Cognitive Resilience and Community Context: Examining the role of Neighborhood Built and Social Environments for Slowing the Progression of Dementia among older Americans

项目总结 先前的研究已经确定了多种生物、遗传和行为因素与 认知功能受损和衰退。最近，一部平行文献超越了个人层面的因素，着眼于 考虑社会和建筑环境的作用。研究结果表明，居住在社会经济学中 有利的社区可能会促进认知功能和/或缓冲认知能力下降，部分原因是 更高密度的物质资源(娱乐中心、健身房、公园、步行道、健康食品店) 以及社会和机构资源(图书馆、书店、社区中心、社交俱乐部)，促进 身体活动和促进精神刺激(例如，社会互动)，这可能会缓冲认知能力下降 年龄。然而，这些关系还没有用基于国家人口的数据进行实证检验。这 研究将考察社区建设和社会环境对儿童发展轨迹的调节作用 自2003年以来，对全国不同种族的美国人的认知功能进行了跟踪调查。我们将确定如何 社会和建筑环境的特征与认知功能的衰退率有关 中风的地理和种族差异原因研究(READS)的参与者。致敬的是 自2003年以来，一项全国性的纵向队列研究对30,000多名年龄在45岁以上的黑人和白人进行。在……里面 除了作为一项纵向研究，每隔一年收集关于认知功能的前瞻性数据， 研究还通过地理坐标跟踪住宅位置，这些地理坐标将链接到二次源 来描述周围的社会和建筑环境。这个为期4年的项目的目标是i) 在有关研究中为受访者描述建筑和社会环境的特征 可以缓解认知衰退的物质和社会资源；ii)使用纵向数据来检查 社区资源与认知衰退率之间的关系；以及iii)决定 建筑和社会环境在多大程度上解释了种族认知功能的差异。通过增加这一点 现有由美国国立卫生研究院资助的具有社区特征的纵向队列研究，这项研究将提供关键的 研究社区建设和社会环境对防止认知衰退的作用的机会 随着美国人年龄的增长。

PROJECT SUMMARY Previous research has identified multiple biological, genetic, and behavioral factors that are associated with cognitive impairment and decline. Recently, a parallel literature has looked beyond individual-level factors to consider the role of the social and built environment. Findings suggest that residence in socioeconomically advantaged neighborhoods may promote cognitive function and/or buffer cognitive decline in part through their greater density of physical resources (recreational centers, gyms, parks, walking paths, healthy food stores) as well as social and institutional resources (libraries, bookstores, community centers, social clubs) that promote physical activity and facilitate mental stimulation (e.g. social interaction) that may buffer cognitive decline with age. However, these relationships have not been empirically tested with national population-based data. This study will examine the moderating role of neighborhood built and social environments on trajectories of cognitive function in a national, racially-diverse sample of Americans followed since 2003. We will identify how features of the social and built environment are related to rates of decline in cognitive function among participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. REGARDS is a national longitudinal cohort study of over 30,0000 black and white individuals age 45+ ongoing since 2003. In addition to being a longitudinal study collecting prospective data on cognitive function at annual intervals, the study also tracks residential locations through geographic coordinates that will be linked to secondary sources to characterize the surrounding social and built environment. The aims of this 4-year project are to i) characterize the built and social environment for respondents in the REGARDS study with respect to the physical and social resources that could mitigate cognitive decline; ii) use longitudinal data to examine the relationship between neighborhood resources and rates of cognitive decline over time; and iii) determine the extent to which built and social environments explain racial disparities in cognitive function. By augmenting this existing NIH-funded longitudinal cohort study with neighborhood characteristics, this study will provide a critical opportunity to examine the role of neighborhood built and social environments for preventing cognitive decline in Americans as they age.