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The Association Between Street Network Accessibility and Cognitive Impairment

Lookup NU author(s): Dr Eman ZiedORCiD, Professor Fiona MatthewsORCiD


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Background Access to lifestyle factors, such as healthcare and green spaces, can reduce the risk of cognitive impairment in older adults. However, the role of the street network in enabling access has not been extensively studied. The aim of this study is to investigate the relationship between one aspect of street network accessibility (proximity to a main road) and the risk of cognitive impairment. Methods This research uses the Cognitive Function and Ageing Study (CFAS) II (2008-2011), a cohort study of people aged 65+ across three centres in England. Cognitive impairment is defined by the individuals’ Mini Mental State Exam (MMSE) score and categorised into three groups: no cognitive impairment (MMSE>26), mild cognitive impairment (MMSE 22-25), moderate-severe cognitive impairment (MMSE<21). Using Geographical Information System software (GIS), proximity to a main road is calculated within 300m walk of the individual’s postcode and categorised into tertiles (low, medium, high). Logistic regression was used to investigate the risk of cognitive impairment overall and the risk of moderate-severe cognitive impairment at baseline, while adjusting for age, sex, education, and area deprivation. Participants who were housebound were excluded from the analysis. Results At baseline (N= 7485), 76% (N= 5669) had no cognitive impairment and 24% (N =1816) had some form of cognitive impairment (MMSE<26). 544 of the 1816 had moderate-severe cognitive impairment (MMSE<21). Logistic regression shows that compared to those who live further from a main road, those who live closer have reduced risk of cognitive impairment overall (OR 0.817 CI [0.716, 0.932] for medium proximity, OR 0.756 CI [0.662, 0.863] for high proximity). The associations still hold after adjusting for age, sex, education, and area deprivation (OR 0.771 CI [0.671, 0.886] for medium proximity, OR 0.755 CI [0.656, 0.869] for high proximity). There was no association between living near a main road and the risk of moderate-severe cognitive impairment. Conclusion The results suggest some evidence for the role of street network accessibility in reducing the risk of cognitive impairment in non-housebound individuals, by enabling them to fulfil their daily needs more easily. Other individual and environmental factors could influence accessibility and warrant further investigation.

Publication metadata

Author(s): Zied Abozied E, Wu Y, Matthews F

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Alzheimer's Association International Conference

Year of Conference: 2023

Online publication date: 18/07/2023

Acceptance date: 31/03/2023