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Community environment, cognitive impairment and dementia in later life: Results from the Cognitive Function and Ageing Study

Lookup NU author(s): Dr Yu-Tzu WuORCiD, Professor Matthew Prina, Professor Fiona MatthewsORCiD, Professor Carol Brayne



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society.Background: few studies have investigated the impact of the community environment, as distinct from area deprivation, on cognition in later life. This study explores cross-sectional associations between cognitive impairment and dementia and environmental features at the community level in older people.Method: the postcodes of the 2,424 participants in the year-10 interview of the Cognitive Function and Ageing Study in England were mapped into small area level geographical units (Lower-layer Super Output Areas) and linked to environmental data in government statistics. Multilevel logistic regression was conducted to investigate associations between cognitive impairment (defined as MMSE ≤ 25), dementia (organicity level ≥3 in GMS-AGECAT) and community level measurements including area deprivation, natural environment, land use mix and crime. Sensitivity analyses tested the impact of people moving residence within the last two years.Results: higher levels of area deprivation and crime were not significantly associated with cognitive impairment and dementia after accounting for individual level factors. Living in areas with high land use mix was significantly associated with a nearly 60% reduced odds of dementia (OR: 0.4; 95% CI: 0.2, 0.8) after adjusting for individual level factors and area deprivation, but there was no linear trend for cognitive impairment. Increased odds of dementia (OR: 2.2, 95% CI: 1.2, 4.2) and cognitive impairment (OR: 1.4, 95% CI: 1.0, 2.0) were found in the highest quartile of natural environment availability. Findings were robust to exclusion of the recently relocated.Conclusion: features of land use have complex associations with cognitive impairment and dementia. Further investigations should focus on environmental influences on cognition to inform health and social policies.

Publication metadata

Author(s): Wu Y-T, Prina AM, Jones AP, Barnes LE, Matthews FE, Brayne C

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2015

Volume: 44

Issue: 6

Pages: 1005-1011

Print publication date: 01/11/2015

Online publication date: 13/10/2015

Acceptance date: 05/08/2015

Date deposited: 27/05/2020

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press


DOI: 10.1093/ageing/afv137

PubMed id: 26464419


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