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Nexus Between Exposure to Natural Outdoor Environments and Cognitive Competence among Older Adults in China
Anita Fang Chen, Kai Cao, Ye Liu, Sabrina L. Li, Huashuai Chen, Marcus Yu-Lung Chiu. Annals of the American Association of Geographers, 2025-03-26
Topic: Risk, prevention and care in population studies
With a rapidly aging population and an increasing number of older people with cognitive impairment, a multitude of social problems could arise. The natural outdoor environments (NOEs) surrounding residential areas are important environments as they directly influence the residents’ quality of life and even physical health. A plethora of studies have suggested the definitive impact of NOE on the physical and mental health of older people. There have been very few studies, however, investigating the nexus between exposure to NOE, especially blue spaces, and cognitive competence among older populations. Our study aims to explore the effects of exposure to residential NOE on cognition by investigating the correlations between exposure to the county-level NOE (i.e., green and blue spaces) and cognitive competence of older Chinese adults. Using regression methods and stratified analysis, we demonstrate that there exists a positive relation between access to blue-green spaces and cognitive competence among older Chinese adults. The cognitive competence of older adults could benefit from increased exposure to NOEs with abundant blue-green spaces. Path analysis has been further conducted to investigate the pathways through which exposure to NOE affects cognitive ability and identify the mediating effects of population density and PM2.5 concentration. Under the person–environment framework, the findings of this study highlight the importance of well-designed NOEs for senior citizens and provide a strong theoretical foundation to support the building of age-friendly cities that could provide a healthier environment for aging in place. Finally, the limitations of this study and a few potential directions for future research are also discussed.
Key findings
- Using regression methods and stratified analysis, we demonstrate that there exists a positive relation between access to blue-green spaces and cognitive competence among older Chinese adults.
- The cognitive competence of older adults could benefit from increased exposure to NOEs with abundant blue-green spaces.
- Path analysis has been further conducted to investigate the pathways through which exposure to NOE affects cognitive ability and identify the mediating effects of population density and PM2.5 concentration.
- Under the person–environment framework, the findings of this study highlight the importance of well-designed NOEs for senior citizens and provide a strong theoretical foundation to support the building of age-friendly cities that could provide a healthier environment for aging in place.
- Finally, the limitations of this study and a few potential directions for future research are also discussed.
Why it matters
In older Chinese adults, greater access to blue-green spaces was positively associated with cognitive competence. The relationship appeared to be mediated by population density and PM2.5 concentration.
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Study details
- Evidence strengthLow
How this study scored 31/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Annals of the American Association of Geographers) |
| Journal's citation record | 1 / 4 | Annals of the American Association of Geographers: journal h-index 84 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Marcus Yu-Lung Chiu: h-index 20 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Nottingham: institution h-index 879 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 4 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 31 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Chen, A. F., Cao, K., Liu, Y., Li, S. L., Chen, H., & Chiu, M. Y.-L. (2025). Nexus Between Exposure to Natural Outdoor Environments and Cognitive Competence among Older Adults in China. Annals of the American Association of Geographers. https://doi.org/10.1080/24694452.2024.2380889
Vancouver
Chen AF, Cao K, Liu Y, Li SL, Chen H, Chiu MY.-L. Nexus Between Exposure to Natural Outdoor Environments and Cognitive Competence among Older Adults in China. Annals of the American Association of Geographers. 2025. doi:10.1080/24694452.2024.2380889.
BibTeX
@article{chen2025-2744acee,
author = {Chen, Anita Fang and Cao, Kai and Liu, Ye and Li, Sabrina L. and Chen, Huashuai and Chiu, Marcus Yu-Lung},
title = {{Nexus Between Exposure to Natural Outdoor Environments and Cognitive Competence among Older Adults in China}},
journal = {Annals of the American Association of Geographers},
year = {2025},
doi = {10.1080/24694452.2024.2380889},
url = {https://doi.org/10.1080/24694452.2024.2380889}
}
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