLoS One 2023; 18:e0292214. [PMID: 37792854 PMCID: PMC10550106 DOI: 10.1371/journal.pone.0292214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Ageing societies and urbanization are global phenomena that pose new challenges for care delivery. It is important to create a scientific evidence base to prepare for these changes. Hence, the aim of our study was to assess which research agenda older adults living in an urban environment in Germany suggest. METHODS A total of 1000 participants aged 65 years or older from five different neighborhoods of Berlin were randomly chosen and were sent a single item questionnaire allowing them to freely propose research topics regarding ageing well in the city. Codes were developed inductively and clustered into categories. In a second stage, these results were discussed with the participants and local stakeholders in a workshop and video calls. RESULTS 102 persons suggested 18 research topics in 6 categories: health, living environment, social issues, mobility, and accessibility to information and communication. Proposed research topics ranged from accessibility of health care, green spaces and recreational means to social involvement and loneliness. CONCLUSION There is a substantial interest of older adults for research regarding their living situation. Research projects and local urban planning committees are encouraged to invite older adults to participate and integrate their perspectives suggested by older adults.
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Affiliation(s)
- Philip Oeser
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nora Bruckmann
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfram J. Herrmann
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Walsh S, Roscoe H, Mathie E, Wallace L, Govia I, Brayne C. Exploring English policymakers' attitudes towards dementia risk reduction: A qualitative study. Int J Geriatr Psychiatry 2023; 38:e6009. [PMID: 37794627 DOI: 10.1002/gps.6009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
AIM A growing evidence-base indicates that dementia occurrence can be changed. This has been linked to potentially modifiable risk factors. Risk reduction and primary prevention strategies are increasingly recognized as needing to include population-level policies to tackle the social and commercial determinants of health. How this knowledge can influence policymaking on dementia prevention is unknown. Understanding attitudes of policymakers is an important step in translating evidence into practice, helping to gauge system readiness for implementation, and potential barriers and enablers for influencing policy. The aim of this qualitative study is to explore the understanding of, and attitudes to, dementia risk reduction and population-level prevention strategies amongst English policymakers at national, regional, and local level. METHODS Semi-structured interviews were undertaken with a range of dementia and prevention policymakers, with purposive sampling of national and local policymakers, including politicians, government officials, health system leaders, academics, and dementia charity directors. Analysis of interview transcripts was undertaken by thematic analysis. RESULTS 14 policymakers were interviewed between November 2021 and February 2022. Three main themes were identified (1) Preventability of dementia, (2) Prevention approach, (3) Barriers and facilitators to improving the approach. DISCUSSION Policymakers generally held dementia to be partially preventable. Policymakers recognised that both individual- and population-level approaches to primary prevention of dementia are required - with some policymakers perceiving that population-level approaches are under-utilised. Key barriers to implementing more population-level approaches were identified as the complexity and co-ordination required to effectively tackle upstream determinants of health.
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Affiliation(s)
- Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Hannah Roscoe
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Elspeth Mathie
- Centre for Research in Public Health and Community Care, College Lane, University of Hertfordshire, Hatfield, UK
| | - Lindsay Wallace
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
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6
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Riedel-Heller S, Jessen F. [Prevention of dementia]. DER NERVENARZT 2023; 94:373-374. [PMID: 37140599 DOI: 10.1007/s00115-023-01474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 05/05/2023]
Affiliation(s)
- Steffi Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
| | - Frank Jessen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Uniklinik Köln, Köln, Deutschland
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Röhr S, Pabst A, Baber R, Engel C, Glaesmer H, Hinz A, Schroeter ML, Witte AV, Zeynalova S, Villringer A, Löffler M, Riedel-Heller SG. Socioeconomic Inequalities in Cognitive Functioning Only to a Small Extent Attributable to Modifiable Health and Lifestyle Factors in Individuals Without Dementia. J Alzheimers Dis 2022; 90:1523-1534. [PMID: 36278347 DOI: 10.3233/jad-220474] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are socioeconomic inequalities in dementia risk. Underlying pathways are not well known. OBJECTIVE To investigate whether modifiable health and lifestyle factors for brain health mediate the association of socioeconomic status (SES) and cognitive functioning in a population without dementia. METHODS The "LIfestyle for BRAin health" (LIBRA) score was computed for 6,203 baseline participants of the LIFE-Adult-Study. LIBRA predicts dementia in midlife and early late life, based on 12 modifiable factors. Associations of SES (education, net equivalence income, and occupational status) and LIBRA with cognitive functioning (composite score) were investigated using adjusted linear regression models. Bootstrapped structural equation modelling (SEM) was used to investigate whether LIBRA mediated the association of SES and cognitive functioning. RESULTS Participants were M = 57.4 (SD = 10.6, range: 40-79) years old; 50.3% were female. Both, SES (Wald: F(2)=52.5, p < 0.001) and LIBRA (Wald: F(1)=5.9, p < 0.05) were independently associated with cognitive functioning; there was no interaction (Wald: F(2)=2.9, p = 0.060). Lower SES and higher LIBRA scores indicated lower cognitive functioning. LIBRA partially mediated the association of SES and cognitive functioning (IE: =0.02, 95% CI [0.02, 0.03], p < 0.001). The proportion mediated was 12.7%. CONCLUSION Differences in cognitive functioning due to SES can be partially attributed to differences in modifiable health and lifestyle factors; but to a small extent. This suggests that lifestyle interventions could attenuate socioeconomic inequalities in cognitive functioning. However, directly intervening on the social determinants of health may yield greater benefits for dementia risk reduction.
