TY - JOUR
T1 - Neighborhood environment and cognitive function in older adults
T2 - A multilevel analysis in Hong Kong
AU - Guo, Yingqi
AU - Chan, Chee Hon
AU - Chang, Qingsong
AU - Liu, Tianyin
AU - Yip, Paul S.F.
N1 - Funding Information:
The research is supported by a GRF (No: 106160261 ) of the Research Grants Committee (RGC) . The funder had no role in study design; in the analysis, and interpretation of data; in writing of the article; or in the decision to submit the article. This study was approved by The University of Hong Kong. The authors are grateful to the detailed comments from the reviewers. We also thank Department of Health, Census and Statistics Department, Lands Department and Planning Department, The Government of the Hong Kong Special Administrative Region, for their supports in getting access to the data. Interested researchers can obtain the data by request or purchase from the Hong Kong Government by contacting relevant Departments – Elderly Health Services of the Department of Health for elderly checkup data, Census and Statistics Department for the census tracts data, Lands Department for the Geo-Community Database and the Geo-Reference Database and Planning Department for the geographical census boundary data. We also thank Dr. Mengni Chen at Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, for helpful discussions.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/7
Y1 - 2019/7
N2 - In considering the influence of the neighborhood environment on cognitive function, little research has looked beyond the individual factors. Here, we conducted a study on 21,008 older adults aged 65 years and above in Hong Kong to examine the cross-sectional associations of neighborhood economic disadvantage, recreational resources, walkability, library accessibility and physical activities on cognitive function and dementia. Both smaller and larger census tracts were adopted as proxies for neighborhoods. Using multilevel regression, neighborhood economic disadvantage was found to be associated with cognitive decline, net of individual features. This association was not explained by neighborhood built environment. Recreational environment was not a significant factor for older adults' cognitive function while library accessibility was. Neighborhood walkability was only related to dementia but not the cognitive function score. Physical activity can partly explain the relationship between neighborhood environment and cognitive function. No significant interaction effect was identified except on the educational level and neighborhood library accessibility. To conclude, late life residential environments are important contexts for aging. Aging-in-place interventions in Hong Kong should thus address neighborhood poverty, improve accessibility of libraries and walkability to reduce future risks of cognitive decline.
AB - In considering the influence of the neighborhood environment on cognitive function, little research has looked beyond the individual factors. Here, we conducted a study on 21,008 older adults aged 65 years and above in Hong Kong to examine the cross-sectional associations of neighborhood economic disadvantage, recreational resources, walkability, library accessibility and physical activities on cognitive function and dementia. Both smaller and larger census tracts were adopted as proxies for neighborhoods. Using multilevel regression, neighborhood economic disadvantage was found to be associated with cognitive decline, net of individual features. This association was not explained by neighborhood built environment. Recreational environment was not a significant factor for older adults' cognitive function while library accessibility was. Neighborhood walkability was only related to dementia but not the cognitive function score. Physical activity can partly explain the relationship between neighborhood environment and cognitive function. No significant interaction effect was identified except on the educational level and neighborhood library accessibility. To conclude, late life residential environments are important contexts for aging. Aging-in-place interventions in Hong Kong should thus address neighborhood poverty, improve accessibility of libraries and walkability to reduce future risks of cognitive decline.
KW - Cognitive function
KW - Neighborhood economic disadvantage
KW - Neighborhood library accessibility
KW - Neighborhood recreational resources
KW - Neighborhood walkability
UR - http://www.scopus.com/inward/record.url?scp=85066787637&partnerID=8YFLogxK
U2 - 10.1016/j.healthplace.2019.102146
DO - 10.1016/j.healthplace.2019.102146
M3 - Journal article
C2 - 31177067
AN - SCOPUS:85066787637
SN - 1353-8292
VL - 58
JO - Health and Place
JF - Health and Place
M1 - 102146
ER -
