Lifecourse of Place: how environments throughout life can support healthy ageing

为我们生活和变老的地方如何最好地设计以支持健康老龄化提供新的见解已成为一项重要的研究和政策优先事项。许多研究都在寻找老年人健康和有效运作的障碍，并试图创造老年人所经历的环境，以支持人们安享晚年。然而，我们对一生中所经历的环境的各个方面知之甚少，这些方面可能会支持晚年健康功能的维持。因此，这个跨学科的建议汇集了地理学、心理学和景观建筑学的专业知识，利用新的纵向数据集来研究从童年到余生的基于地点的环境如何促进健康的老龄化。这项研究采用了一个新的框架，称为“生活地点”，它帮助我们研究地点如何随着时间的推移而演变，以及在生命过程的不同阶段如何预测晚年的健康结果。我们将利用两个纵向数据集-洛锡安出生队列1936 （LBC1936）以及一套小区域历史环境测量-作为早期研究的一部分进行整理。这些综合数据集提供了1936年出生的一组人（LBC1936）的详细信息，以及参与者一生中不同时期所处的环境环境。这些数据收集工作产生了一个独特的数据集，其中包括一组老年人一生的环境情况（包括绿地、空气污染和地区层面的剥夺），以及详细的个人信息，包括健康老龄化的高质量指标。我们工作的一个关键新颖之处将是检查整个生命周期的暴露。该研究利用了LBC1936参与者可获得的一套健康衰老指标，这些指标通过脑成像、认知测试和生物衰老的生物标志物（端粒长度和表观遗传时钟）收集。这些结果很少用于社会科学研究。因此，首要的研究问题是检查终生暴露于绿地、空气污染和区域层面的剥夺是否会影响健康老龄化的指标（认知衰老、大脑健康和生物衰老的测量）。特别是，我们将研究是否存在(a)关键时期（童年、成年早期、成年和成年后期），其中三个区域层面的特征在解释晚年结果方面特别重要，和/或(b)环境因素是否在整个生命过程中积累，从而影响健康的老龄化。我们的分析将考虑这种关系是否因性别和社会经济环境而异。通过检查整个生命过程中的关系，研究结果有可能对我们理解地方动态及其对晚年健康轨迹的影响做出重大贡献。英国政府已经将满足老龄化社会的需求确定为其“重大挑战”之一，并致力于确定创新的方式，以确保老年人能够通过独立和充实的生活继续为社会做出贡献。该战略的明确任务之一是“确保到2035年，人们可以享受至少额外的5年健康、独立的生活，同时缩小最富裕和最贫穷之间的差距。”我们的研究将提高我们对生活中地方在支持健康老龄化方面的作用的理解，并确定关键环境因素影响随后健康轨迹和不平等的关键时期。因此，通过确定可行的、长期的和可持续的政策机会，并与我们的主要项目合作伙伴合作，拟议的研究有可能为满足老龄化社会的需求做出重大贡献。

Providing new insights into the how the places we live and grow older can be best designed to support healthy ageing has emerged as an important research and policy priority. Many studies have looked to identify the barriers to health and effective functioning for older people, and into producing environments experienced in older age that support people to age well. However, we know much less about the aspects of environments experienced throughout life that might support the maintenance of healthy functioning in later life. Therefore, this interdisciplinary proposal draws together expertise from geography, psychology and landscape architecture to utilise novel longitudinal datasets to examine how place-based circumstances from childhood through the rest of life can enhance healthy ageing.The study draws on a new framework labelled the "life course of place" which helps us to examine how places evolve over time and matter at different points in the lifecourse in predicting later life health outcomes. We will utilise two longitudinal datasets - the Lothian Birth Cohort 1936 (LBC1936) alongside a suite of small area historical environmental measures - which were collated as part of an earlier study. The combined datasets provide detailed information on a cohort of people born in 1936 (LBC1936) as well as the environmental circumstances in which the participants lived at various points during their lives. These data collection efforts resulted in a unique dataset that captured the lifetime environmental circumstances (including green space, air pollution and area-level deprivation) of a cohort of older people alongside detailed individual-level information, including high quality indicators of healthy ageing. A key novelty of our work will be to examine full lifetime exposures. The study utilises a set of robust indicators of healthy ageing available for LBC1936 participants, collected through brain imaging, cognitive testing and biomarkers of biological ageing (telomere length and epigenetic clock). These outcomes are rarely utilised in social scientific research.The overarching research question therefore is to examine whether lifetime exposure to green space, air pollution and area-level deprivation affect indicators of healthy ageing (measures of cognitive ageing, brain health and biological ageing). In particular, we will examine whether there are (a) critical periods (childhood, early adulthood, adulthood and later adulthood) in which the three area-level characteristics are particularly important in explaining the later life outcomes, and/or (b) whether the environmental factors accumulate over the lifecourse to affect healthy ageing. Our analyses will consider whether the relationships differ by sex and socioeconomic circumstances.By examining relationships over the full lifecourse, the research findings have the potential to make a significant contribution to our understanding of the dynamics of places and the implications for health trajectories in later life. The UK Government has identified meeting the needs of an ageing society as one of its 'Grand Challenges' and has committed to identifying innovative ways to ensure older citizens can continue to contribute to society through leading independent and fulfilled lives. One of the defined missions in the strategy is to "ensure that people can enjoy at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest." Our research will improve our understanding of the role of place throughout life in supporting healthy ageing, and identify critical periods in which key environmental factors affect subsequent health trajectories and inequalities. Therefore, by identifying actionable, long-term and sustainable policy opportunities, and working with our key project partners, the proposed research has the potential to make significant contributions to meeting the needs of an ageing society.