William W Aitken1, Joanna Lombard2,3, Kefeng Wang2, Matthew Toro4, Margaret Byrne5, Maria I Nardi6, Jack Kardys6, Abraham Parrish7, Chuanhui Dong8, José Szapocznik2,3, Tatjana Rundek8, Scott C Brown2,3. 1. Cardiovascular Division, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA. 2. Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. 3. University of Miami School of Architecture, Coral Gables, FL, USA. 4. Arizona State University Library, Temple, AZ, USA. 5. Moffitt Cancer Center, Tampa, FL, USA. 6. Miami-Dade County Department of Parks, Recreation and Open Spaces (MDPROS), Miami, FL, USA. 7. University of Miami Libraries, Coral Gables, FL, USA. 8. Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
Abstract
BACKGROUND: Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied. OBJECTIVE: This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries. METHODS: Participants were 249,405 US Medicare beneficiaries aged > 65 years living in Miami-Dade County, FL, from 2010 to 2011. Multi-level analyses examined the relationship of greenness, assessed by mean Census block level Normalized Difference Vegetation Index (NDVI), to odds of each of AD, Alzheimer's disease and related dementias (ADRD), and non-AD dementia, respectively. Covariates included age, gender, race/ethnicity, number of comorbid health conditions, and neighborhood income. RESULTS: Higher greenness was associated with reduced risk of AD, ADRD, and non-AD dementia, respectively, adjusting for individual and neighborhood sociodemographics. Compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD by 20%(odds ratio, 0.80; 95%CI, 0.75-0.85), ADRD by 18%(odds ratio, 0.82; 95%CI, 0.77-0.86), and non-AD dementia by 11%(odds ratio, 0.89; 95%CI, 0.82-0.96). After further adjusting for number of comorbidities, compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD (OR, 0.94; 95%CI, 0.88-1.00) and ADRD (OR, 0.93; 95%CI, 0.88-0.99), but not non-AD dementia (OR, 1.01; 95%CI, 0.93-1.08). CONCLUSION: High neighborhood greenness may be associated with lower odds of AD and ADRD. Environmental improvements, such as increasing neighborhood vegetation, may be a strategy to reduce risk for AD and possibly other dementias.
BACKGROUND:Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied. OBJECTIVE: This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries. METHODS:Participants were 249,405 US Medicare beneficiaries aged > 65 years living in Miami-Dade County, FL, from 2010 to 2011. Multi-level analyses examined the relationship of greenness, assessed by mean Census block level Normalized Difference Vegetation Index (NDVI), to odds of each of AD, Alzheimer's disease and related dementias (ADRD), and non-AD dementia, respectively. Covariates included age, gender, race/ethnicity, number of comorbid health conditions, and neighborhood income. RESULTS: Higher greenness was associated with reduced risk of AD, ADRD, and non-AD dementia, respectively, adjusting for individual and neighborhood sociodemographics. Compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD by 20%(odds ratio, 0.80; 95%CI, 0.75-0.85), ADRD by 18%(odds ratio, 0.82; 95%CI, 0.77-0.86), and non-AD dementia by 11%(odds ratio, 0.89; 95%CI, 0.82-0.96). After further adjusting for number of comorbidities, compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD (OR, 0.94; 95%CI, 0.88-1.00) and ADRD (OR, 0.93; 95%CI, 0.88-0.99), but not non-AD dementia (OR, 1.01; 95%CI, 0.93-1.08). CONCLUSION:High neighborhood greenness may be associated with lower odds of AD and ADRD. Environmental improvements, such as increasing neighborhood vegetation, may be a strategy to reduce risk for AD and possibly other dementias.
Entities:
Keywords:
Alzheimer’s disease; Medicare beneficiaries; built environment; dementia; health disparities; natural environment; neighborhood greenness; older adults
Authors: Marcia P Jimenez; Elise G Elliott; Nicole V DeVille; Francine Laden; Jaime E Hart; Jennifer Weuve; Francine Grodstein; Peter James Journal: JAMA Netw Open Date: 2022-04-01
Authors: Jiyun Jung; Jae Yoon Park; Woojae Myung; Jun-Young Lee; Hyunwoong Ko; Hyewon Lee Journal: Int J Environ Res Public Health Date: 2022-03-15 Impact factor: 3.390