Neighborhood characteristics, GPS-based activity space, and cognitive health

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Project Summary/Abstract This five-year plan for the Pathway to Independence Award will help launch Dr. Jinshil Hyun’s independent research career focused on environmental/behavioral factors that modify trajectories of cognitive aging and Alzheimer’s disease and associated dementia (ADRD). Her proposed aims use geospatial and GPS-based methods to comprehensively characterize the impact of neighborhood on cognitive health. Her proposed training will supplement her expertise in ambulatory cognition and cognitive aging with a foundation in neuro- epidemiology (Dr. Lipton), spatial analysis and urban health (Dr. Lovasi), and biostatistics (Dr. Hall). The proposed research and training plan will leverage rich dataset from the Einstein Aging Study and existing resources at the Albert Einstein College of Medicine. The findings from this study will identify person- and contextual-level risk profiles for ADRD, which will ultimately support personalized and population-level interventions, especially among vulnerable populations. There have been important advances in our understanding of risk and protective factors for ADRD, including studies that explore the impact of neighborhood environments on cognition. Although most studies used data from objective measures of geospatially-defined neighborhoods, individuals’ perception of their neighborhoods and person-specific experience of neighborhood environments may vary among individuals even within the same area. This project aims to investigate the influence of neighborhood characteristics, assessed by (i) objective, geospatially-defined and subjective neighborhood aspects and (ii) GPS-based, person-specific activity space measures, on cognitive decline, ADRD, and cognitive health disparities. The PI will process and analyze data collected from the Einstein Aging Study’s annual ecological momentary assessments battery. Continuous GPS tracking from smartphones will allow to characterize person-specific neighborhood experiences (i.e., activity space). Cognitive outcomes will be measured by both yearly conventional neuropsychological tests and smartphone-based ambulatory assessments (6x/day) over 14-day burst data collection periods each year of follow-up. In the K99 phase, the PI will examine how objective and subjective neighborhood aspects are associated with cognitive outcomes (Aim 1). In this phase, the PI will also complete training in spatial analysis, and based on that, will process GPS data and develop/validate activity space measures. In the R00 phase, the PI will examine the associations of GPS-based activity space with cognitive and brain health (Aim 2), and subgroup (e.g., biological sex, race, APOE e4) differences in the associations (Aim 3). Aims 1 to 3 results will provide the basis for an R01 application in the fourth award year. Keywords: activity space, neighborhood, urban health, GPS, Geographic information system, spatial analysis, ecological momentary assessments, ambulatory cognition, cognitive aging, ADRD, disparities.