BACKGROUND Midlife residential exposure to greenspace may slow cognitive decline by increasing opportunities for physical activity and social connection, restoring attention, or reducing stress or adverse environmental exposures. However, prospective studies on the association between greenness and cognitive decline are sparse. OBJECTIVE We investigated the prospective association between greenness at midlife and cognitive decline later in life. We explored effect measure modification by apolipoprotein E (APOE)-ɛ4 carrier status, neighborhood socioeconomic status (NSES), and rural/urban regions. METHODS The Nurses' Health Study (N=121,700) started in 1976 with married female nurses, 30-55 years of age, located across 11 US states. We examined 16,962 nurses who were enrolled in a substudy starting in 1995-2001 (mean age=74y) through 2008. We assessed average summer residential greenness in a 270-m buffer using Landsat Normalized Difference Vegetation Index data from 1986-1994. Starting in 1995-2001, participants underwent up to four repeated measures of five cognitive tests. A global composite score was calculated as the average of all z-scores for each task to evaluate overall cognition. We used linear mixed models to evaluate the association of average greenness exposure at midlife with cognitive decline in later life, adjusted for age, education, NSES, and depression. RESULTS In adjusted models, higher midlife greenness exposure [per interquartile range (IQR): 0.18] was associated with a 0.004-unit (95% CI: 0.001, 0.006) slower annual rate of cognitive decline. For comparison, we found that 1 year of age is related to a -0.006 mean annual difference for global cognition in the full sample; thus, higher midlife greenness appeared equivalent to slowing cognitive decline by ∼8 months. In analysis exploring gene-environment interactions, we found that among APOE-ɛ4 carriers, an IQR increase in greenness was associated with a rate of decline that was slower by 0.01 units of global composite score (95% CI: 0.0004, 0.02). This association was attenuated among APOE-ɛ4 noncarriers. We did not observe associations between greenness and baseline or annual rate of cognitive decline of verbal memory. DISCUSSION Higher midlife greenness exposure is associated with slower cognitive decline later in life. Future research is necessary to confirm these findings. https://doi.org/10.1289/EHP13588.

中文翻译：

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护士健康研究参与者的中年住宅绿色和晚年认知能力下降。


背景技术中年居住在绿色空间中可以通过增加身体活动和社交联系的机会、恢复注意力或减少压力或不利的环境暴露来减缓认知能力的下降。然而，关于绿色与认知能力下降之间关系的前瞻性研究很少。目的 我们调查了中年绿色与晚年认知能力下降之间的前瞻性关联。我们探索了载脂蛋白 E (APOE)-ɛ4 携带者状态、社区社会经济地位 (NSES) 和农村/城市地区对影响测量的修改。方法 护士健康研究（N=121,700）于 1976 年开始，调查对象为美国 11 个州的 30-55 岁已婚女护士。我们对 16,962 名护士进行了调查，他们从 1995 年至 2001 年（平均年龄 = 74 岁）到 2008 年参加了一项子研究。我们使用 1986 年至 1994 年的 Landsat 归一化植被指数数据评估了 270 米缓冲区中的平均夏季住宅绿化度。从 1995 年至 2001 年开始，参与者接受了五项认知测试的四次重复测量。全局综合分数计算为每项任务的所有 z 分数的平均值，以评估整体认知。我们使用线性混合模型来评估中年平均绿色暴露与晚年认知能力下降的关系，并根据年龄、教育程度、NSES 和抑郁进行调整。结果在调整后的模型中，较高的中年绿色暴露[每四分位数范围（IQR）：0.18]与认知能力下降的年率减慢0.004个单位（95％CI：0.001，0.006）相关。作为比较，我们发现 1 岁与 -0 相关。006 整个样本中全球认知的平均年差异；因此，较高的中年绿色度似乎相当于将认知能力下降减缓约 8 个月。在探索基因-环境相互作用的分析中，我们发现在 APOE-ɛ4 携带者中，绿色度 IQR 的增加与整体综合得分减慢 0.01 个单位的下降率相关（95% CI：0.0004，0.02）。这种关联在 APOE-ɛ4 非携带者中减弱。我们没有观察到绿色与语言记忆认知衰退的基线或年率之间的关联。讨论 中年接触绿色较多与晚年认知能力下降较慢有关。未来的研究需要证实这些发现。 https://doi.org/10.1289/EHP13588。