How environments throughout life can support healthy ageing
With the number of older people increasing rapidly across the world, finding ways to create the environments that ensure everyone has the opportunity to live a long and healthy life is increasingly important. The latest research tells us that the places where people live and grow older can support healthy ageing, and that factors across the whole of our lives are potentially important. However, what we are less clear about is which aspects of the environment support healthy ageing and how these factors work to “get under the skin” to affect our health.
The aim of this research was to examine whether and how exposure to various environmental factors in childhood, adulthood and old age affects healthy ageing. It made use of a unique dataset that follows adults born in 1936 in the area around Edinburgh, Scotland – the Lothian Birth Cohort. We used information collected from historical records about the neighbourhoods that the participants have lived in throughout their lives to examine these questions.
This interdisciplinary project ran from September 2020 for 24 months and involved expertise from human geography, psychology, epidemiology and landscape architecture, included partners from policy and advocacy, and was funded by the Economic and Social Research Council’s Secondary Data Analysis Initiative (grant award ES/T003669/1).
ANIMATION > Lifecourse of Place: how environments throughout life can support healthy ageing
Key findings
1. Life-course neighbourhood deprivation is linked to adverse brain structure characteristics in older adults and lower social class amplifies the vulnerability.
Neighbourhood characteristics have been shown to influence cognitive ageing, but how neighbourhood disadvantage at different stages of the life course may be associated with brain health has remained poorly understood. Utilising the Lothian Birth Cohort 1936, the study explored the relationship between residential neighbourhood deprivation from birth to late adulthood, and global and local neuroimaging measures at age 73. Based on a total of 689 participants with at least one valid brain measure, the study found that residing in disadvantaged neighbourhoods in mid- to late adulthood was associated with smaller total brain, grey matter, and normal-appearing white matter volumes, thinner cortex, and lower general white matter fractional anisotropy. We also found some evidence on the accumulating impact of neighbourhood deprivation from birth to late adulthood on age 73 total brain and grey matter volumes. Among individuals belonging to lower social classes, the brain-neighbourhood associations were particularly strong, with the impact of neighbourhood deprivation on total brain and grey matter volumes, and general white matter fractional anisotropy accumulating across the life course. The findings suggest that living in deprived neighbourhoods across the life course, but especially in mid- to late adulthood, is associated with adverse brain morphologies, and lower social class amplifies the vulnerability.
Publication: Baranyi G, Buchanan CR, Conole ELS, Backhouse EV, Maniega SM, Valdés Hernández MDC, Bastin ME, Wardlaw J, Deary IJ, Cox SR, Pearce J. Life-course neighbourhood deprivation and brain structure in older adults: the Lothian Birth Cohort 1936. Mol Psychiatry. 2024 May 21. doi: 10.1038/s41380-024-02591-9
2. Living in advantaged areas in mid-to-late adulthood may directly contribute to better cognitive function and slower decline, whereas an advantaged childhood neighbourhood likely affects functioning through cognitive reserves
Neighbourhoods influence our physical, cognitive and mental health. However, understanding the long-term impact of residing in socially advantaged or disadvantaged areas is not an easy task and requires unique information about the same individuals across the life course. The rich longitudinal data of the Lothian Birth Cohort 1936 helped to explore how neighbourhood deprivation, with more overcrowding and higher unemployment, from birth to late adulthood contributes to cognitive ageing. We linked historical measures of neighbourhood deprivation in childhood (1936–1955), young adulthood (1956–1975), and mid- to late adulthood (1976–2014) to residential history provided by LBC1936 participants. The key findings showed that living in disadvantaged areas of Edinburgh during mid- and late adulthood is associated with cognitive function: older adults living in deprived neighbourhoods had not only lower levels of general cognitive ability when they were 70 years old, but they also experienced faster cognitive decline in the following years. Furthermore, childhood neighbourhoods also contributed to late-life cognitive function: those growing up in socially advantaged neighbourhoods experienced more years spent in education, which, the authors suggest, likely contributed to ‘cognitive reserves’ and delayed age-related cognitive decline.
