Neighborhood characteristics and dementia symptomology among community-dwelling older adults with Alzheimer's disease.
Neighborhood characteristics and dementia symptomology among community-dwelling older adults with Alzheimer's disease.
复制标题
DOI：
10.3389/fnagi.2022.937915
复制
发表时间：
2022
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
神经精神症状（NPSs）导致阿尔茨海默病（AD）患者的无数不良健康结果。先前的研究已经观察到家庭环境的各个方面与NPS之间的关联，但是宏观层面的环境压力因素（例如，邻里收入）也可能破坏神经元微环境并加剧NPSs。然而，据我们所知，没有研究调查邻里环境和NPSs之间的关系。使用2010年从南卡罗来纳州阿尔茨海默病登记处收集的AD老年人数据，我们估计了总体人群和种族/民族的邻里特征和NPSs之间的横断面关联。邻里措施（在1/2英里的居住半径）来自美国社区调查和农村城市通勤地区代码。我们将家庭收入中位数分为三分位数：<30，500美元，30，500 - 40，000美元和> 40，000美元，农村分为：农村，小城市和大城市。居住不稳定性的定义是过去一年内搬家的居民百分比。使用包括所有12个领域的综合测量的神经精神病量表问卷来定义NPS。调整年龄，性别/性别，种族/民族，和照顾者的教育程度，我们使用负二项回归估计患病率（PR）和95%置信区间（CI）的NPSs的邻里特征。在212名合格参与者中，平均年龄为82 ± 8.7岁，72%为女性，55%为非西班牙裔（NH）黑人。生活在<30，500美元与> 40，000美元收入社区的AD患者有53%（PR = 1.53; 95% CI = 1.06-2.23）NPSs的患病率较高，而居住在农村的个体比居住在大城市社区的个体NPSs的患病率低36%（PR = 0.64; 95% CI = 0.45-0.90），调整后。我们没有观察到住宅不稳定性和NPS之间的关联（PR = 0.92; 95% CI = 0.86-1.00）;然而，我们的估计表明，居住在住宅不稳定地区的NH-白人老年人的NPS较低，（PR = 0.89; 95%CI = 0.82-0.96）与NH黑人老年人（PR = 0.96; 95%CI = 0.86-1.07）相比。在种族/民族群体中，生活在低收入地区的AD患者有更多的神经病学。在复制之前，干预工作应考虑向高需求社区分配资源（例如，低收入），研究应调查这种关系的潜在机制。
Neuropsychiatric symptoms (NPSs) lead to myriad poor health outcomes among individuals with Alzheimer’s disease (AD). Prior studies have observed associations between the various aspects of the home environment and NPSs, but macro-level environmental stressors (e.g., neighborhood income) may also disrupt the neuronal microenvironment and exacerbate NPSs. Yet, to our knowledge, no studies have investigated the relationship between the neighborhood environment and NPSs. Using 2010 data among older adults with AD collected from a sample of the South Carolina Alzheimer’s Disease Registry, we estimated cross-sectional associations between neighborhood characteristics and NPSs in the overall population and by race/ethnicity. Neighborhood measures (within a 1/2-mile radius of residence) came from the American Community Survey and Rural Urban Commuting Area Code. We categorized median household income into tertiles: < $30,500, $30,500–40,000, and > $40,000, and rurality as: rural, small urban, and large urban. Residential instability was defined as the percent of residents who moved within the past year. NPSs were defined using the Neuropsychiatric Inventory Questionnaire that included the composite measure of all 12 domains. Adjusting for age, sex/gender, race/ethnicity, and caregiver educational attainment, we used negative binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for NPSs by neighborhood characteristics. Among 212 eligible participants, mean age was 82 ± 8.7 years, 72% were women, and 55% non-Hispanic (NH)-Black. Individuals with AD living in < $30,500 vs. > $40,000 income neighborhoods had a 53% (PR = 1.53; 95% CI = 1.06–2.23) higher prevalence of NPSs while individuals living in rural vs. large urban neighborhoods had a 36% lower prevalence of NPSs (PR = 0.64; 95% CI = 0.45–0.90), after adjustment. We did not observe an association between residential instability and NPSs (PR = 0.92; 95% CI = 0.86–1.00); however, our estimates suggested differences by race/ethnicity where NH-White older adults living in residential instable areas had lower NPSs (PR = 0.89; 95% CI = 0.82–0.96) compared to NH-Black older adults (PR = 0.96; 95% CI = 0.86–1.07). Across racial/ethnic groups, individuals with AD had more symptomology when living in lower income areas. Pending replication, intervention efforts should consider resource allocation to high-need neighborhoods (e.g., lower income), and studies should investigate underlying mechanisms for this relationship.
登录
查看更多内容
影响因子：
5.6
作者：
Clarke PJ;Weuve J;Barnes L;Evans DA;Mendes de Leon CF
通讯作者：
Mendes de Leon CF
影响因子：
14
作者：
通讯作者：
--
影响因子：
5
作者：
Balfour, JL;Kaplan, GA
通讯作者：
Kaplan, GA
影响因子：
4
作者：
Ferrari, Camilla;Lombardi, Gemma;Sorbi, Sandro
通讯作者：
Sorbi, Sandro
影响因子：
5.5
作者：
Besser LM;McDonald NC;Song Y;Kukull WA;Rodriguez DA
通讯作者：
Rodriguez DA