Association between neighborhood availability of physical activity facilities and cognitive performance in older adults

Hui-Wen Yang; Yun-Hsuan Wu; Mei-Chen Lin; Shu-Fen Liao; Chun-Chieh Fan; Chi-Shin Wu; Shi-Heng Wang

doi:10.1016/j.ypmed.2023.107669

Association between neighborhood availability of physical activity facilities and cognitive performance in older adults

Prev Med. 2023 Oct:175:107669. doi: 10.1016/j.ypmed.2023.107669. Epub 2023 Aug 16.

Authors

Hui-Wen Yang¹, Yun-Hsuan Wu¹, Mei-Chen Lin², Shu-Fen Liao³, Chun-Chieh Fan⁴, Chi-Shin Wu⁵, Shi-Heng Wang⁶

Affiliations

¹ Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
² National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
³ Department of Medical Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
⁴ Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA; Department of Radiology, School of Medicine, University of California San Diego, La Jolla, CA, USA.
⁵ National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Yunlin branch, Douliu, Taiwan.
⁶ Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan. Electronic address: shwang@nhri.edu.tw.

PMID: 37595898
DOI: 10.1016/j.ypmed.2023.107669

Abstract

The existing evidence on the contextual influence of the availability of local facilities for physical activity on the cognitive health of elderly residents is sparse. This study examined the association between neighborhood physical activity facilities and cognitive health in older individuals. A cohort study of community-dwelling older adults was performed using baseline data and follow-up data from the Taiwan Biobank. Cognitive health was measured in 32,396 individuals aged 60-70 years using the Mini-Mental State Examination (MMSE) with follow-up information on 8025 participants. The district was used as the proxy for local neighborhood. To determine neighborhood physical activity facilities, school campuses, parks, activity centers, gyms, swimming pools, and stadiums were included. Multilevel linear regression models were applied to examine the associations of neighborhood physical activity facilities with baseline MMSE and MMSE decline during follow-up, with adjustment for individual factors and neighborhood socioeconomic characteristics. Multilevel analyses revealed that there was a neighborhood-level effect on cognitive health among older adults. After adjusting for compositional and neighborhood socioeconomic characteristics, baseline MMSE was higher in individuals living in the middle- (beta = 0.12, p-value = 0.140) and high-density facility (beta = 0.22, p-value = 0.025) groups than in the low-density group (p-value for trend-test = 0.031). MMSE decline during follow-up was slower in the middle- (beta = 0.15, p-value = 0.114) and high-density facility (beta = 0.27, p-value = 0.052) groups than in the low-density group (p-value for trend-test = 0.032). Greater neighborhood availability of physical activity facilities was associated with better cognitive health among older residents. These findings have implications for designing communities and developing strategies to support cognitive health of an aging population.

Keywords: Cognitive aging; Cognitive impairment; Cognitive performance; Mini-Mental State Examination; Multilevel analysis; Neighborhood environment; Neighborhood physical activity facilities.