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Social and Built Environments and Healthy Brain Aging

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (15 June 2021) | Viewed by 38698

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Special Issue Editors

Dr. Lilah Besser

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Guest Editor

School of Urban & Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA
Interests: brain health; brain aging; dementia; neurodegenerative disorders

Dr. Willa D. Brenowitz

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Assistant Guest Editor

Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94158, USA
Interests: Alzheimer’s disease; dementia; sensory impairments; aging; social determinants of health; causal inference methods

Dr. Oanh Le Meyer

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Assistant Guest Editor

Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
Interests: Alzheimer’s disease; dementia; cognition; neighborhood; race; ethnicity; culture; social determinants; caregiving

Special Issue Information

Dear colleague,

We invite you to submit an article to this Special Issue on how social and built environments affect brain health. Health-promoting behaviors and exposures throughout life (e.g., diet, physical activity, air pollution) have been associated with childhood brain development and brain aging during middle and older age. Social and built environments at the household, neighborhood, city, and regional scale encourage health-promoting behaviors and exposures previously associated with brain health and recently have been associated with late-life cognitive function and risk for Alzheimer’s disease and associated disorders. However, studies focused on social and built environments and brain health have yet to determine the important life stages for exposure (childhood, middle and older adulthood). In addition, methods used to measure the built and social environment exposures have been limited, and the causal mechanisms linking these exposures to brain health have yet to be elucidated.

In this Special Issue, we aim to increase awareness of the potential benefits of social and built environments for brain health, by presenting (1) promising new research on the topic, (2) reviews of the relevant literature and causal mechanisms potentially relating social/built environments to brain health, and (3) the gaps in the literature and methods applied to date.

Please feel free to contact Dr. Lilah Besser ([email protected]) to determine if your paper fits this Special Issue.

Dr. Lilah M. Besser
Dr. Willa D. Brenowitz
Dr. Oanh Le Meyer
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

brain aging
cognition
brain biomarker
Alzheimer’s disease and associated disorders
social environment
built environment
life course
neighborhood
urban planning
dementia

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Published Papers (9 papers)

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Research

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16 pages, 1202 KiB

Open AccessArticle

Relationship between Residential Segregation, Later-Life Cognition, and Incident Dementia across Race/Ethnicity

by Daniel J. Pohl, Dominika Seblova, Justina F. Avila, Karen A. Dorsman, Erin R. Kulick, Joan A. Casey and Jennifer Manly

Int. J. Environ. Res. Public Health 2021, 18(21), 11233; https://doi.org/10.3390/ijerph182111233 - 26 Oct 2021

Cited by 31 | Viewed by 4371

Abstract

Systemic racism leads to racial/ethnic residential segregation, which can result in health inequities. We examined if the associations between residential segregation and later-life cognition and dementia differed based on segregation measure and by participant race/ethnicity. Tests of memory (n = 4616), language (n = 4333), visuospatial abilities (n = 4557), and incident dementia (n = 4556) were analyzed in older residents of Northern Manhattan, New York (mean age: 75.7 years). Segregation was measured at the block group-level using three indices: dissimilarity, isolation, and interaction. We fit multilevel linear or Cox proportional hazards models and included a race/ethnicity × segregation term to test for differential associations, adjusting for socioeconomic and health factors. Living in block groups with higher proportions of minoritized people was associated with −0.05 SD lower language scores. Living in block groups with higher potential contact between racial/ethnic groups was associated with 0.06–0.1 SD higher language scores. The findings were less pronounced for other cognitive domains and for incident dementia. Non-Hispanic Black adults were most likely to experience negative effects of neighborhood segregation on cognition (language and memory) and dementia. All indices partly capture downstream effects of structural racism (i.e., unequal distributions of wealth/resources) on cognition. Therefore, desegregation and equitable access to resources have the potential to improve later-life cognitive health. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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12 pages, 489 KiB

Open AccessArticle

Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis

by Lilah M. Besser, Lun-Ching Chang, Jana A. Hirsch, Daniel A. Rodriguez, John Renne, Stephen R. Rapp, Annette L. Fitzpatrick, Susan R. Heckbert, Joel D. Kaufman and Timothy M. Hughes

