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

项目概要 我们的长期目标是更好地了解社区环境如何决定健康轨迹 跨越不同社会的生命周期。随着人口快速老龄化，认知障碍和痴呆症 已成为世界范围内的重大健康和社会问题，导致日常活动丧失独立性 降低老年生活质量。先前的研究表明邻里之间存在关联 中老年人的环境和认知功能。然而，目前尚不清楚如何 邻里环境有助于认知功能。拟议研究的主要目标是 确定两者之间关系的根本机制和潜在调节因素 邻里环境与发展中国家的中老年认知功能和认知衰退 国家。中国被定位为正在经历人口快速老龄化的发展中国家， 导致阿尔茨海默病和相关痴呆症的患病率上升。国家也在经历着 家庭作为老年人护理主要来源的减少以及长期护理设施的缺乏。此外， 在考虑中国特定的文化、社会和经济背景因素时需要注意 邻里环境对老年人健康的影响将为识别提供丰富的景观 可能跨文化普遍适用的机制和因素。该项目有三个具体目标：（1） 确定邻里环境对中年认知能力下降的影响机制 和中国老年人； (2) 判断邻里环境是否对认知产生影响 下降幅度因性别、城市/农村居住地和年龄组而异； (3) 判断邻域是否 环境对不同的认知领域有不同的影响。该项目将分析来自三个方面的数据 中国健康与退休追踪研究（CHARLS）和其他来源的浪潮。它将测量 使用 CHARLS 社区调查和其他来源的社区自然、建筑和社会环境 并检查它们对认知能力下降的单独和联合影响。一系列多级线性增长曲线 将估计模型以确定邻里环境之间关系的机制 和认知能力下降，并检查这种关系是否因性别、城市/农村居住地、年龄而异 群体和不同的认知领域。这种方法是创新的，因为它将焦点从 建立邻里环境与识别认知之间的关联 这种关系中的机制和背景。拟议的研究意义重大，因为它可以推进我们的研究 了解邻里环境与晚年健康之间的具体途径。随着快速 世界各地的人口老龄化和医疗保健系统负担过重，通过以下方式确定机制： 哪些社区环境会影响老年人的健康轨迹可能会更有效 干预措施的形式。

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.