C170 - Neighborhood Physical Disorder and Prevalence of Alzheimer's Disease
Time: 05:00 PM - 05:50 PMTopics: Social and Environmental Context and Health, Aging
Poster Number: C170
Introduction
Alzheimer’s disease dementia (AD) impacts around 5 million people in the United States and these numbers are expected to rise as the older adult population expands in the coming years. There has been a recent focus on exploring the impact of social and built environments on cognitive function in older adults. This ecological study investigates the relationship between neighborhood physical disorder and AD prevalence across five U.S. regions: New York City, NY; Philadelphia, PA; Jackson, MS; San Antonio, TX; and Rio Grande Valley, TX.
Methods
Data from 599 Zip Code Tabulation Areas (ZCTAs) were analyzed by combining AD prevalence among Medicare beneficiaries from the National Alzheimer’s Disease Index (NADEX) with neighborhood physical disorder scores derived from virtual audit data from 2007-2022. We fit multivariate Poisson regression models to estimate the association between physical disorder and AD prevalence, adjusting for sociodemographic covariates. We fit models stratified by region and tested effect modification by population density using an interaction model.
Results
Alzheimer's disease prevalence varied across regions, ranging from 7.84% in San Antonio to 13.39% in the Rio Grande Valley. The fully adjusted model showed an inverse association between physical disorder and AD prevalence (Prevalence Ratio [PR]=0.98, 95% Confidence Interval [CI]: 0.97-0.99). The stratified analysis revealed that the direction of the association differed by region. In less densely populated areas like the Rio Grande Valley and Jackson, physical disorder was positively associated with AD prevalence (PR=1.27, 95% CI: 1.19-1.35; PR=1.17, 95% CI: 1.02-1.34), while in more densely populated regions like New York City, the association was inverse (PR=0.92, 95% CI: 0.91-0.93). We found evidence of effect modification by population density (p<0.001); the positive physical disorder-AD prevalence association was stronger in ZCTAs with lower population density.
Conclusions
This study highlights the complex relationship between neighborhood physical disorder and AD prevalence, which may vary by population density and geographic context. Future research should explore longitudinal data to understand the causal pathways linking neighborhood physical disorder and cognitive health in aging populations.
Keywords: Alzheimer’s disease; neighborhood physical disorder; aging; ecological study
Keywords: Physical environment, Alzheimer's diseaseAlzheimer’s disease dementia (AD) impacts around 5 million people in the United States and these numbers are expected to rise as the older adult population expands in the coming years. There has been a recent focus on exploring the impact of social and built environments on cognitive function in older adults. This ecological study investigates the relationship between neighborhood physical disorder and AD prevalence across five U.S. regions: New York City, NY; Philadelphia, PA; Jackson, MS; San Antonio, TX; and Rio Grande Valley, TX.
Methods
Data from 599 Zip Code Tabulation Areas (ZCTAs) were analyzed by combining AD prevalence among Medicare beneficiaries from the National Alzheimer’s Disease Index (NADEX) with neighborhood physical disorder scores derived from virtual audit data from 2007-2022. We fit multivariate Poisson regression models to estimate the association between physical disorder and AD prevalence, adjusting for sociodemographic covariates. We fit models stratified by region and tested effect modification by population density using an interaction model.
Results
Alzheimer's disease prevalence varied across regions, ranging from 7.84% in San Antonio to 13.39% in the Rio Grande Valley. The fully adjusted model showed an inverse association between physical disorder and AD prevalence (Prevalence Ratio [PR]=0.98, 95% Confidence Interval [CI]: 0.97-0.99). The stratified analysis revealed that the direction of the association differed by region. In less densely populated areas like the Rio Grande Valley and Jackson, physical disorder was positively associated with AD prevalence (PR=1.27, 95% CI: 1.19-1.35; PR=1.17, 95% CI: 1.02-1.34), while in more densely populated regions like New York City, the association was inverse (PR=0.92, 95% CI: 0.91-0.93). We found evidence of effect modification by population density (p<0.001); the positive physical disorder-AD prevalence association was stronger in ZCTAs with lower population density.
Conclusions
This study highlights the complex relationship between neighborhood physical disorder and AD prevalence, which may vary by population density and geographic context. Future research should explore longitudinal data to understand the causal pathways linking neighborhood physical disorder and cognitive health in aging populations.
Keywords: Alzheimer’s disease; neighborhood physical disorder; aging; ecological study
Authors and Affliiates
Author: Anil Kumar, MPH, Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PACo-Author: Mark Hernandez, MPH, 1. Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA. 2. Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA.
Co-Author: Francesca Mucciaccio, MPH, 1. Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA. 2. Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA.
Co-Author: Tara McAlexander, PhD, MPH, 1. Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA. 2. Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA.
Co-Author: Cristian Maestre, Neuro and Behavioral Health Integrated Services Unit, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX
Co-Author: Jesus Melgarejo, MD, PhD, Neuro and Behavioral Health Integrated Services Unit, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX
Co-Author: Noe Garza, DO, Neuro and Behavioral Health Integrated Services Unit, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX
Co-Author: Gladys Maestre, MD, PhD, School of Medicine, Alzheimer's Disease Resource Center for Minority Aging Research, University of Texas Rio Grande Valley, Brownsville, Texas, USA.
Co-Author: Gina Lovasi, PhD, MPH, 1. Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA. 2. Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA.
C170 - Neighborhood Physical Disorder and Prevalence of Alzheimer's Disease
Category
Scientific > Poster/Paper/Live Research Spotlight