Publication: Baranyi G, Conte F, Deary IJ, Shortt N, Thompson CW, Cox SR, Pearce J. Neighbourhood deprivation across eight decades and late-life cognitive function in the Lothian Birth Cohort 1936: a life-course study. Age Ageing. 2023;52(4):afad056. doi: https://doi.org/10.1093/ageing/afad056
3. Living in deprived neighbourhoods across the life course contributes to frailty and frailty progression, but associations may differ between males and females
Neighbourhood characteristics are important predictors of frailty (physical, mental and cognitive vulnerability to stressors), but evidence is mainly limited to cross-sectional studies without indication of long-term impact. Describing how living in different contexts across the life course is associated with frailty is crucial in identifying modifiable risk factors, understanding age-related decline, and developing age-friendly policies to support healthy aging. Findings showed that growing up and growing old in disadvantaged neighbourhoods lead to higher risk of becoming frail in late adulthood among men while, for women, neighbourhood deprivation only showed an influence during the second half of life. Childhood is a formative period for educational and behavioural development. Boys are likely more exposed to physical and social neighbourhood influences, historically, they spent more time outside of their homes while playing with friends and engaging in other activities in their wider neighbourhood. Growing up in more advantaged areas had a stronger and long-lasting impact on their development and heath in later adulthood. We also found that growing old in less deprived areas was important for staying resilient. Such places likely provide better opportunities to support healthy ageing, with access to recreational, cultural and health facilities as well as to higher quality green spaces. In comparison to more deprived areas, they usually have lower rates of crime and violence.
Publication: Baranyi G, Welstead M, Corley J, Deary IJ, Muniz-Terrera G, Redmond P, Shortt N, Taylor AM, Ward Thompson C, Cox SR, Pearce J. Association of Life-Course Neighborhood Deprivation With Frailty and Frailty Progression From Ages 70 to 82 Years in the Lothian Birth Cohort 1936. Am J Epidemiol. 2022 Oct 20;191(11):1856-1866. doi: https://doi.org/10.1093/aje/kwac134
4. Greater exposure to air pollution in earlier life may be associated with faster biological ageing, which likely persists across the entire life course.
Higher exposure to air pollution has been linked to a wide range of diseases and potential mechanistic pathways may include chemical modification affecting the DNA. Tiny air pollutants can enter the bloodstream and may induce changes in gene expression, which can affect later life health and well-being. Using the Lothian Birth Cohort 1936, we explored whether living in more polluted areas across the life course are associated with faster biological ageing derived from chemical tags of the DNA (i.e. epigenetic clocks). Air pollution concentrations in 1935, 1950, 1970, 1980, 1990 and 2001 were linked to participants’ residential addresses; epigenetic clocks were derived from blood samples between ages of 70 and 80 years. We found that living in more polluted areas around birth and during young-to-middle adulthood was associated with faster biological ageing.
Publication: Baranyi G, Deary IJ, McCartney DL, Harris SE, Shortt N, Reis S, Russ TC, Ward Thompson C, Vieno M, Cox SR, Pearce J. Life-course exposure to air pollution and biological ageing in the Lothian Birth Cohort 1936. Environ Int. 2022;169:107501. doi: https://doi.org/10.1016/j.envint.2022.107501
Earlier work from the research team
Cherrie, M., Shortt, N., Ward Thompson, C., Deary, I. & Pearce, J. 2019. Association between the activity space exposure to parks in childhood and adolescence and cognitive aging in later life. IJERPH 16(4), 632; doi:10.3390/ijerph16040632
Neale, C., Roe, J., Aspinall, P., Coyne, R., Mavros, P., Tilley, S., Thin, N., Cinderby, S., & Ward Thompson, C. 2019. The impact of walking in different urban environments on brain activity in older people. Cities and Health 4:1, 94-106, doi: 10.1080/23748834.2019.1619893
Pearce J, Cherrie M, Shortt N, Deary I, Ward Thompson C. Life course of place: A longitudinal study of mental health and place. Trans Inst Br Geogr. 2018;43:555-572.
Cherrie MPC, Shortt NK, Mitchell RJ, et al. Green space and cognitive ageing: A retrospective life course analysis in the Lothian Birth Cohort 1936. Soc Sci Med. 2018;196:56-65.
Cox SR, Ritchie SJ, Tucker-Drob EM, et al. Ageing and brain white matter structure in 3,513 UK Biobank participants. Nat Commun. 2016;7:13629.
Pearce JR, Shortt N, Rind E, Mitchell R. Life course, green space and health: Incorporating place into life course epidemiology. Int J Environ Res Public Health. 2016;13(3):331.
Website of the Lothian Birth Cohorts> https://lothian-birth-cohorts.ed.ac.uk/