Effects of physical and social environments on the risk of dementia among Taiwanese older adults: a population-based case-control study

Abstract

Background: Physical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This study aims to explore the influence of physical and social environments on the incidence of dementia through a populationbased case-control design in Taiwan. Methods: We identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level. Results: We observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81-0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87-0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04-1.25), such a significant relationship did not appear in the full model. Conclusions: Our study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.

Rural-urban Disparities in the Prevalence of Mild Cognitive Impairment and Dementia in Taiwan: A Door-to-door Nationwide Study

“…The urbanization classification was proposed by Huang et al 18 They categorized all 358 cities and townships of Taiwan into five ordered levels of urbanization based on different indicators, including the number of residents, population density, and the percentage of people working in secondary and tertiary industries. 18,32,33…”

How can urban environments support dementia risk reduction? A qualitative study

“…However, such a holistic perspective is fairly new in the evolving concept of brain health. 16 Only in recent years, researchers started to investigate environmental impacts on dementia development, with air and noise pollution [17][18][19] and the built and green environment [20][21][22] being considered as potential factors. For example, Liu et from health insurance claims in older Taiwanese citizens and linked it to environmental measures: odds for dementia were lower in environments with more playgrounds, sports venues and community centers.…”

“…For example, Liu et from health insurance claims in older Taiwanese citizens and linked it to environmental measures: odds for dementia were lower in environments with more playgrounds, sports venues and community centers. 22 Wu et al investigated environmental aspects and dementia risk in the HIC-cohort Cognitive Function and Ageing Study (CFAS II) from the UK as well as in the LMIC-cohort 10/66 study: living far from daily amenities was associated with higher odds for dementia in both studies, while living far from lifestyle and healthcare amenities was associated with increased odds of dementia only in the 10/66 study, and living far from public parks with lower odds of dementia in CFAS II. 23 Epidemiological findings have yet to be translated into risk reduction interventions.…”

Social-Economic Environments and Depressive Symptoms in Community-Dwelling Adults: A Multi-Level Analysis for Two Nationwide Datasets in Taiwan

“…As the skewness still appeared after using several transformation methods, we thus categorized the study variables into groups to lower the misclassification for normality. Thus, all study variables were divided by tertiles (low, medium, and high) and the lowest served as the reference group [ 13 ].…”

“…Scarce studies have examined the relationships between social-economic environments and depression. Only two recent studies by Liu et al (2020) and Liu (2021) were found to investigate the effects of social-economic environments on health, where their outcome variables were dementia and mortality, while the social-economic indicators differed from a case to another [13,14].…”