Effects of physical and social environments on the risk of dementia among Taiwanese older adults: a population-based case-control study.

Case-control studies Dementia Incidence Older adults Physical environments Social environments

Journal

BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548

Informations de publication

Date de publication:
26 06 2020
Historique:
received: 10 03 2020
accepted: 18 06 2020
entrez: 28 6 2020
pubmed: 28 6 2020
medline: 22 12 2020
Statut: epublish

Résumé

Physical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This study aims to explore the influence of physical and social environments on the incidence of dementia through a population-based case-control design in Taiwan. We identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level. We observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81-0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87-0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04-1.25), such a significant relationship did not appear in the full model. Our study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.

Sections du résumé

BACKGROUND
Physical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This study aims to explore the influence of physical and social environments on the incidence of dementia through a population-based case-control design in Taiwan.
METHODS
We identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level.
RESULTS
We observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81-0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87-0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04-1.25), such a significant relationship did not appear in the full model.
CONCLUSIONS
Our study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.

Identifiants

pubmed: 32590941
doi: 10.1186/s12877-020-01624-6
pii: 10.1186/s12877-020-01624-6
pmc: PMC7318767
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

226

Subventions

Organisme : Health Promotion Administration, Ministry of Health and Welfare, Taiwan
ID : MOHW107-HPA-M-114-144703
Pays : International

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Auteurs

Chih-Ching Liu (CC)

Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Road, Wufeng District, Taichung, 41354, Taiwan.

Yu Sun (Y)

Department of Neurology, En Chu Kong Hospital, No. 399, Fuxing Road, Sanxia District, New Taipei City, 23702, Taiwan.

Shiann-Far Kung (SF)

Department of Urban Planning, College of Planning & Design, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.

Hsien-Wen Kuo (HW)

Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei city, 112, Taiwan.

Nuan-Ching Huang (NC)

Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.

Chung-Yi Li (CY)

Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Road, Wufeng District, Taichung, 41354, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
Department of Public Health, College of Public Health, China Medical University, Taichung, 404, Taiwan.

Susan C Hu (SC)

Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan. shuhu@mail.ncku.edu.tw.
Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan. shuhu@mail.ncku.edu.tw.

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