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。较低的社区社会经济地位与较差的身体健康状况、较低的身体活动率、较高的抑郁和心理压力发生率以及较少的社区社会支持网络和社会参与有关。许多这些健康和幸福结果也被确定为晚年认知的相关因素。然而，迄今为止，很少有研究专门调查了社区在认知衰老中作为解释差异的独特来源的作用。目前的研究旨在补充美国国立卫生研究院资助的ACTIVE（独立和重要老年人高级认知训练）研究中收集的数据，并从公开可用的数据集中获得额外的社区数据。ACTIVE提供了一个独特的机会来检查邻里水平特征的关系，不仅与基线认知水平有关，而且与认知训练的反应有关。在ACTIVE研究中，来自美国六个流域的2,802名65-96岁的成年人完成了基线认知评估，并被随机分配到三个10期认知干预项目中的一个或无接触控制条件。立即进行后测，重复大部分认知评估，以评估与训练相关的变化。本研究利用地理信息系统（GIS），结合空间分析和统计分析，探讨1)社区水平的社会经济地位（SEP）是否与活动参与者的初始认知水平和训练反应相关；2)社区支持身体和心理健康的设施数量是否在社区水平的社会经济地位与活动认知结果之间起中介作用。通过创新性地连接社会流行病学和认知衰老传统，本研究旨在提高我们对影响晚年认知个体差异的背景因素的理解。

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.