Int. J. Environ. Res. Public Health 2021, 18(15), 7973; https://doi.org/10.3390/ijerph18157973 - 28 Jul 2021

Cited by 11 | Viewed by 4256

Abstract

Few studies have examined associations between neighborhood built environments (BE) and longitudinally measured cognition. We examined whether four BE characteristics were associated with six-year change in global cognition and processing speed. We obtained data on 1816 participants without dementia from the Multi-Ethnic Study of Atherosclerosis. BE measures included social destination density, walking destination density, proportion of land dedicated to retail, and network ratio (street connectivity). Global cognition was measured with the Cognitive Abilities Screening Instrument (CASI) and processing speed with the Digit Symbol Coding test (DSC). Multivariable random intercept logistic models tested associations between neighborhood BE at 2010–2012 and maintained/improved cognition (versus decline) from 2010–2018, and mediation by minutes of physical activity (PA)/week. The sample was an average of 67 years old (standard deviation = 8.2) (first cognitive measurement) and racially/ethnically diverse (29% African American, 11% Chinese, 17% Hispanic, 44% White). Compared to individuals with no walking destinations in the 1-mile surrounding their residence, those with 716 walking destinations (maximum observed) were 1.24 times more likely to have maintain/improved DSC score (Odds ratio: 1.24; 95% confidence interval: 1.03–1.45). No other associations were observed between BE and cognition, and PA minutes/week did not mediate the association between walking destination density and DSC change. This study provides limited evidence for an association between greater neighborhood walking destinations and maintained/improved processing speed in older age and no evidence for associations between the other BE characteristics and cognition. Future studies with finer grained BE and cognitive measures and longer-term follow up may be required. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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11 pages, 5210 KiB

Open AccessArticle

Neighborhood Socioeconomic Resources and Crime-Related Psychosocial Hazards, Stroke Risk, and Cognition in Older Adults

by Linda D. Ruiz, Molly Brown, Yan Li, Elizabeth A. Boots, Lisa L. Barnes, Leonard Jason, Shannon Zenk, Philippa Clarke and Melissa Lamar

Int. J. Environ. Res. Public Health 2021, 18(10), 5122; https://doi.org/10.3390/ijerph18105122 - 12 May 2021

Cited by 6 | Viewed by 3991

Abstract

Living in neighborhoods with lower incomes, lower education/occupational levels, and/or higher crime increases one’s risk of developing chronic health problems including cardiovascular disease risk factors and stroke. These cardiovascular health problems are known to contribute to cognitive decline and dementia. The purpose of this study was to determine the association of neighborhood socioeconomic resources and crime-related psychosocial hazards on stroke risk and cognition, hypothesizing that cardiovascular health would mediate any relationship between the neighborhood-level environment and cognition. The study evaluated 121 non-demented Chicago-area adults (~67 years; 40% non-Latino White) for cardiovascular health problems using the Framingham Stroke Risk Profile 10-year risk of stroke (FSRP-10). The cognitive domains that were tested included memory, executive functioning, and attention/information processing. Neighborhood socioeconomic resources were quantified at the census tract level (income, education, and occupation); crime-related psychosocial hazards were quantified at the point level. Structural equation modeling (SEM) did not show that the FSRP-10 mediated the relationship between neighborhood characteristics and domain-specific cognition. The SEM results did suggest that higher crime rates were associated with a higher FSRP-10 (β(105) = 2.38, p = 0.03) and that higher FSRP-10 is associated with reduced attention/information processing performance (β(105) = −0.04, p = 0.02) after accounting for neighborhood socioeconomic resources. Clinicians may wish to query not only individual but also neighborhood-level health when considering cognition. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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13 pages, 327 KiB

Open AccessArticle

Social and Built Environments Related to Cognitive Function of Older Adults: A Multi-Level Analysis Study in Taiwan

by Hui-Chuan Hsu and Chyi-Huey Bai

Int. J. Environ. Res. Public Health 2021, 18(6), 2820; https://doi.org/10.3390/ijerph18062820 - 10 Mar 2021

