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Cerin E, Soloveva MV, Molina MA, Schroers RD, Knibbs LD, Akram M, Wu YT, Mavoa S, Prina M, Sachdev PS, Sorensen Catts V, Jalaludin B, Poudel G, Symmons M, Barnett A, Hamidul Huque M, Leung Y, Cherbuin N, Anstey KJ. Neighbourhood environments and cognitive health in the longitudinal Personality and Total Health (PATH) through life study: A 12-year follow-up of older Australians. ENVIRONMENT INTERNATIONAL 2024; 191:108984. [PMID: 39208561 DOI: 10.1016/j.envint.2024.108984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/17/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Urban neighbourhood environments may impact older adults' cognitive health. However, longitudinal studies examining key environmental correlates of cognitive health are lacking. We estimated cross-sectional and longitudinal associations of neighbourhood built and natural environments and ambient air pollution with multiple cognitive health outcomes in Australian urban dwellers aged 60+ years. METHODS The study included 1160 participants of the PATH Through Life study (60+ cohort) who were followed up for 12 years (four assessments; 2001/02 to 2013/15) and with data on socio-demographics, health, cognitive functions and diagnoses, and full residential address. Neighbourhood environmental features encompassed population and street-intersection densities, non-commercial land use mix, transit points, presence of blue space, percentages of commercial land, parkland and tree cover, and annual average PM2.5 and NO2 concentrations. All exposures except for tree cover were assessed at two time points. Generalised additive mixed models estimated associations of person-level average, and within-person changes in, exposures with cognitive functions. Multi-state hidden Markov models estimated the associations of neighbourhood attributes with transitions to/from mild cognitive impairment (MCI). RESULTS Dense, destination-rich neighbourhoods were associated with a lower likelihood of transition to MCI and reversal to no MCI. Positive cross-sectional and longitudinal associations of non-commercial land use mix, street intersection density and percentage of commercial land were observed especially with global cognition and processing speed. While access to parkland and blue spaces were associated with a lower risk of transition to MCI, the findings related to cognitive functions were mixed and supportive of an effect of parkland on verbal memory only. Higher levels of PM2.5 and NO2 were consistently associated with steeper declines and/or decreases in cognitive functions and worse cognitive states across time. CONCLUSION To support cognitive health in ageing populations, neighbourhoods need to provide an optimal mix of environmental complexity, destinations and access to the natural environment and, at the same time, minimise ambient air pollution.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.
| | - Maria V Soloveva
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Miguel A Molina
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Ralf-Dieter Schroers
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, New South Wales, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.
| | - Muhammad Akram
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Yu-Tzu Wu
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Suzanne Mavoa
- Population Health, Murdoch Children's Research Institute, Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia.
| | - Matthew Prina
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Vibeke Sorensen Catts
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW, Sydney, Australia.
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Randwick, New South Wales, Australia.
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Mark Symmons
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | - Md Hamidul Huque
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia.
| | - Yvonne Leung
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia.
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Canberra, Australian Capital Territory, Australia.
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Randwick, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia; UNSW Ageing Futures Institute, Sydney, Australia.
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Astell-Burt T, Navakatikyan MA, Feng X. Why might urban tree canopy reduce dementia risk? A causal mediation analysis of 109,688 adults with 11 years of hospital and mortality records. Health Place 2023; 82:103028. [PMID: 37182375 DOI: 10.1016/j.healthplace.2023.103028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023]
Abstract
Urban tree canopy is associated with lower dementia risk, but no mediation analysis has been attempted to reveal potential mechanisms. We examined 3,639 dementia diagnoses in 109,688 participants of the Sax Institute's 45 and Up Study. Adjusted models indicated ≥20% tree canopy lowered the odds of developing dementia by 14% over 11 years (Odds Ratio = 0.86, 95%CI = 0.79-0.93). Association between tree canopy and dementia was partially mediated by physical activity (4.5%) and absences of psychological distress (5.7%), social support (2.9%), sleep duration (2.3%) and diabetes (1.8%). Social loneliness and absence of heart disease or hypertension did not mediate the tree canopy-dementia association.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia.