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Affiliation(s)
- Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.,Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.,School of Psychology, Massey University, Manawatū Campus, Palmerston North, New Zealand
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ronny Baber
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - A Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Samira Zeynalova
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Markus Löffler
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
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Social determinants and lifestyle factors for brain health: implications for risk reduction of cognitive decline and dementia. Sci Rep 2022; 12:12965. [PMID: 35902604 PMCID: PMC9334303 DOI: 10.1038/s41598-022-16771-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/15/2022] [Indexed: 11/08/2022] Open
Abstract
Substantial evidence indicates a huge potential for risk reduction of cognitive decline and dementia based on modifiable health and lifestyle factors. To maximize the chances for risk reduction, it is useful to investigate associations of social determinants and lifestyle for brain health. We computed the "LIfestyle for BRAin health" (LIBRA) score for baseline participants of the Leipzig Research Centre for Civilization Diseases (LIFE) Adult Study, a population-based urban cohort in Germany. LIBRA predicts dementia in midlife and early late life populations, comprising 12 modifiable risk factors (heart disease, kidney disease, diabetes, obesity, hypertension, hypercholesterolemia, alcohol consumption, smoking, physical inactivity, diet, depression, cognitive inactivity). Associations of social determinants (living situation, marital status, social isolation, education, net equivalence income, occupational status, socioeconomic status/SES, employment) with LIBRA were inspected using age- and sex-adjusted multivariable linear regression analysis. Z-standardization and sampling weights were applied. Participants (n = 6203) were M = 57.4 (SD = 10.6, range 40-79) years old and without dementia, 53.0% were women. Except for marital status, all considered social determinants were significantly associated with LIBRA. Beta coefficients for the association with higher LIBRA scores were most pronounced for low SES (β = 0.80, 95% CI [0.72-0.88]; p < 0.001) and middle SES (β = 0.55, 95% CI [0.47-0.62]; p < 0.001). Social determinants, particularly socioeconomic factors, are associated with lifestyle for brain health, and should thus be addressed in risk reduction strategies for cognitive decline and dementia. A social-ecological public health perspective on risk reduction might be more effective and equitable than focusing on individual lifestyle behaviors alone.
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Daly T. Ethics, evidence, and the environment in dementia risk reduction. THE LANCET. HEALTHY LONGEVITY 2022; 3:e131. [PMID: 36098288 DOI: 10.1016/s2666-7568(22)00028-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Timothy Daly
- Sorbonne Université, Science, Norms, Democracy, UMR 8011, Paris, 75005, France.
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Daly T. Giving a fairer face to urban space: Progress on the long road to dementia prevention. Int J Geriatr Psychiatry 2022; 37. [PMID: 34792218 DOI: 10.1002/gps.5657] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Timothy Daly
- Sorbonne Université, Sciences Norms Democracy, Paris, France
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Röhr S, Riedel-Heller SG. [A Lot of Room for Improvement: Primary Prevention of Cognitive Disorders and Dementia from the Public Health Perspective]. PSYCHIATRISCHE PRAXIS 2021; 48:391-394. [PMID: 34741284 DOI: 10.1055/a-1666-8540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Susanne Röhr
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Deutschland.,Global Brain Health Institute (GBHI), Trinity College Dublin, Ireland
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Deutschland
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