Relationship of Neighborhood Greenness to Alzheimer's Disease and Non-Alzheimer's Dementia among 249,405 U.S. Medicare Beneficiaries

William W. Aitken, Joanna Lombard, Kefeng Wang, Matthew Toro, Margaret Byrne, Maria I. Nardi, Jack Kardys, Abraham Parrish, Chuanhui Dong, José Szapocznik, Tatjana Rundek, Scott C. Brown

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Neighborhood greenness (vegetative presence) has been linked to multiple health outcomes, but its relationship to Alzheimer's disease (AD) and non-Alzheimer's (non-AD) dementia has been less studied. Objective: This study examines the relationship of greenness to both AD and non-AD dementia in a population-based sample of Medicare beneficiaries. Methods: Participants were 249,405 US Medicare beneficiaries aged >65 years living in Miami-Dade County, FL, from 2010 to 2011. Multi-level analyses examined the relationship of greenness, assessed by mean Census block level Normalized Difference Vegetation Index (NDVI), to odds of each of AD, Alzheimer's disease and related dementias (ADRD), and non-AD dementia, respectively. Covariates included age, gender, race/ethnicity, number of comorbid health conditions, and neighborhood income. Results: Higher greenness was associated with reduced risk of AD, ADRD, and non-AD dementia, respectively, adjusting for individual and neighborhood sociodemographics. Compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD by 20%(odds ratio, 0.80; 95%CI, 0.75-0.85), ADRD by 18%(odds ratio, 0.82; 95%CI, 0.77-0.86), and non-AD dementia by 11%(odds ratio, 0.89; 95%CI, 0.82-0.96). After further adjusting for number of comorbidities, compared to the lowest greenness tertile, the highest greenness tertile was associated with reduced odds of AD (OR, 0.94; 95%CI, 0.88-1.00) and ADRD (OR, 0.93; 95%CI, 0.88-0.99), but not non-AD dementia (OR, 1.01; 95%CI, 0.93-1.08). Conclusion: High neighborhood greenness may be associated with lower odds of AD and ADRD. Environmental improvements, such as increasing neighborhood vegetation, may be a strategy to reduce risk for AD and possibly other dementias.

Original languageEnglish (US)
Pages (from-to)597-606
Number of pages10
JournalJournal of Alzheimer's Disease
Volume81
Issue number2
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Medicare beneficiaries
  • built environment
  • dementia
  • health disparities
  • natural environment
  • neighborhood greenness
  • older adults

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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