Citation

Tani Y, Hanazato M, Fujiwara T, Suzuki N, Kondo K. Am. J. Epidemiol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Oxford University Press)

DOI

10.1093/aje/kwab043

PMID

unavailable

Abstract

Sidewalks are indispensable environmental resources for daily life in that they encourage physical activity. However, the percentage of sidewalks installation is low even in developed countries. We examined the association between neighborhood sidewalk environment and dementia in Japan. We conducted a 3-year follow-up (2010-2013) among participants in a Japan Gerontological Evaluation Study, a population-based cohort study of community-dwelling older adults. We ascertained the incidence of dementia for 76,053 participants from the public long-term care insurance system. We calculated sidewalk coverage (sidewalk area as a percentage of road area) within 436 residential neighborhood units using the geographic information system. Multilevel survival models were used to estimate hazard ratios (HR) for the incidence of dementia. During the follow-up, 5310 dementia cases were found. In urban areas, compared with the lowest quartile for sidewalk coverage, the HR was 0.42 (95% confidence interval (CI): 0.33-0.54) for the highest quartile, adjusting for individual covariates. After successive adjustments for other neighborhood factors (land slope, numbers of hospitals, grocery stores, parks, stations and bus stops, education level, and unemployment rate), the HR remained statistically significant (HR=0.75, 95% CI: 0.59-0.94). Living in neighborhoods with high sidewalks installation was associated with low dementia incidence in urban areas.

Language: en

Keywords

dementia; older adults; community dwellers; sidewalk