Disabilities moderate the association between neighbourhood urbanity and cognitive health: Results from the Irish longitudinal study on ageing.
BACKGROUND
Geographical variations in cognitive health have been extensively explored, but the evidence on adult individuals with disabilities is inconclusive. While urban living is suggested as more cognitively stimulating than rural dwelling in epidemiological research, both rurality and urbanity can present barriers that may negatively impact cognitive health, the former due to limited accessibility to stimulation, and the latter because presenting environmental stressors.


OBJECTIVE
To bridge this gap in the literature, we investigated geographical variations in multiple cognitive skills in adult age based on neighbourhood urbanity and having disabilities.


METHODS
Data on global cognition, memory, speed of processing and executive functions, as well as reported functional limitations, was taken from 4127 individuals aged 50 + participating in the first wave of The Irish Longitudinal Study on Ageing (TILDA). Neighbourhood urbanity was measured using Census data on population density. Multivariate regression analyses controlled for socio-demographic, health and lifestyle covariates.


RESULTS
Residence in medium-high densely populated areas was significantly associated with better cognitive performance across all measures, after controlling for covariates. However, having disabilities was linked to worse global cognitive functioning (MoCA, p = .005), immediate recall (p = .022) and executive functions (CTT2, p = .009) in the least and most densely populated areas.


CONCLUSIONS
Living in urbanised areas may provide more mental stimulation than rural places; however, functional limitations moderate this association, suggesting potential environmental challenges both in rural and urban areas. Considering both individual and environmental circumstances can enrich investigations of geographical variations in cognitive health.
['Cassarino|Marica|M|', "O'Sullivan|Vincent|V|", 'Kenny|Rose A|RA|', 'Setti|Annalisa|A|']
D000328:Adult D000368:Aged D000375:Aging D003071:Cognition D060825:Cognitive Dysfunction D006233:Disabled Persons D004777:Environment D056344:Executive Function D005260:Female D006304:Health Status D006801:Humans D007494:Ireland D008137:Longitudinal Studies D008297:Male D008606:Mental Processes D011939:Mental Recall D008875:Middle Aged D015999:Multivariate Analysis D011156:Population Density D011610:Psychosocial Deprivation D012111:Residence Characteristics D012424:Rural Population D013315:Stress, Psychological D014505:Urban Population
Disabilities Population density Urbanisation Cognitive aging