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  1. Article ; Online: Validation of the shortened version of the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) using participants from the Dog Aging Project.

    Wilkins, Vanessa / Evans, Jeremy / Park, Christina / Fitzpatrick, Annette L / Creevy, Kate E / Ruple, Audrey

    PloS one

    2024  Volume 19, Issue 4, Page(s) e0299973

    Abstract: The Canine Behavioral Assessment and Research Questionnaire (C-BARQ) is a 100-item owner-completed survey instrument used for assessing behavior and temperament of companion dogs. The shortened version of the C-BARQ (C-BARQ(S)) consists of 42 items of ... ...

    Abstract The Canine Behavioral Assessment and Research Questionnaire (C-BARQ) is a 100-item owner-completed survey instrument used for assessing behavior and temperament of companion dogs. The shortened version of the C-BARQ (C-BARQ(S)) consists of 42 items of the long C-BARQ. We aimed to validate the shortened C-BARQ(S) by comparing it with the long questionnaire in the same human-dog pair. We examined data from a nationwide cohort of companion dogs enrolled in the large-scale longitudinal Dog Aging Project (DAP) study. Among 435 participating owners who completed both the long and shortened versions of the C-BARQ within 60 days of each other, agreement between individual questions of the long and shortened C-BARQ using an unweighted kappa statistic and percent agreement was examined. Associations between the two questionnaires for mean behavior and temperament domain scores and mean miscellaneous category scores were assessed using Pearson correlation coefficients. Of 435 dogs in the study, the mean (SD) age was 7.3 (4.3) years and 216 (50%) were female. Kappa values between the long and shortened C-BARQ for individual questions within the 14 behavior and temperament domains and a miscellaneous category ranged from fair to moderate (0.23 to 0.40 for 21 items and 0.41 to 0.58 for 26 items, respectively). Pearson correlation coefficients above 0.60 between both questionnaires for 12 of the 14 mean behavior and temperament domain scores and a category of miscellaneous items were observed. Kappa values for individual questions between the long and shortened C-BARQ ranged from fair to moderate and correlations between mean domain scores ranged from moderate to strong.
    MeSH term(s) Animals ; Child ; Dogs ; Female ; Humans ; Male ; Aggression ; Aging ; Behavior, Animal ; Surveys and Questionnaires ; Temperament
    Language English
    Publishing date 2024-04-11
    Publishing country United States
    Document type Journal Article ; Validation Study
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0299973
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The impact of falls on activities of daily living in older adults: A retrospective cohort analysis.

    Adam, Claire E / Fitzpatrick, Annette L / Leary, Cindy S / Ilango, Sindana D / Phelan, Elizabeth A / Semmens, Erin O

    PloS one

    2024  Volume 19, Issue 1, Page(s) e0294017

    Abstract: Background: Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, ...

    Abstract Background: Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, as well as identifying the characteristics of older adults more likely to have post-fall ADL impairment is critical to inform fall prevention and post-fall intervention. The purpose of this study is to 1) Quantify the association between falls and post-fall ADL impairment and 2) Model trajectories of ADL impairment pre- and post-fall to estimate the long-term impact of falls and identify characteristics of older adults most likely to have impairment.
    Method: Study participants were from the Ginkgo Evaluation of Memory Study, a randomized controlled trial in older adults (age 75+) in the United States. Self-reported incident falls and ADL scores were ascertained every 6 months over a 7-year study period. We used Cox proportional hazards analyses (n = 2091) to quantify the association between falls and ADL impairment and latent class trajectory modeling (n = 748) to visualize trajectories of ADL impairment pre-and post-fall.
    Results: Falls reported in the previous 6 months were associated with impairment in ADLs (HR: 1.42; 95% CI 1.32, 1.52) in fully adjusted models. Based on trajectory modeling (n = 748), 19% (n = 139) of participants had increased, persistent ADL impairment after falling. Participants who were female, lived in a neighborhood with higher deprivation, or experienced polypharmacy were more likely to have ADL impairment post-fall.
    Conclusions: Falls are associated with increased ADL impairment, and this impairment can persist over time. It is crucial that all older adults, and particularly those at higher risk of post-fall ADL impairment have access to comprehensive fall risk assessment and evidence-based fall prevention interventions, to help mitigate the negative impacts on ADL function.
    MeSH term(s) Aged ; Female ; Humans ; Male ; Activities of Daily Living ; Cohort Studies ; Quality of Life ; Retrospective Studies ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2024-01-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0294017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection.