| | - Michael A Navakatikyan
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Population Health, University of New South Wales, Sydney, Australia; The George Institute of Global Health, Sydney, NSW, Australia
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Besser LM, Jimenez MP, Reimer CJ, Meyer OL, Mitsova D, George KM, Adkins-Jackson PB, Galvin JE. Diversity of Studies on Neighborhood Greenspace and Brain Health by Racialized/Ethnic Group and Geographic Region: A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5666. [PMID: 37174185 PMCID: PMC10178609 DOI: 10.3390/ijerph20095666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Studies examining associations between greenspace and Alzheimer's disease and related dementia (ADRD) outcomes are rapidly on the rise, yet no known literature reviews have summarized the racialized/ethnic group and geographic variation of those published studies. This is a significant gap given the known disparities in both greenspace access and ADRD risk between racialized/ethnic groups and between developed versus developing countries. In this rapid literature review, we (1) describe the diversity of published greenspace-brain health studies with respect to racialized/ethnic groups and geographic regions; (2) determine the extent to which published studies have investigated racialized/ethnic group differences in associations; and (3) review methodological issues surrounding studies of racialized/ethnic group disparities in greenspace and brain health associations. Of the 57 papers meeting our inclusion criteria as of 4 March 2022, 21% (n = 12) explicitly identified and included individuals who were Black, Hispanic/Latinx, and/or Asian. Twenty-one percent of studies (n = 12) were conducted in developing countries (e.g., China, Dominican Republic, Mexico), and 7% (n = 4) examined racialized/ethnic group differences in greenspace-brain health associations. None of the studies were framed by health disparities, social/structural determinants of health, or related frameworks, despite the known differences in both greenspace availability/quality and dementia risk by racialized/ethnic group and geography. Studies are needed in developing countries and that directly investigate racialized/ethnic group disparities in greenspace-brain health associations to target and promote health equity.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
| | - Marcia Pescador Jimenez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Cameron J. Reimer
- Department of Earth & Environment, Boston University, Boston, MA 02118, USA
| | - Oanh L. Meyer
- Department of Neurology, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Diana Mitsova
- School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Kristen M. George
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA 95817, USA
| | - Paris B. Adkins-Jackson
- Departments of Epidemiology and Sociomedical Sciences, Columbia University, New York, NY 10032, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
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Slawsky ED, Hoffman JC, Cowan KN, Rappazzo KM. Beneficial Use Impairments, Degradation of Aesthetics, and Human Health: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106090. [PMID: 35627644 PMCID: PMC9142078 DOI: 10.3390/ijerph19106090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/16/2022]
Abstract
In environmental programs and blue/green space development, improving aesthetics is a common goal. There is broad interest in understanding the relationship between ecologically sound environments that people find aesthetically pleasing and human health. However, to date, few studies have adequately assessed this relationship, and no summaries or reviews of this line of research exist. Therefore, we undertook a systematic literature review to determine the state of science and identify critical needs to advance the field. Keywords identified from both aesthetics and loss of habitat literature were searched in PubMed and Web of Science databases. After full text screening, 19 studies were included in the review. Most of these studies examined some measure of greenspace/bluespace, primarily proximity. Only one study investigated the impacts of making space quality changes on a health metric. The studies identified for this review continue to support links between green space and various metrics of health, with additional evidence for blue space benefits on health. No studies to date adequately address questions surrounding the beneficial use impairment degradation of aesthetics and how improving either environmental quality (remediation) or ecological health (restoration) efforts have impacted the health of those communities.
