Neighborhood Environments and Cognitive Decline Among Middle-Aged and Older Adults in China

项目摘要 我们的长期目标是更好地了解邻里环境如何决定健康轨迹 跨越不同社会的生命周期。随着人口迅速老龄化，认知障碍和痴呆 已经成为世界范围内的主要健康和社会问题，导致日常活动和生活中丧失独立性 老年生活质量下降。之前的研究已经证明了邻里之间的联系 中老年人的环境和认知功能。然而，人们并不清楚它是如何 邻里语境有助于认知功能的发挥。拟议研究的主要目标是 确定潜在的机制和潜在的缓和因素之间的关系 社区环境、认知功能与发展中中老年认知功能下降 国家。中国被视为一个正在经历快速人口老龄化的发展中国家，它已经 导致阿尔茨海默病和相关痴呆症的患病率上升。这个国家也在经历 作为老年人护理的主要来源的家庭减少，以及缺乏长期护理设施。此外， 中国作品中特定的文化、社会和经济语境因素值得注意 社区环境对老年人健康的影响将为识别提供丰富的景观 可以在不同文化中推广的机制和因素。该项目有三个具体目标：(1) 找出邻里环境对中年人认知能力下降的影响机制 (2)确定邻里环境对认知的影响 下降因性别、城乡户口和年龄段而异；以及(3)确定社区是否 环境对不同的认知领域有不同的影响。该项目将从三个方面分析数据 浪潮的中国健康与退休纵向研究(CHARLS)等来源。它将测量 使用CHARLS的社区调查和其他来源的社区自然、建筑和社会环境 并研究它们对认知下降的单独和联合影响。一系列多水平的线性增长曲线 将估计模型以确定邻里环境之间的关系的机制 和认知能力下降，并考察这种关系是否因性别、城乡居住地、年龄而异 队列和不同的认知领域。这种方法是创新的，因为它将重点从 建立邻里环境与认知之间的联系 这种关系中的机制和背景。提出的研究具有重要意义，因为它可以推动我们的 了解邻里环境与晚年健康之间的具体途径。使用快速 世界各地的人口老龄化和负担过重的医疗保健系统，通过 哪些邻里环境影响老年人的健康轨迹可能会更有效 干预的形式。

Project Summary Our long-term goal is to better understand how neighborhood environments determine health trajectories across the lifespan of different societies. With rapid population aging, cognitive impairment and dementias have become major health and social problems worldwide, causing loss of independence in daily activities and lowering quality of life in old age. Previous research has demonstrated an association between neighborhood environments and cognitive function in middle-aged and older adults. However, it is not well understood how neighborhood context contributes to cognitive function. The primary objective for the proposed research is to determine the underlying mechanisms and potential moderating factors in the relationship between neighborhood environments and cognitive function and cognitive decline in middle and old age in a developing country. China is being targeted as a developing country that is experiencing rapid population aging, which has resulted in rising prevalence of Alzheimer’s disease and related dementias. The country is also experiencing both a decline in families as the major source of eldercare and a lack of long term care facilities. Further, specific cultural, social, and economic context factors in China that warrant attention when considering the influence of neighborhood environments on health in aging adults will provide a rich landscape for identifying mechanisms and factors that may generalize across cultures. The project has three specific aims: (1) to identify the mechanisms of the effects of neighborhood environments on cognitive decline among middle-aged and older Chinese adults; (2) to determine whether the effects of neighborhood environments on cognitive decline vary by gender, urban/rural residency, and age cohort; and (3) to determine whether neighborhood environments have different effects on different domains of cognition. This project will analyze data from three waves of the China Health and Retirement Longitudinal Study (CHARLS) and other sources. It will measure neighborhood natural, built and social environments using CHARLS’s community survey and other sources and examine their separate and joint effects on cognitive decline. A series of multi-level linear growth curve models will be estimated to identify the mechanisms in the relationship between neighborhood environments and cognitive decline and examine whether this relationship varies by gender, urban/rural residence, age cohort and different domains of cognition. This approach is innovative because it shifts the focus from the establishment of an association between neighborhood environments and cognition to the identification of mechanisms and contexts in this relationship. The proposed research is significant because it can advance our understanding of the specific pathways between neighborhood environments and health in later life. With rapid population aging and overburdened medical care systems worldwide, identifying the mechanisms through which neighborhood environments affect the health trajectories of older people might suggest more effective forms of interventions.