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BMC Geriatr. 2019 Jan 7;19(1):4. doi: 10.1186/s12877-018-1017-7.

Influence of activity space on the association between neighborhood characteristics and dementia risk: results from the 3-City study cohort.

Author information

1
INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France. noemie.letellier@inserm.fr.
2
INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
3
Department of Neurology, Memory Research and Resources Center, Montpellier University Hospital Gui de Chauliac, F-34295, Montpellier, France.
4
Inserm, Bordeaux Population Health Research Center, team SEPIA, UMR 1219, University Bordeaux, F-33000, Bordeaux, France.
5
CHU Bordeaux, CMRR, F-33000, Bordeaux, France.
6
Bordeaux school of public health (ISPED), Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, University Bordeaux, F-33000, Bordeaux, France.
7
Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, University Bordeaux, F-33000, Bordeaux, France.
8
IRD - Hydrosciences UMR 5569, Montpellier University, F-34090, Montpellier, France.

Abstract

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.

KEYWORDS:

Cognitive aging; Deprivation; Life-space mobility; Living environment; Social health inequalities

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