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The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II
Wu YT, Prina AM, Jones A, Matthews FE, Brayne C, Medical Research Council Cognitive Function and Ageing Study Collaboration.. American journal of preventive medicine, 2017-01-09
Topic: Risk, prevention and care in population studies
Introduction Built environment features have been related to behavior modification and might stimulate cognitive activity with a potential impact on cognitive health in later life. This study investigated cross-sectional associations between features of land use and cognitive impairment and dementia, and also explored urban and rural differences in these associations. Methods Postcodes of the 7,505 community-based participants (aged ≥65 years) in the Cognitive Function and Ageing Study II (collected in 2008-2011) were linked to environmental data from government statistics. Multilevel logistic regression investigated associations between cognitive impairment (defined as Mini-Mental State Examination score ≤25) and dementia (Geriatric Mental Status and Automatic Geriatric Examination for Computer-Assisted Taxonomy organicity level ≥3) and land use features, including natural environment availability and land use mix, fitting interaction terms with three rural/urban categories. Data were analyzed in 2015. Results Associations between features of land use and cognitive impairment were not linear. After adjusting for individual-level factors and area deprivation, living in areas with high land use mix was associated with a nearly 30% decreased odds of cognitive impairment (OR=0.72, 95% CI=0.58, 0.89). This was similar, yet non-significant, for dementia (OR=0.70, 95% CI=0.46, 1.06). In conurbations, living in areas with high natural environment availability was associated with 30% reduced odds of cognitive impairment (OR=0.70, 95% CI=0.50, 0.97). Conclusions Non-linear associations between features of land use and cognitive impairment were confirmed in this new cohort of older people in England. Both lack of and overload of environmental stimulation may be detrimental to cognition in later life.
Key findings
- Results Associations between features of land use and cognitive impairment were not linear.
- After adjusting for individual-level factors and area deprivation, living in areas with high land use mix was associated with a nearly 30% decreased odds of cognitive impairment (OR=0.72, 95% CI=0.58, 0.89).
- This was similar, yet non-significant, for dementia (OR=0.70, 95% CI=0.46, 1.06).
- In conurbations, living in areas with high natural environment availability was associated with 30% reduced odds of cognitive impairment (OR=0.70, 95% CI=0.50, 0.97).
Why it matters
Among 7,505 adults aged 65+ in the Cognitive Function and Ageing Study II, living in areas with high land use mix was linked to lower odds of cognitive impairment (OR 0.72, 95% CI 0.58–0.89). The similar result for dementia was not statistically significant (OR 0.70, 0.46–1.06). In conurbations, high natural environment availability was also linked to lower odds of cognitive impairment (OR 0.70, 0.50–0.97). These are one-time-point associations from postcode-linked data, so they cannot show that neighbourhood design prevents or treats dementia.
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Study details
- Study designcross-sectional
- Effect sizeOR=0.72; OR=0.70
- Evidence strengthModerate
How this study scored 58/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, 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 (American journal of preventive medicine) |
| Journal's citation record | 3 / 4 | American Journal of Preventive Medicine: journal h-index 316 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 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 | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | 4 / 7 | Cited 99 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.0 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 3 / 6 | Cited 5.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 2 / 4 | Cited 28 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Carol Brayne: h-index 159 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Cambridge: institution h-index 1,973 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28082001) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
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Read the original
- DOI: 10.1016/j.amepre.2016.11.020
- PubMed: 28082001
- Original source →
- Free full text: American Journal of Preventive Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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
Wu, Y. T., Prina, A. M., Jones, A., Matthews, F. E., Brayne, C., & Medical Research Council Cognitive Function and Ageing Study Collaboration. (2017). The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II. American journal of preventive medicine. https://doi.org/10.1016/j.amepre.2016.11.020
Vancouver
Wu YT, Prina AM, Jones A, Matthews FE, Brayne C, Medical Research Council Cognitive Function and Ageing Study Collaboration. The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II. American journal of preventive medicine. 2017. doi:10.1016/j.amepre.2016.11.020. PMID: 28082001.
BibTeX
@article{wu2017-28082001,
author = {Wu, Y. T. and Prina, A. M. and Jones, A. and Matthews, F. E. and Brayne, C. and {Medical Research Council Cognitive Function and Ageing Study Collaboration}},
title = {{The Built Environment and Cognitive Disorders: Results From the Cognitive Function and Ageing Study II}},
journal = {American journal of preventive medicine},
year = {2017},
doi = {10.1016/j.amepre.2016.11.020},
pmid = {28082001},
url = {https://doi.org/10.1016/j.amepre.2016.11.020}
}
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