Neighborhood Influences on Cognitive Level and Training Gains in the ACTIVE Study

描述(由申请人提供)：越来越多的研究支持社区特征在老年人生活中的作用。社区层面的社会经济地位低与身体健康较差、体力活动减少、抑郁和心理压力的发生率增加以及基于社区的社会支持网络和社会参与度较低相关。其中许多健康和幸福的结果也被确定为与晚年认知相关。然而，到目前为止，很少有研究专门调查邻里关系在认知老化中作为解释差异的独特来源所起的作用。目前的研究试图用来自公开数据集的更多邻里层面的数据来补充NIH资助的ACTIVE(独立和重要老年人的高级认知训练)研究中收集的数据。Active提供了一个独特的机会来检查邻居水平特征的关联，不仅与基线认知水平，而且与认知训练的反应。在活动中，来自六个美国集水区的2,802名年龄在65-96岁之间的成年人完成了基线认知评估，并被随机分为三个为期十个疗程的认知干预计划之一或非接触性对照条件。一项即刻的后测重复了大多数认知评估，以评估与培训相关的变化。结合地理信息系统(GIS)的空间分析和统计分析，本研究试图调查1)社区层面的社会经济地位(SEP)是否与积极参与者的初始认知水平和训练反应有关，2)支持身体和心理社会健康的社区设施的数量是否在社区SEP与积极认知结果之间的关系中起中介作用。通过创新性地将社会流行病学和认知老龄化传统联系起来，这一建议试图提高我们对影响晚年认知个体差异的背景因素的理解。 公共卫生相关性：通过探索社区环境对晚年认知的影响，可以确定有效的社区层面干预的目标，和/或更优化利用社区资源的个人策略指导。

DESCRIPTION (provided by applicant): A growing body of research supports the role of neighborhood characteristics in the lives of older adults. Low neighborhood-level socioeconomic status has been associated with poorer physical health, reduced rates of physical activity, increased incidence of depression and psychological stress, and less neighborhood-based social support networks and social engagement. Many of these health and well being outcomes have also been identified as correlates of late life cognition. Yet few studies to date have specifically investigated the role of the neighborhood as a unique source of explanatory variance in cognitive aging. The current study seeks to supplement data collected in the NIH-funded ACTIVE (Advanced Cognitive Training with Independent and Vital Elders) study with additional neighborhood-level data derived from publicly available data sets. ACTIVE offers a unique opportunity to examine the association of neighborhood-level characteristics not only with baseline cognitive level, but also with response to cognitive training. In ACTIVE, 2,802 adults aged 65-96 from six US catchment area completed a baseline cognitive assessment and were randomized to one of three ten-session cognitive intervention programs or a no- contact control condition. An immediate posttest repeated most of the cognitive assessments to assess training-related change. Combining spatial and statistical analysis using geographic information systems (GIS), the proposed study seeks to investigate 1) whether neighborhood-level socioeconomic position (SEP) is related to initial cognitive level and training response in ACTIVE participants and 2) whether the number of neighborhood facilities supporting physical and psychosocial health mediates the relationship between neighborhood SEP and the ACTIVE cognitive outcomes. By innovatively bridging the social epidemiology and cognitive aging traditions, this proposal seeks to improve our understanding of the contextual factors influencing individual differences in late life cognition. PUBLIC HEALTH RELEVANCE: By exploring the influence of the neighborhood context on cognition in late life, targets may be identified for effective neighborhood level interventions, and/or individual strategy instruction in more optimal utilization of neighborhood resources.