    Vu, Quan M / Fitzpatrick, Annette L / Cope, Jennifer R / Bertolli, Jeanne / Sotoodehnia, Nona / West, T Eoin / Gentile, Nikki / Unger, Elizabeth R

    Emerging infectious diseases

    2024  Volume 30, Issue 3, Page(s) 539–547

    Abstract: This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during ... ...

    Abstract This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020-February 2021 who were followed for a median of 11.4 (interquartile range 7.8-15.5) months and compared them to data from 9,022 propensity score-matched non-COVID-19 controls. Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non-COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48-1.92) for fatigue and 4.32 (95% CI 2.90-6.43) for chronic fatigue. The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.
    MeSH term(s) Humans ; Incidence ; COVID-19/epidemiology ; Fatigue Syndrome, Chronic ; Muscle Fatigue ; SARS-CoV-2
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid3003.231194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Balance and cognitive decline in older adults in the cardiovascular health study.

    Meunier, Claire C / Smit, Ellen / Fitzpatrick, Annette L / Odden, Michelle C

    Age and ageing

    2021  Volume 50, Issue 4, Page(s) 1342–1348

    Abstract: Background: Previous studies have demonstrated an association between gait speed and cognitive function. However, the relationship between balance and cognition remains less well explored. This study examined the cross-sectional and longitudinal ... ...

    Abstract Background: Previous studies have demonstrated an association between gait speed and cognitive function. However, the relationship between balance and cognition remains less well explored. This study examined the cross-sectional and longitudinal relationship of balance and cognitive decline in older adults.
    Methods: A cohort of 4,811 adults, aged ≥65 years, participating in the Cardiovascular Health Study was followed for 6 years. Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST) were used to measure cognition. Tandem balance measures were used to evaluate balance. Regression models were adjusted for demographics, behavioural and disease factors.
    Results: Worse balance was independently associated with worse cognition in cross-sectional analysis. Longitudinally, participants aged ≥76 years with poorer balance had a faster rate of decline after adjustment for co-variates: -0.97 points faster decline in 3MSE per year (95% confidence interval (CI): -1.32, -0.63) compared to the participants with good balance. There was no association of balance and change in 3MSE among adults aged <76 years (P value for balance and age interaction < 0.0001). DSST scores reflected -0.21 (95% CI: -0.37, -0.05) points greater decline when adjusted for co-variates. In Cox proportional hazard models, participants with worse balance had a higher risk of being cognitively impaired over the 6 years of follow-up visits (adjusted HR:1.72, 95% CI: 1.30, 2.29).
    Conclusions: Future studies should evaluate standing balance as a potential screening technique to identify individuals at risk of cognitive decline. Furthermore, a better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.
    MeSH term(s) Aged ; Cognition ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/epidemiology ; Cross-Sectional Studies ; Humans ; Neuropsychological Tests ; Walking Speed
    Language English
    Publishing date 2021-03-10
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afab038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: A review of frailty instruments in human medicine and proposal of a frailty instrument for dogs.

    Melvin, Rachel L / Ruple, Audrey / Pearson, Elizabeth B / Olby, Natasha J / Fitzpatrick, Annette L / Creevy, Kate E

    Frontiers in veterinary science

    2023  Volume 10, Page(s) 1139308

    Abstract: Over the last few decades, frailty has become a pillar of research and clinical assessment in human gerontology. This complex syndrome, characterized by loss of physiologic reserves leading to decreased resilience to stressors, is of critical importance ... ...

