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Associations between neighborhood greenspace and brain imaging measures in non-demented older adults: the Cardiovascular Health Study

Social Psychiatry and Psychiatric Epidemiology volume 56, pages 1575–1585 (2021)Cite this article

Abstract

Purpose

Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer’s disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer’s disease.

Methods

We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, population-based Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989–1999) were obtained/analyzed in 2020.

Results

Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: − 0.30; 95% confidence interval: − 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex.

Conclusion

This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.

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Acknowledgments

This research was supported by contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, N01HC15103, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 and R01AG15928 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. This work was supported by the National Institute of Aging (grants 1R01AG049970, 3R01AG049970-04S1), Commonwealth Universal Research Enhancement (C.U.R.E) program funded by the Pennsylvania Department of Health—2015 Formula award—SAP #4100072543, the Urban Health Collaborative at Drexel University, and the Built Environment and Health Research Group at Columbia University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. No authors have conflicts of interest to disclose and the following authors have funding support: Dr. Besser (NIH/NIA K01AG063895), Yvonne Michael (NIH/NIA 3R01AG049970-04S1), Phil Hurvitz NIH grants R01DK076608, R01CA178343, R01AG049970, R01DK114196, R01HD091089, R01NR016942), James Galvin (NIA/NIH Grants R01AG040211, R01NS101483.William Longstreth is co-investigator on several NIH-funded studies, including the CHS, and serves as a co-PI for the NIH-funded ARCADIA trial, which receives in-kind study drug from the BMS-Pfizer Alliance and ancillary funding from Roche Diagnostics

Funding

Lilah Besser is supported by NIH/NIA award K01AG063895. Yvonne Michael is supported by National Institute on Aging (3R01AG049970-04S1). Phil Hurvitz is supported by NIH grants R01DK076608, R01CA178343, R01AG049970, R01DK114196, R01HD091089, and R01NR016942. James Galvin is supported by NIA/NIH Grants R01AG040211 and R01NS101483. William Longstreth co-investigator on several NIH-funded studies, including the CHS, and serves as a co-PI for the NIH-funded ARCADIA trial. Jana Hirsch and Gina Lovasi are supported by the National Institute on Aging (1R01AG049970, 3R01AG049970-04S1), Commonwealth Universal Research Enhancement (C.U.R.E) program funded by the Pennsylvania Department of Health—2015 Formula award—SAP #4100072543, the Urban Health Collaborative at Drexel University, and the Built Environment and Health Research Group at Columbia University. The remaining authors have no funding to disclose.

Author information

Affiliations

  1. Institute for Human Health and Disease Intervention, Department of Urban and Regional Planning, Florida Atlantic University, 777 Glades Rd, SO-44, Room 284H, Boca Raton, FL, 33431, USA

    Lilah M. Besser

  2. Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA

    Gina S. Lovasi & Jana A. Hirsch

  3. Department of Epidemiology and Biostatistics, Dornslife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA

    Yvonne L. Michael

  4. Division of Cardiology, Keck School of Medicine, University of Southern California, 1510 San Pablo Street Suite #322, Los Angeles, CA, 90033, USA

    Parveen Garg

  5. Division of Research, Evaluation, and Policy, The New York Academy of Medicine, New York, NY, 10029, USA

    David Siscovick

  6. Center for Studies in Demography and Ecology and Urban Form Lab, University of Washington, Seattle, WA, 98195, USA

    Phil Hurvitz

  7. Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, 98195, USA

    Mary L. Biggs

  8. Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA

    James E. Galvin

  9. Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA

    Traci M. Bartz

  10. Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, 98195-9775, USA

    W. T. Longstreth

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  1. Lilah M. Besser
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  6. David Siscovick
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  7. Phil Hurvitz
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  11. W. T. Longstreth
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Corresponding author

Correspondence to Lilah M. Besser.

Ethics declarations

Conflict of interest:

Lilah Besser has no conflict of interest. Gina Lovasi has no conflict of interest. Yvonne Michael has no conflict of interest. Parveen Garg has no conflict of interest. Jana Hirsch has no conflict of interest. David Siscovick has no conflict of interest. Phil Hurvitz has no conflict of interest. Mary Lou Biggs has no conflict of interest. James Galvin has no conflict of interest. Traci Bartz has no conflict of interest. William Longstreth serves as a co-PI for the NIH-funded ARCADIA trial, which receives in-kind study drug from the BMS-Pfizer Alliance and ancillary funding from Roche Diagnostics.

Availability of data

Researchers can request access to CHS data through the Cardiovascular Health Study, at https://chs-nhlbi.org/.

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Besser, L.M., Lovasi, G.S., Michael, Y. et al. Associations between neighborhood greenspace and brain imaging measures in non-demented older adults: the Cardiovascular Health Study. Soc Psychiatry Psychiatr Epidemiol 56, 1575–1585 (2021). https://doi.org/10.1007/s00127-020-02000-w

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  • DOI: https://doi.org/10.1007/s00127-020-02000-w

Keywords

  • Neighborhood
  • Green space
  • MRI
  • Brain volume
  • Hippocampal
  • White matter