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Association of Environmental Features and the Risk of Alzheimer’s Dementia in Older Adults: A Nationwide Longitudinal Case-Control Study

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  • Chih-Ching Liu

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan)

  • Chung-Yi Li

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
    Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan)

  • Shiann-Far Kung

    (Department of Urban Planning, National Cheng Kung University, Tainan 701, Taiwan
    Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan)

  • Hsien-Wen Kuo

    (Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei 112, Taiwan)

  • Nuan-Ching Huang

    (Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan)

  • Yu Sun

    (Department of Neurology, En Chu Kong Hospital, New Taipei City 23702, Taiwan
    These authors contributed equally to this work.)

  • Susan C. Hu

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
    Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan
    These authors contributed equally to this work.)

Abstract

Little is known about the association between environmental features and the risk of Alzheimer’s dementia (AD). This study aims to investigate the association of physical and social environments with the incidence of AD. We identified 12,401 newly diagnosed AD cases aged ≥65 years in 2010, with the same no. of matched controls from National Health Insurance claims in Taiwan. Environmental data were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was conducted to calculate the odds ratios (OR) of AD in association with environmental features at the township level. Results showed that living in the areas with higher availability of playgrounds and sport venues was associated with a 3% decreased odds of AD (95% CI = 0.96–0.99), while higher density of elderly living alone was associated with a 5% increased odds of AD (95% CI = 1.01–1.11), after controlling for individual and other environmental factors. In further examination by urbanization level, the above relationships were found only in rural areas but not in urban areas. This study provides evidence that specific physical and social environmental features have different impacts on the risk of AD.

Suggested Citation

  • Chih-Ching Liu & Chung-Yi Li & Shiann-Far Kung & Hsien-Wen Kuo & Nuan-Ching Huang & Yu Sun & Susan C. Hu, 2019. "Association of Environmental Features and the Risk of Alzheimer’s Dementia in Older Adults: A Nationwide Longitudinal Case-Control Study," IJERPH, MDPI, vol. 16(16), pages 1-16, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2828-:d:255758
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    References listed on IDEAS

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    3. Nuan-Ching Huang & Shiann-Far Kung & Susan C. Hu, 2018. "The Relationship between Urbanization, the Built Environment, and Physical Activity among Older Adults in Taiwan," IJERPH, MDPI, vol. 15(5), pages 1-20, April.
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    Cited by:

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    2. Lilah M. Besser & Lun-Ching Chang & Jana A. Hirsch & Daniel A. Rodriguez & John Renne & Stephen R. Rapp & Annette L. Fitzpatrick & Susan R. Heckbert & Joel D. Kaufman & Timothy M. Hughes, 2021. "Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis," IJERPH, MDPI, vol. 18(15), pages 1-12, July.
    3. Lilah M. Besser & Marcia Pescador Jimenez & Cameron J. Reimer & Oanh L. Meyer & Diana Mitsova & Kristen M. George & Paris B. Adkins-Jackson & James E. Galvin, 2023. "Diversity of Studies on Neighborhood Greenspace and Brain Health by Racialized/Ethnic Group and Geographic Region: A Rapid Review," IJERPH, MDPI, vol. 20(9), pages 1-22, April.

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