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    Rights statement: This is the author’s version of a work that was accepted for publication in Disability and Health Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Disability and Health Journal, 11, (3), 2018 DOI: 10.1016/j.dhjo.2017.12.002

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    Embargo ends: 13/12/18

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Disabilities Moderate the Association between Neighbourhood Urbanity and Cognitive Health: Results from the Irish Longitudinal Study on Ageing

Research output: Contribution to journalJournal article

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<mark>Journal publication date</mark>07/2018
<mark>Journal</mark>Disability and Health Journal
Issue number3
Volume11
Number of pages8
Pages (from-to)359-366
StatePublished
Early online date13/12/17
Original languageEnglish

Abstract

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 4,127 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.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Disability and Health Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Disability and Health Journal, 11, (3), 2018 DOI: 10.1016/j.dhjo.2017.12.002