Neighborhood greenspace and neighborhood income associated with white matter grade worsening: Cardiovascular Health Study

Besser, L. M., Lovasi, G. S., Zambrano, J. J., Camacho, S., Dhanekula, D., Michael, Y. L., Garg, P., Hirsch, J. A., Siscovick, D., Hurvitz, P. M., Biggs, M. L., Galvin, J. E., Bartz, T. M., & Longstreth, W. T. (2023). Neighborhood greenspace and neighborhood income associated with white matter grade worsening: Cardiovascular Health Study. Alzheimer’s & Dementia : Diagnosis, Assessment & Disease Monitoring, 15(4), e12484–e12484. https://doi.org/10.1002/dad2.12484

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Abstract

INTRODUCTION
We examined whether a combined measure of neighborhood greenspace and neighborhood median income was associated with white matter hyperintensity (WMH) and ventricle size changes.

METHODS
The sample included 1260 cognitively normal ≥ 65‐year‐olds with two magnetic resonance images (MRI; ≈ 5 years apart). WMH and ventricular size were graded from 0 (least) to 9 (most) abnormal (worsening = increase of ≥1 grade from initial to follow‐up MRI scans). The four‐category neighborhood greenspace–income measure was based on median neighborhood greenspace and income values at initial MRI. Multivariable logistic regression tested associations between neighborhood greenspace–income and MRI measures (worsening vs. not).

RESULTS
White matter grade worsening was more likely for those in lower greenspace–lower income neighborhoods than higher greenspace–higher income neighborhoods (odds ratio = 1.73; 95% confidence interval = 1.19–2.51).

DISCUSSION
The combination of lower neighborhood income and lower greenspace may be a risk factor for worsening white matter grade on MRI. However, findings need to be replicated in more diverse cohorts.

HIGHLIGHTS
Population‐based cohort of older adults (≥ 65 years) with greenspace and MRI data
Combined measure of neighborhood greenspace and neighborhood income at initial MRI
MRI outcomes included white matter hyperintensities (WMH) and ventricular size
Longitudinal change in MRI outcomes measured approximately 5 years apart
Worsening WMH over time more likely for lower greenspace‐lower income neighborhoods

Keywords

built environment; green space; magnetic resonance imaging; neighborhood; socioeconomic status