Yin Yuan1,2,3,4, Feng Huang1,2,3,4, Fan Lin1,2,3,4, Pengyi Zhu5, Pengli Zhu6,7,8,9. 1. The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China. 2. Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China. 3. Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China. 4. Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China. 5. School of Economics, Fujian Normal University, Fuzhou, China. 962383745@qq.com. 6. The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China. zpl7755@hotmail.com. 7. Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China. zpl7755@hotmail.com. 8. Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China. zpl7755@hotmail.com. 9. Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China. zpl7755@hotmail.com.
Abstract
BACKGROUND: With the launch of the "Global Age-Friendly Cities project", increasing emphasis has been placed on the effects of green spaces on health in the elderly. The previous literature has shown that green spaces are beneficial to a range of health-related outcomes in adults. However, associations of greenness with mortality and cardiovascular outcomes are less certain, which may differ depending on the age class. This review aimed to synthesize current evidence from observational studies to assess relationships of green space exposure with mortality and cardiovascular outcomes in older individuals. METHODS: Five databases were searched. Qualitative evaluation and meta-analyses of included studies were conducted. This review is registered with PROSPERO, CRD42020160366. RESULTS: Of the 8,143 records identified, we finally included 22 studies. In a narrative systematic review, we observed that the majority of studies showed reductions in the risk of all-cause mortality and total cardiovascular disease. Further meta-analyses which included eight cohort studies, indicated that greater greenness exposure (per 0.1 unit increase of normalized difference vegetation index (NDVI)) was associated with a reduced risk of all-cause mortality (pooled hazard ratios (HR) (95% confidence interval (CI) = 0.99 (0.97, 1.00)) and stroke mortality (pooled HR (95% CI) = 0.77 (0.59, 1.00)) in older individuals. CONCLUSIONS: This review supports increasing green space exposure in terms of the prevention of death and cardiovascular outcomes in older individuals. Effective measures to increase or preserve greenspaces should therefore be considered as important public health interventions.
BACKGROUND: With the launch of the "Global Age-Friendly Cities project", increasing emphasis has been placed on the effects of green spaces on health in the elderly. The previous literature has shown that green spaces are beneficial to a range of health-related outcomes in adults. However, associations of greenness with mortality and cardiovascular outcomes are less certain, which may differ depending on the age class. This review aimed to synthesize current evidence from observational studies to assess relationships of green space exposure with mortality and cardiovascular outcomes in older individuals. METHODS: Five databases were searched. Qualitative evaluation and meta-analyses of included studies were conducted. This review is registered with PROSPERO, CRD42020160366. RESULTS: Of the 8,143 records identified, we finally included 22 studies. In a narrative systematic review, we observed that the majority of studies showed reductions in the risk of all-cause mortality and total cardiovascular disease. Further meta-analyses which included eight cohort studies, indicated that greater greenness exposure (per 0.1 unit increase of normalized difference vegetation index (NDVI)) was associated with a reduced risk of all-cause mortality (pooled hazard ratios (HR) (95% confidence interval (CI) = 0.99 (0.97, 1.00)) and stroke mortality (pooled HR (95% CI) = 0.77 (0.59, 1.00)) in older individuals. CONCLUSIONS: This review supports increasing green space exposure in terms of the prevention of death and cardiovascular outcomes in older individuals. Effective measures to increase or preserve greenspaces should therefore be considered as important public health interventions.
Entities:
Keywords:
Cardiovascular disease; Green space; Mortality; Older adults
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