Neighborhood Food Environment and Dementia Incidence: the Japan Gerontological Evaluation Study Cohort Survey
Neighborhood Food Environment and Dementia Incidence: the Japan Gerontological Evaluation Study Cohort Survey
复制标题
DOI：
10.1016/j.amepre.2018.10.028
复制
发表时间：
2019-03-01
影响因子：
5.5
通讯作者：
Kondo, Katsunori
中科院分区：
文献类型：
--
作者：
Tani, Yukako;Suzuki, Norimichi;Kondo, Katsunori
前言：针对建筑环境因素的干预措施可能会鼓励老年人采取良好的行为，降低痴呆症的风险，但流行病学证据有限。本研究调查社区饮食环境与痴呆症发病率的关系。方法：对日本老年评估研究的参与者进行了为期3年(2010-2013年)的跟踪调查，该研究是一项基于人群的65岁老年人队列研究。通过公共长期护理保险系统评估了49,511名参与者的痴呆症发病率。使用客观的(基于地理信息系统的)和主观的(参与者报告的)测量来评估每个参与者的食品店的可用性(定义为在住所500米或1公里内销售水果和蔬菜的食品店的数量)。对2017年至2018年的数据进行分析。结果：随访期间共发生痴呆3162例。与客观食品供应的最高四分位数相比，调整年龄和性别的风险比为1.60(95%CI=1.43，1.78)，第二低四分位数。与主观可获得性最高的食品店相比，最低类别的风险比为1.74(95%CI=1.49，2.04)。在对社会人口学特征、健康状况和其他地理社区因素(餐馆、便利店和社区中心的可用性)进行连续调整后，风险比在统计学上仍然显著。结论：食品商店可用性较低与痴呆症发病率的增加有关。鉴于购买食物是老年人的日常活动和外出的主要动机，增加食品店的供应可能有助于预防痴呆症。(C)《2018美国预防医学杂志》。由爱思唯尔公司出版。
Introduction: Interventions targeting built environmental factors may encourage older people to engage in favorable behaviors and decrease dementia risk, but epidemiologic evidence is limited. This study investigated the association between neighborhood food environment and dementia incidence.Methods: A 3-year follow-up (2010-2013) was conducted among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of older adults aged >65 years. Dementia incidence for 49,511 participants was assessed through the public long-term care insurance system. Availability of food stores (defined as the number of food stores selling fruits and vegetables within 500 meters or 1 kilometer of residence) was assessed for each participant using objective (GIS-based) and subjective (participant-reported) measurements. Data were analyzed from 2017 to 2018.Results: A total of 3,162 cases of dementia occurred during the follow-up. Compared with the highest quartile for objective availability of food stores, the hazard ratio adjusting for age and sex was 1.60 (95% CI=1.43, 1.78) for the second-lowest quartile. Compared with the highest subjective availability of food stores, the hazard ratio was 1.74 (95% CI=1.49, 2.04) for the lowest category. After successive adjustment for sociodemographic characteristics, health status, and other geographic neighborhood factors (availability of restaurants, convenience stores, and community centers), the hazard ratio remained statistically significant.Conclusions: Lower food store availability was associated with increased dementia incidence. Given that food shopping is a routine activity and a main motive for going out among older adults, increasing the availability of food stores may contribute to dementia prevention. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc.