Influence of activity space on the association between neighborhood characteristics and dementia risk: results from the 3-City study cohort.
Activities of Daily Living
/ psychology
Aged
Aged, 80 and over
Cities
/ epidemiology
Cohort Studies
Dementia
/ economics
Environment Design
/ economics
Female
Humans
Longitudinal Studies
Male
Poverty
/ economics
Residence Characteristics
Risk Factors
Social Class
Social Environment
Socioeconomic Factors
Cognitive aging
Deprivation
Life-space mobility
Living environment
Social health inequalities
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
07 01 2019
07 01 2019
Historique:
received:
02
10
2018
accepted:
14
12
2018
entrez:
9
1
2019
pubmed:
9
1
2019
medline:
19
11
2019
Statut:
epublish
Résumé
Socioeconomic level of residential environment was found to influence cognitive performance. However, individuals from the same place of residence may be affected differently. We aim to investigate for the first time the influence of individual activity space on the association between neighborhood socioeconomic status (NSES) and the risk of dementia. In the frame of the Three-City cohort, a French population-based study, we followed longitudinally (12 years) 7009 participants aged over 65. The activity space (i.e., the spatial area through which a person moves daily) was defined using two questions from Lawton's Instrumental Activities of Daily Living scale ("Goes shopping independently","Travels alone"), and one question about mobility restriction. The survival analysis was performed using a Cox marginal model that takes into account intra-neighborhood correlations and includes a large number of potential confounders. Among people with a limited activity space (n = 772, 11%), risk of dementia is increased in subjects living in a deprived area (characterized by high GINI index or low median income) compared to those living in more favored. This study shows that the individual activity space modifies the association between NSES and the risk of dementia providing a more complete picture of residential inequalities. If confirmed in different populations, these findings suggest that people with limited activity space and living in a deprived neighborhood are particularly at risk and should be targeted for prevention.
Sections du résumé
BACKGROUND
Socioeconomic level of residential environment was found to influence cognitive performance. However, individuals from the same place of residence may be affected differently. We aim to investigate for the first time the influence of individual activity space on the association between neighborhood socioeconomic status (NSES) and the risk of dementia.
METHODS
In the frame of the Three-City cohort, a French population-based study, we followed longitudinally (12 years) 7009 participants aged over 65. The activity space (i.e., the spatial area through which a person moves daily) was defined using two questions from Lawton's Instrumental Activities of Daily Living scale ("Goes shopping independently","Travels alone"), and one question about mobility restriction. The survival analysis was performed using a Cox marginal model that takes into account intra-neighborhood correlations and includes a large number of potential confounders.
RESULTS
Among people with a limited activity space (n = 772, 11%), risk of dementia is increased in subjects living in a deprived area (characterized by high GINI index or low median income) compared to those living in more favored.
CONCLUSION
This study shows that the individual activity space modifies the association between NSES and the risk of dementia providing a more complete picture of residential inequalities. If confirmed in different populations, these findings suggest that people with limited activity space and living in a deprived neighborhood are particularly at risk and should be targeted for prevention.
Identifiants
pubmed: 30616586
doi: 10.1186/s12877-018-1017-7
pii: 10.1186/s12877-018-1017-7
pmc: PMC6323794
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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