title: Geographic Elevation and Cognitive Function among Elderly Residents in Rural Mountainous Areas: Shimane CoHRE Study.
abstract: The aim of this study was to test whether there is an association between elevation and cognitive function among elderly residents in rural mountainous areas. Data were collected in 2012 from a cross-sectional study conducted in Ohnan Town, which is located in a rural mountainous area in the southern part of Shimane Prefecture, Japan. Cognitive function was evaluated using CADi (Cognitive Assessment for Dementia, iPad version) and elevation was estimated by using Geographic Information Systems according to the participant's address. After excluding subjects with missing data, 866 participants were analyzed. After adjustment for potential confounding factors, higher elevation was significantly associated with decreased cognitive function. This finding suggests that it is important to consider the physical environment, i.e., elevation, that would affect accessibility to health-promoting goods, services, and resources when seeking to maintain cognitive function in elderly people living in rural mountainous areas.
authors.affiliation: Center for Community-Based Health Research and Education (CoHRE), Organization for the Promotion of Project Research, Shimane University, 223-8 Enya-cho, Izumo, Shimane 693-8501, Japan. thamano@med.shimane-u.ac.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamano
authors.affiliation: Department of Neurology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan. onodak1@med.shimane-u.ac.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Onoda
authors.affiliation: Center for Community-Based Health Research and Education (CoHRE), Organization for the Promotion of Project Research, Shimane University, 223-8 Enya-cho, Izumo, Shimane 693-8501, Japan. cohre1@med.shimane-u.ac.jp.
authors.forename: Miwako
authors.initials: M
authors.lastname: Takeda
authors.affiliation: Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Building 28, floor 11, Jan Waldenströms gata 35, Skåne University Hospital, SE-205 02 Malmö, Sweden. kristina.sundquist@med.lu.se.|Stanford Prevention Research Center, Stanford University, Medical School Office Building (MSOB), 251 Campus Drive MC 5411, Stanford, CA 94305, USA. kristina.sundquist@med.lu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Department of Neurology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan. yamagu3n@med.shimane-u.ac.jp.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Center for Community-Based Health Research and Education (CoHRE), Organization for the Promotion of Project Research, Shimane University, 223-8 Enya-cho, Izumo, Shimane 693-8501, Japan. nabika@med.shimane-u.ac.jp.|Department of Functional Pathology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan. nabika@med.shimane-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nabika
mesh_terms: D000368:Aged; D000531:Altitude; D003071:Cognition; D003430:Cross-Sectional Studies; D003704:Dementia; D004777:Environment; D005260:Female; D040362:Geographic Information Systems; D006295:Health Resources; D006801:Humans; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012424:Rural Population / Q000706:statistics & numerical data
keywords: cognitive function; elderly people; elevation; rural mountainous area