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Affiliation(s)
- Erik D. Slawsky
- Oak Ridge Associated Universities (ORAU) Student Services Contractor at US EPA, Research Triangle Park, NC 27711, USA;
| | - Joel C. Hoffman
- Center for Computational Toxicology & Exposure, Office of Research and Development, US Environmental Protection Agency, Duluth, MN 55804, USA;
| | - Kristen N. Cowan
- Oak Ridge Institute for Science and Education (ORISE) United States Environmental Protection Agency (US EPA), Research Triangle Park, NC 27711, USA; or
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Kristen M. Rappazzo
- Center for Public Health & Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA
- Correspondence: ; Tel.: +1-919-966-6205
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Slawsky ED, Hajat A, Rhew IC, Russette H, Semmens EO, Kaufman JD, Leary CS, Fitzpatrick AL. Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study. Environ Health 2022; 21:14. [PMID: 35033073 PMCID: PMC8760791 DOI: 10.1186/s12940-022-00830-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/06/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. METHODS Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. RESULTS Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. CONCLUSIONS This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
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Zagnoli F, Filippini T, Jimenez MP, Wise LA, Hatch EE, Vinceti M. Is Greenness Associated with Dementia? A Systematic Review and Dose-Response Meta-analysis. Curr Environ Health Rep 2022; 9:574-590. [PMID: 35857243 PMCID: PMC9729322 DOI: 10.1007/s40572-022-00365-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW We assessed the relation between environmental greenness and risk of dementia and cognitive impairment, based on a systematic review and meta-analysis up to March 30, 2022, characterizing whenever possible the shape of the association using dose-response meta-analysis. RECENT FINDINGS Twelve studies were included in this review, either using normalized difference vegetation index (NDVI) or land use/cover (LU/LC) methodology to assess greenness. Comparing the highest versus lowest exposure categories of greenness assessed using the NDVI (6 studies) or LU/LC (6 studies), we found no association with dementia. Dose-response meta-analysis of the association between greenness measured by LU/LC and dementia, based on only 3 studies, indicated a U-shaped association, but estimates were imprecise. Our systematic review and meta-analysis provided some evidence of a slight inverse association between greenness and dementia at intermediate exposure levels, but not at high levels. Potential methodological limitations, such as exposure misclassification and unmeasured confounding, may have affected the results.
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Affiliation(s)
- Federico Zagnoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,School of Public Health, University of California Berkeley, Berkeley, CA 94704 USA
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
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Green Space and Health in Mainland China: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189937. [PMID: 34574854 PMCID: PMC8472560 DOI: 10.3390/ijerph18189937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Abstract
Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.
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Harwell MC, Jackson CA. Synthesis of Two Decades of US EPA's Ecosystem Services Research to Inform Environmental, Community, and Sustainability Decision Making. SUSTAINABILITY 2021; 13:1-8249. [PMID: 34804601 PMCID: PMC8597581 DOI: 10.3390/su13158249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A conceptual framework is helpful to understand what types of ecosystem services (ES) information is needed to support decision making. Principles of structured decision making are helpful for articulating how ES consideration can influence different elements in a given decision context resulting in changes to the environment, human health, and well-being. This article presents a holistic view of an ES framework, summarizing two decades of the US EPA's ES research, including recent advances in final ES, those ES that provide benefits directly to people. Approximately 150 peer-reviewed publications, technical reports, and book chapters characterize a large ES research portfolio. In introducing framework elements and the suite of relevant US EPA research for each element, both challenges and opportunities are identified. Lessons from research to advance each of the final ES elements can be useful for identifying gaps and future science needs. Ultimately, the goal of this article is to help the reader develop an operational understanding of the final ES conceptual framework, an understanding of the state of science for a number of ES elements, and an introduction to some ES tools, models, and frameworks that may be of use in their case-study applications or decision-making contexts.
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Affiliation(s)
| | - Chloe A. Jackson
- US EPA, Gulf Ecosystem Measurement and Modeling Division, Gulf Breeze, FL 32561, USA
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