    Abstract Over the last few decades, frailty has become a pillar of research and clinical assessment in human gerontology. This complex syndrome, characterized by loss of physiologic reserves leading to decreased resilience to stressors, is of critical importance because it predicts higher risks of poor health outcomes, including mortality. Thus, identifying frailty among the elderly human population has become a key focus of gerontology. This narrative review presents current scientific literature on frailty in both humans and animals. The authors discuss the need for an accessible frailty instrument for companion dogs suitable for general use in veterinary medicine and the advances that would be facilitated by this instrument. A phenotypic frailty instrument for companion dogs, utilizing components that are easily collected by owners, or in the general practice setting, is proposed. The authors elaborate on the domains (physical condition, physical activity, mobility, strength, cognitive task performance, and social behavior), factors that will be included, and the data from the Dog Aging Project that inform each domain.
    Language English
    Publishing date 2023-06-27
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2834243-4
    ISSN 2297-1769
    ISSN 2297-1769
    DOI 10.3389/fvets.2023.1139308
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: An Examination of the Joint Effect of the Social Environment and Air Pollution on Dementia Among US Older Adults.

    Ilango, Sindana D / Leary, Cindy S / Ritchie, Emily / Semmens, Erin O / Park, Christina / Fitzpatrick, Annette L / Kaufman, Joel D / Hajat, Anjum

    Environmental epidemiology (Philadelphia, Pa.)

    2023  Volume 7, Issue 3, Page(s) e250

    Abstract: Evidence suggests exposure to air pollution increases the risk of dementia. Cognitively stimulating activities and social interactions, made available through the social environment, may slow cognitive decline. We examined whether the social environment ... ...

    Abstract Evidence suggests exposure to air pollution increases the risk of dementia. Cognitively stimulating activities and social interactions, made available through the social environment, may slow cognitive decline. We examined whether the social environment buffers the adverse effect of air pollution on dementia in a cohort of older adults.
    Methods: This study draws from the Ginkgo Evaluation of Memory Study. Participants aged 75 years and older were enrolled between 2000 and 2002 and evaluated for dementia semi-annually through 2008. Long-term exposure to particulate matter and nitrogen dioxide was assigned from spatial and spatiotemporal models. Census tract-level measures of the social environment and individual measures of social activity were used as measures of the social environment. We generated Cox proportional hazard models with census tract as a random effect and adjusted for demographic and study visit characteristics. Relative excess risk due to interaction was estimated as a qualitative measure of additive interaction.
    Results: This study included 2,564 individuals. We observed associations between increased risk of dementia and fine particulate matter (µg/m
    Conclusions: We found no consistent evidence to suggest a synergistic effect between exposure to air pollution and measures of the social environment. Given the many qualities of the social environment that may reduce dementia pathology, further examination is encouraged.
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Journal Article
    ISSN 2474-7882
    ISSN (online) 2474-7882
    DOI 10.1097/EE9.0000000000000250
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Developing a cognitive assessment toolkit for primary care: qualitative assessment of providers' needs and perceptions of usability in clinical practice.

    Suchsland, Monica Zigman / Gaster, Barak / Raetz, Jaqueline / Belza, Basia / McGuire, Lisa / Olivari, Benjamin / Tracy, Karen / Fitzpatrick, Annette L

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 1006

    Abstract: Background: Burden of dementia is expected to substantially increase. Early dementia is underdiagnosed in primary care. Given the benefits of active management of dementia, earlier detection in primary care is imperative. The aim of this study was to ... ...

