Urban greenspace and dementia: Measures, mechanisms, and methodological guidance.

Ingrid Jarvis, Lilah Besser, Jessica Finlay, Perry Hystad, Kevin J Lane, Ruth F Hunter, Peter James, Marcia Pescador Jiménez, Mark Nieuwenhuijsen, Matilda van den Bosch, David Van Riper, Jinkook Lee, Dany Doiron, Jeffrey Brook, Sara D Adar, Michael Brauer

Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association 2026;22(6):e71557

PMID: 42252512

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Abstract

Urban greenspace has been associated with improved cognition and reduced Alzheimer's disease (AD) and AD-related dementias (ADRD) risk, but findings remain mixed, study quality varies, and evidence is largely cross-sectional. To advance the field, we offer guidance to select and apply greenspace exposure measures in AD/ADRD research. Our interdisciplinary expert working group synthesized existing knowledge and developed consensus-based recommendations through collaborative discussion. In this paper, we outline hypothesized pathways, summarize data sources and measurement approaches, and propose criteria and recommendations to select and apply greenspace exposure measures in research. Based on hypothesized pathways, we recommend tree canopy cover for stress reduction, attention restoration, and improved mental health; parks for increased physical and social activity; and greenness for reduced harmful exposures, highlighting the Normalized Difference Vegetation Index as capturing multiple pathways. We also identify future research priorities to advance understanding of greenspace-AD/ADRD associations and support more rigorous, comparable, and policy-relevant evidence.

Address: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.; Comprehensive Center for Brain Health, University of Miami School of Medicine, Boca Raton, Florida, USA.; Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA.; Department of Geography, University of Colorado Boulder, Boulder, Colorado, USA.; School of Nutrition and Public Health, Oregon State University, Corvallis, Oregon, USA.; Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.; Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Royal Victoria Hospital, Northern Ireland, Belfast, UK.; Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California, USA.; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.; Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain.; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.; Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain.; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; European Forest Institute (EFI), BioCities Facility, Rome, Italy.; Life Course Center, University of Minnesota, Minneapolis, Minnesota, USA.; Department of Economics, University of Southern California, Los Angeles, California, USA.; Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA.; Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Québec, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

DOI: 10.1002/alz.71557

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https://doi.org/10.1002/alz.71557

MeSH Terms: Humans, Dementia, Parks, Recreational, Alzheimer Disease, Urban Population