Cited by 10 | Viewed by 3214

Abstract

The purpose of this study was to examine the associations between cognitive function, the city’s social environment, and individual characteristics of older adults. The individual data of older people were from the Nutrition and Health Survey in Taiwan 2013–2016. The participants who were aged 65 and above were included in the analysis (n = 1356). City-level data were obtained for twenty cities in Taiwan. The data of city-level indicators were from governmental open data and Taiwan’s Age Friendly Environment Monitor Study. A multilevel mixed-effect model was applied in the analysis. Population density, median income, safety in the community, barrier-free sidewalks, high education rate of the population, low-income population rate, household income inequality, and elderly abuse rate were related to cognitive function in the bivariate analysis. When controlling for individual factors, the city’s low-income population rate was still significantly related to lower cognitive function. In addition, the participants who were at younger age, had a higher education level, had a better financial satisfaction, had worse self-rated health, had higher numbers of disease, and had better physical function had better cognitive function. Social and built environments associated with cognitive function highlight the importance of income security and the age friendliness of the city for older adults. Income security for older people and age-friendly city policies are suggested. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

15 pages, 1486 KiB

Open AccessArticle

The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study

by Allan K. Nkwata, Ming Zhang, Xiao Song, Bruno Giordani and Amara E. Ezeamama

Int. J. Environ. Res. Public Health 2021, 18(3), 1358; https://doi.org/10.3390/ijerph18031358 - 2 Feb 2021

Cited by 9 | Viewed by 3357

Abstract

Background: Race/ethnicity, toxic stress (TS), resilience-promoting factors (RPFs), and their interactions were investigated in relationship to neurocognitive impairment (NI) in a nationally representative sample of adult Americans ≥50 years enrolled in the Health and Retirement Study (HRS) between 2012 and 2014. Methods: NI was defined as physician diagnosis of Alzheimer’s disease/dementia or HRS total cognition score ≤ 10. Race/ethnicity (i.e., African American, White, or Other), TS (i.e., everyday discrimination and chronic stressors), and mastery (as indicator of RPF) were self-reported. Multivariable logistic regression models estimated race-, TS-, RPF-associated odds ratios (ORs), and 95% confidence intervals (CI) for NI adjusting for socio-demographic confounders. Results: 6317 respondents interviewed between the years 2012 and 2014, age range 55–104 years old, 83% White, 13% Black and 4% Other race were included in the study. Chronic stress (OR = 1.88, 95% CI: 1.42–2.48), discrimination (OR = 3.31, 95% CI: 2.12–5.19) and low mastery (OR = 1.85, 95% CI: 1.38–2.48) were each associated with higher NI risk while low mastery was associated with higher NI risk in discrimination and race/ethnicity dependent manner. Specifically, low mastery-associated risk for NI was evident among adults that denied experiencing discrimination (OR = 2.01, 95% CI: 1.51–2.68), but absent among those that experienced discrimination (OR = 0.72, 95% CI: 0.32–1.62). Further, AA race was associated with NI risk but only among adults with high mastery (OR = 2.00, 95% CI: 1.20–3.35). Conclusions: Discrimination, chronic stress, and low mastery were associated with worse cognition. Persisting cognitive disadvantage for AA vs. White/Other race only among high mastery adults suggests that adverse social experiences may counteract mastery-associated cognitive benefits among AA population. TS reduction through policies that promote equal treatment by race/ethnicity in social life, health, justice, and economic systems may promote successful cognitive aging. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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Review

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13 pages, 1291 KiB

Open AccessReview

The Long-Term Public Health Impact of Social Distancing on Brain Health: Topical Review

by Anagha Kumar and Joel Salinas

Int. J. Environ. Res. Public Health 2021, 18(14), 7307; https://doi.org/10.3390/ijerph18147307 - 8 Jul 2021

Cited by 12 | Viewed by 4721

Abstract

Social distancing has been a critical public health measure for the COVID-19 pandemic, yet a long history of research strongly suggests that loneliness and social isolation play a major role in several cognitive health issues. What is the true severity and extent of risks involved and what are potential approaches to balance these competing risks? This review aimed to summarize the neurological context of social isolation and loneliness in population health and the long-term effects of social distancing as it relates to neurocognitive aging, health, and Alzheimer’s disease and related dementias. The full scope of the underlying causal mechanisms of social isolation and loneliness in humans remains unclear partly because its study is not amenable to randomized controlled trials; however, there are many detailed experimental and observational studies that may provide a hypothesis-generating theoretical framework to better understand the pathophysiology and underlying neurobiology. To address these challenges and inform future studies, we conducted a topical review of extant literature investigating associations of social isolation and loneliness with relevant biological, cognitive, and psychosocial outcomes, and provide recommendations on how to approach the need to fill key knowledge gaps in this important area of research. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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19 pages, 852 KiB