    Abstract Background: Burden of dementia is expected to substantially increase. Early dementia is underdiagnosed in primary care. Given the benefits of active management of dementia, earlier detection in primary care is imperative. The aim of this study was to understand primary care provider (PCP) perceptions of implementing a cognitive assessment toolkit in primary care.
    Methods: PCPs in a large health system in the US were recruited to a qualitative study utilizing semi-structured interviews. Interviews captured provider perceptions of options for implementing a cognitive assessment toolkit derived from the Gerontological Society of America (GSA) KAER (Kickstart, Assess, Evaluate, Refer) toolkit, including a workflow and adapted clinical tools. A content analysis approach distinguished themes and exemplary quotes.
    Results: Ten PCPs were interviewed. They found the toolkit useful, felt the term Kickstart was not specific to dementia care, and stressed that addressing cognitive evaluation would need to be easy to implement in a clinical workflow. Finally, providers knew many resources for referral but were unsure how to help patients navigate options.
    Conclusions: Providers stressed simplicity, ease, and efficiency for implementation of a cognitive assessment toolkit. Incorporating these findings into the development of clinical tools and workflows may increase cognitive evaluations conducted by PCPs.
    MeSH term(s) Humans ; Emotions ; Geriatrics ; Primary Health Care ; Cognition ; Dementia/diagnosis
    Language English
    Publishing date 2023-09-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-09991-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Change in gait speed and fall risk among community-dwelling older adults with and without mild cognitive impairment: a retrospective cohort analysis.

    Adam, Claire E / Fitzpatrick, Annette L / Leary, Cindy S / Hajat, Anjum / Ilango, Sindana D / Park, Christina / Phelan, Elizabeth A / Semmens, Erin O

    BMC geriatrics

    2023  Volume 23, Issue 1, Page(s) 328

    Abstract: Background: Although slow gait speed is an established risk factor for falls, few studies have evaluated change in gait speed as a predictor of falls or considered variability in effects by cognitive status. Change in gait speed may be a more useful ... ...

    Abstract Background: Although slow gait speed is an established risk factor for falls, few studies have evaluated change in gait speed as a predictor of falls or considered variability in effects by cognitive status. Change in gait speed may be a more useful metric because of its potential to identify decline in function. In addition, older adults with mild cognitive impairment are at an elevated risk of falls. The purpose of this research was to quantify the association between 12-month change in gait speed and falls in the subsequent 6 months among older adults with and without mild cognitive impairment.
    Methods: Falls were self-reported every six months, and gait speed was ascertained annually among 2,776 participants in the Ginkgo Evaluation of Memory Study (2000-2008). Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for fall risk relative to a 12-month change in gait speed.
    Results: Slowing gait speed over 12 months was associated with increased risk of one or more falls (HR:1.13; 95% CI: 1.02 to 1.25) and multiple falls (HR:1.44; 95% CI: 1.18 to 1.75). Quickening gait speed was not associated with risk of one or more falls (HR 0.97; 95% CI: 0.87 to 1.08) or multiple falls (HR 1.04; 95% CI: 0.84 to 1.28), relative to those with a less than 0.10 m/s change in gait speed. Associations did not vary by cognitive status (p
    Conclusions: Decline in gait speed over 12 months is associated with an increased likelihood of falls among community-dwelling older adults, regardless of cognitive status. Routine checks of gait speed at outpatient visits may be warranted as a means to focus fall risk reduction efforts.
    MeSH term(s) Humans ; Aged ; Independent Living ; Retrospective Studies ; Gait ; Cohort Studies ; Walking Speed ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/epidemiology
    Language English
    Publishing date 2023-05-25
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-023-03890-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Air pollution and plasma amyloid beta in a cohort of older adults: Evidence from the Ginkgo Evaluation of Memory study

    Hajat, Anjum / Park, Christina / Adam, Claire / Fitzpatrick, Annette L. / Ilango, Sindana D. / Leary, Cindy / Libby, Tanya / López, Oscar / Semmens, Erin O. / Kaufman, Joel D.

