Neighborhood Integration and Connectivity Predict Cognitive Performance and Decline.
OBJECTIVE
Neighborhood characteristics may be important for promoting walking, but little research has focused on older adults, especially those with cognitive impairment. We evaluated the role of neighborhood characteristics on cognitive function and decline over a 2-year period adjusting for measures of walking.


METHODS
In a study of 64 older adults with and without mild Alzheimer's disease (AD), we evaluated neighborhood integration and connectivity using geographical information systems data and space syntax analysis. In multiple regression analyses, we used these characteristics to predict 2-year declines in factor analytically derived cognitive scores (attention, verbal memory, mental status) adjusting for age, sex, education, and self-reported walking.


RESULTS
Neighborhood integration and connectivity predicted cognitive performance at baseline, and changes in cognitive performance over 2 years. The relationships between neighborhood characteristics and cognitive performance were not fully explained by self-reported walking.


CONCLUSIONS
Clearer definitions of specific neighborhood characteristics associated with walkability are needed to better understand the mechanisms by which neighborhoods may impact cognitive outcomes. These results have implications for measuring neighborhood characteristics, design and maintenance of living spaces, and interventions to increase walking among older adults. We offer suggestions for future research measuring neighborhood characteristics and cognitive function.
University of Kansas, Lawrence, USA.
Amber
A
Watts
University of Kansas, Lawrence, USA.
Farhana
F
Ferdous
University of Utah, Salt Lake City, USA.
Keith Diaz
KD
Moore
University of Kansas, Fairway, USA.
Jeffrey M
JM
Burns
Alzheimer's disease; cognitive decline; neighborhood; walking