Open AccessReview

Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review

by Rachel L. Peterson, Kristen M. George, Duyen Tran, Pallavi Malladi, Paola Gilsanz, Amy J. H. Kind, Rachel A. Whitmer, Lilah M. Besser and Oanh L. Meyer

Int. J. Environ. Res. Public Health 2021, 18(13), 7166; https://doi.org/10.3390/ijerph18137166 - 4 Jul 2021

Cited by 7 | Viewed by 5042

Abstract

Background: Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. Methods: A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. Results: Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1–28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. Conclusions: Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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15 pages, 674 KiB

Open AccessReview

A Scoping Review of the Association of Social Disadvantage and Cerebrovascular Disease Confirmed by Neuroimaging and Neuropathology

by Sarah A. Keller, Kellia J. Hansmann, W. Ryan Powell, Barbara B. Bendlin and Amy J. H. Kind

Int. J. Environ. Res. Public Health 2021, 18(13), 7071; https://doi.org/10.3390/ijerph18137071 - 2 Jul 2021

Cited by 2 | Viewed by 2988

Abstract

Social disadvantage—a state of low-income, limited education, poor living conditions, or limited social support—mediates chronic health conditions, including cerebrovascular disease. Social disadvantage is a key component in several health impact frameworks, providing explanations for how individual-level factors interact with interpersonal and environmental factors to create health disparities. Understanding the association between social disadvantage and vascular neuropathology, brain lesions identified by neuroimaging and autopsy, could provide insight into how one’s social context interacts with biological processes to produce disease. The goal of this scoping review was to evaluate the scientific literature on the relationship between social disadvantage and cerebrovascular disease, confirmed through assessment of vascular neuropathology. We reviewed 4049 titles and abstracts returned from our search and included records for full-text review that evaluated a measure of social disadvantage as an exposure variable and cerebrovascular disease, confirmed through assessment of vascular neuropathology, as an outcome measure. We extracted exposures and outcomes from 20 articles meeting the criteria after full-text review, and described the study findings and populations sampled. An improved understanding of the link between social factors and cerebrovascular disease will be an important step in moving the field closer to addressing the fundamental causes of disease and towards more equitable brain health. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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19 pages, 720 KiB

Open AccessReview

Methods to Address Self-Selection and Reverse Causation in Studies of Neighborhood Environments and Brain Health

by Lilah M. Besser, Willa D. Brenowitz, Oanh L. Meyer, Serena Hoermann and John Renne

Int. J. Environ. Res. Public Health 2021, 18(12), 6484; https://doi.org/10.3390/ijerph18126484 - 16 Jun 2021

Cited by 27 | Viewed by 4696

Abstract

Preliminary evidence suggests that neighborhood environments, such as socioeconomic disadvantage, pedestrian and physical activity infrastructure, and availability of neighborhood destinations (e.g., parks), may be associated with late-life cognitive functioning and risk of Alzheimer’s disease and related disorders (ADRD). The supposition is that these neighborhood characteristics are associated with factors such as mental health, environmental exposures, health behaviors, and social determinants of health that in turn promote or diminish cognitive reserve and resilience in later life. However, observed associations may be biased by self-selection or reverse causation, such as when individuals with better cognition move to denser neighborhoods because they prefer many destinations within walking distance of home, or when individuals with deteriorating health choose residences offering health services in neighborhoods in rural or suburban areas (e.g., assisted living). Research on neighborhood environments and ADRD has typically focused on late-life brain health outcomes, which makes it difficult to disentangle true associations from associations that result from reverse causality. In this paper, we review study designs and methods to help reduce bias due to reverse causality and self-selection, while drawing attention to the unique aspects of these approaches when conducting research on neighborhoods and brain aging. Full article

(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)

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