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The impact of built and social environmental characteristics on incidence and estimated risk of dementia
Nasser Bagheri, Suzanne Mavoa, Hossein Tabatabaei‐Jafari, Luke D. Knibbs, Neil T. Coffee, Luis Salvador‐Carulla, Kaarin Jane Anstey. Alzheimer s & Dementia, 2021-12-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Abstract Background Dementia is a public health priority1 and the current study designed to investigate associations between built and social environmental characteristics and dementia incidence, and the estimated future risk of dementia. Further we investigated spatial variations in dementia risk and dementia incidence to identify unmet areas for policy intervention. Method We used 25,511 patients (aged 65 years and older) records in Adelaide between 2011‐2015. In addition to dementia incidence, we calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. The following built and social environment exposures were estimated for each statistical area level 1 (SA1)2: social fragmentation, nitrogen dioxide (NO2), public open spaces, walkability, socio‐economic status and the length of main roads. We performed multilevel regression analyses to allow for the hierarchical nature of the data and applied spatial cluster analysis to identify areas with high and low risk of dementia. Result We found that a one standard deviation (SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% confidence interval (CI): 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1‐SD increase in social fragmentation (mobility component) and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1‐SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of dementia incidence and dementia risk. Conclusion Associations of neighbourhood NO2 level, walkability, public open space and social fragmentation with dementia incidence and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments. Mapping the estimated future risk of dementia and diagnosed cases of dementia offers a novel approach to identifying areas of unmet need. 1. Towards a dementia plan: a WHO guide. Geneva: WHO; 2018. 2. Australian Statistical Geography Standard (ASGS): Volume 1 ‐ Main Structure and Greater Capital City Statistical Areas, 2016.
What this study adds
Evidence grade: Low
The record lists 25,511 participants. The study is about environmental associations with dementia incidence and risk, not about treating, curing, or preventing Alzheimer's disease.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Bagheri, N., Mavoa, S., Tabatabaei‐Jafari, H., Knibbs, L. D., Coffee, N. T., Salvador‐Carulla, L., et al. (2021). The impact of built and social environmental characteristics on incidence and estimated risk of dementia. Alzheimer s & Dementia. https://doi.org/10.1002/alz.055380
Vancouver
Bagheri N, Mavoa S, Tabatabaei‐Jafari H, Knibbs LD, Coffee NT, Salvador‐Carulla L, et al. The impact of built and social environmental characteristics on incidence and estimated risk of dementia. Alzheimer s & Dementia. 2021. doi:10.1002/alz.055380.
BibTeX
@article{bagheri2021-097d785b,
author = {Bagheri, Nasser and Mavoa, Suzanne and Tabatabaei‐Jafari, Hossein and Knibbs, Luke D. and Coffee, Neil T. and Salvador‐Carulla, Luis and Anstey, Kaarin Jane},
title = {{The impact of built and social environmental characteristics on incidence and estimated risk of dementia}},
journal = {Alzheimer s \& Dementia},
year = {2021},
doi = {10.1002/alz.055380},
url = {https://doi.org/10.1002/alz.055380}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Result We found that a one standard deviation (SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% confidence interval (CI): 1%, 21% for NO2 and 0%, 22% for walkability score).
- For estimated future risk of dementia, a 1‐SD increase in social fragmentation (mobility component) and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1‐SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively.
- Conclusion Associations of neighbourhood NO2 level, walkability, public open space and social fragmentation with dementia incidence and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments.
Why it matters
In 25,511 patients aged 65 and older in Adelaide, a one standard deviation increase in nitrogen dioxide and walkability score was associated with 10% higher odds of any versus no dementia, and increases in social fragmentation and nitrogen dioxide were associated with a 1% increase in estimated future dementia risk. The study is about environmental associations with dementia incidence and risk, not about treating, curing, or preventing Alzheimer's disease.
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Study details
- Participants25,511
- Evidence strengthLow
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (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 | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 25,511 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization 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 | 0.3 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 1 / 6 | Cited 0.3× 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 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Kaarin Jane Anstey: h-index 103 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | The University of Queensland: institution h-index 1,516 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 43 / 100 | — |
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