    Environment International. 2023 Feb., v. 172 p.107800-

    2023  

    Abstract: Air pollution has been linked to Alzheimer’s disease and related dementias (ADRD), but the mechanisms connecting air pollution to ADRD have not been firmly established. Air pollution may cause oxidative stress and neuroinflammation and contribute to the ... ...

    Abstract Air pollution has been linked to Alzheimer’s disease and related dementias (ADRD), but the mechanisms connecting air pollution to ADRD have not been firmly established. Air pollution may cause oxidative stress and neuroinflammation and contribute to the deposition of amyloid beta (Aβ) in the brain. We examined the association between fine particulate matter<2.5 μm in diameter (PM₂.₅), particulate matter<10 μm in diameter (PM₁₀), nitrogen dioxide (NO₂), and plasma based measures of Aβ1-40, Aβ1-42 and Aβ1-42/Aβ1-40 using data from 3044 dementia-free participants of the Ginkgo Evaluation of Memory Study (GEMS). Air pollution exposures were estimated at residential addresses that incorporated address histories dating back to 1980, resulting in one-, five-, 10- and 20- year exposure averages. Aβ was measured at baseline (2000–2002) and then again at the end of the study (2007–2008) allowing for linear regression models to assess cross-sectional associations and linear random effects models to evaluate repeated measures. After adjustment for socio-demographic and behavioral covariates, we found small positive associations between each air pollutant and Aβ1-40 but no association with Aβ1-42 or the ratio measures in cross sectional analysis. In repeat measures analysis, we found larger positive associations between each air pollutant and all three outcomes. We observed a 4.43% (95% CI 3.26%, 5.60%) higher Aβ1-40 level, 9.73% (6.20%, 13.38%) higher Aβ1-42 and 1.57% (95% CI: 0.94%, 2.20%) higher Aβ1-42/Aβ1-40 ratio associated with a 2 µg/m³ higher 20-year average PM₂.₅. Associations with other air pollutants were similar. Our study contributes to the broader evidence base on air pollution and ADRD biomarkers by evaluating longer air pollution exposure averaging periods to better mimic disease progression and provides a modifiable target for ADRD prevention.
    Keywords Ginkgo ; air ; air pollutants ; air pollution ; amyloid ; biomarkers ; brain ; disease progression ; environment ; memory ; nitrogen dioxide ; oxidative stress ; particulates ; regression analysis ; Alzheimer’s disease ; Dementia ; Amyloid beta ; Aging
    Language English
    Dates of publication 2023-02
    Publishing place Elsevier Ltd
    Document type Article ; Online
    Note Use and reproduction
    ZDB-ID 554791-x
    ISSN 1873-6750 ; 0160-4120
    ISSN (online) 1873-6750
    ISSN 0160-4120
    DOI 10.1016/j.envint.2023.107800
    Database NAL-Catalogue (AGRICOLA)

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  10. Article ; Online: Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study.

    Slawsky, Erik D / Hajat, Anjum / Rhew, Isaac C / Russette, Helen / Semmens, Erin O / Kaufman, Joel D / Leary, Cindy S / Fitzpatrick, Annette L

    Environmental health : a global access science source

    2022  Volume 21, Issue 1, Page(s) 14

    Abstract: Background: Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults.: Methods: Greenspace exposure was computed for 3047 ... ...

    Abstract Background: Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults.
    Methods: Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD.
    Results: Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies.
    Conclusions: This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
    MeSH term(s) Aged ; Alzheimer Disease/epidemiology ; Alzheimer Disease/prevention & control ; Cohort Studies ; Dementia/epidemiology ; Dementia/prevention & control ; Humans ; Parks, Recreational ; Protective Factors ; Residence Characteristics ; Risk Factors ; United States/epidemiology
    Language English
    Publishing date 2022-01-15
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2092232-2
    ISSN 1476-069X ; 1476-069X
    ISSN (online) 1476-069X
    ISSN 1476-069X
    DOI 10.1186/s12940-022-00830-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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