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Streetview greenspace types and dementia risk in older adults: The Multi-Ethnic Study of Atherosclerosis
Journal article   Open access   Peer reviewed

Streetview greenspace types and dementia risk in older adults: The Multi-Ethnic Study of Atherosclerosis

Marcia Pescador Jimenez, L Paloma Rojas-Saunero, Cameron J Reimer, Esra Suel, Pi-I Debby Lin, Perry Hystad, Francine Grodstein, Ana V Diez-Roux, Brent Coull and Peter James
American journal of epidemiology, Forthcoming
10 Jun 2026
DOI: https://doi.org/10.1093/aje/kwag129
PMID: 42267521
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https://doi.org/10.1093/aje/kwag129View
Published, Version of Record (VoR) Open

Abstract

Greenspace Natural environment Environmental Epidemiology Competing Risks Dementia
Greenspace has been associated with lower dementia risk but most studies have used satellite-derived measures that cannot distinguish vegetation types. We used Street View-based metrics of greenspace from an on-the-ground perspective to examine greenspace types that may be relevant for dementia risk. We followed 6761 participants from the Multi-Ethnic Study of Atherosclerosis, 2000-2018. Using deep learning algorithms applied to streetview images, we measured %trees, %grass, %other green (plants/flowers/fields) in the 500 m area around participants' residences. We examined the controlled direct effect of greenspace with dementia accounting for death as a censoring event, using a weighted Kaplan-Meier survival estimator, with the product of exposure weights and inverse-probability-of-censoring by death. We ran models separately per greenspace type. Mean baseline age was 62 (SD 10). Participants exposed to lowest levels of %Trees were more likely to have a household income < $24 999. We observed 585 (8·7%) dementia cases and 1437 (21·3%) deaths over follow-up. We observed a direct effect of high exposure to %grass on 19-year dementia risk had death been prevented of -4·57 (95% confidence interval:-8·15,-0·40) percentage points. No associations were observed for %trees (-0·07; 95%CI:-2·29,2·11) and %other green (-0·03, 95%CI:-1·59,1·48). Higher percentage of grass may reduce dementia risk.

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