Is Greenness Associated with Dementia? A Systematic Review and Dose-Response Meta-analysis.

Federico Zagnoli, Tommaso Filippini, Marcia P Jimenez, Lauren A Wise, Elizabeth E Hatch, Marco Vinceti

Journal: Current environmental health reports 2022;9(4):574-590

PMID: 35857243

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Abstract

PURPOSE OF REVIEW

We assessed the relation between environmental greenness and risk of dementia and cognitive impairment, based on a systematic review and meta-analysis up to March 30, 2022, characterizing whenever possible the shape of the association using dose-response meta-analysis.

RECENT FINDINGS

Twelve studies were included in this review, either using normalized difference vegetation index (NDVI) or land use/cover (LU/LC) methodology to assess greenness. Comparing the highest versus lowest exposure categories of greenness assessed using the NDVI (6 studies) or LU/LC (6 studies), we found no association with dementia. Dose-response meta-analysis of the association between greenness measured by LU/LC and dementia, based on only 3 studies, indicated a U-shaped association, but estimates were imprecise. Our systematic review and meta-analysis provided some evidence of a slight inverse association between greenness and dementia at intermediate exposure levels, but not at high levels. Potential methodological limitations, such as exposure misclassification and unmeasured confounding, may have affected the results.

Address: Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125, Modena, Italy.; School of Public Health, University of California Berkeley, Berkeley, CA, 94704, USA.; Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA.; Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125, Modena, Italy. [email protected].; Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA. [email protected].

DOI: 10.1007/s40572-022-00365-5