Back to Search
Start Over
Neighborhood Sidewalk Environment and Incidence of Dementia in Older Japanese Adults.
- Source :
-
American journal of epidemiology [Am J Epidemiol] 2021 Jul 01; Vol. 190 (7), pp. 1270-1280. - Publication Year :
- 2021
-
Abstract
- Sidewalks are indispensable environmental resources for daily life in that they encourage physical activity. However, the proportion of sidewalk coverage is low even in developed countries. We examined the association between neighborhood sidewalk environment and dementia in Japan. We conducted a 3-year follow-up (2010-2013) among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of community-dwelling older adults. We ascertained the incidence of dementia for 76,053 participants from the public long-term care insurance system. We calculated sidewalk coverage (sidewalk area as a percentage of road area) within 436 residential neighborhood units using geographic information systems. Multilevel survival models were used to estimate hazard ratios for the incidence of dementia. During follow-up, 5,310 dementia cases were found. In urban areas, compared with the lowest quartile of sidewalk coverage, the hazard ratio was 0.42 (95% confidence interval: 0.33, 0.54) for the highest quartile, adjusting for individual covariates. After successive adjustments for other neighborhood factors (land slope; numbers of hospitals, grocery stores, parks, railway stations, and bus stops; educational level; and unemployment rate), the hazard ratio remained statistically significant (hazard ratio = 0.71, 95% confidence interval: 0.54, 0.92). Living in a neighborhood with a high level of sidewalk installation was associated with low dementia incidence in urban areas.<br /> (© The Author(s) 2021. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.)
- Subjects :
- Aged
Aged, 80 and over
Cohort Studies
Dementia etiology
Female
Follow-Up Studies
Geriatric Assessment
Humans
Incidence
Japan epidemiology
Male
Multilevel Analysis
Proportional Hazards Models
Risk Factors
Survival Analysis
Dementia epidemiology
Environment Design statistics & numerical data
Independent Living psychology
Residence Characteristics statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1476-6256
- Volume :
- 190
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- American journal of epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 33604662
- Full Text :
- https://doi.org/10.1093/aje/kwab043