Longitudinal Impacts of Precision Greenness on Alzheimer's Disease.

BACKGROUND: The potential for greenness as a novel protective factor for Alzheimer's disease (AD) requires further exploration. OBJECTIVES: This study assesses prospectively and longitudinally the association between precision greenness - greenness measured at the micro-environmental level, defined as the Census block - and AD incidence. DESIGN: Older adults living in consistently high greenness Census blocks across 2011 and 2016 were compared to those living in consistently low greenness blocks on AD incidence during 2012-2016. SETTING: Miami-Dade County, Florida, USA. PARTICIPANTS: 230,738 U.S. Medicare beneficiaries. MEASUREMENTS: U.S. Centers for Medicare and Medicaid Services Chronic Condition Algorithm for AD based on ICD-9 codes, Normalized Difference Vegetation Index, age, sex, race/ethnicity, neighborhood income, and walkability. RESULTS: Older adults living in the consistently high greenness tertile, compared to those in the consistently low greenness tertile, had 16% lower odds of AD incidence (OR=0.84, 95% CI: 0.76-0.94, p=0.0014), adjusting for age, sex, race/ethnicity, and neighborhood income. Age, neighborhood income and walkability moderated greenness' relationship to odds of AD incidence, such that younger ages (65-74), lower-income, and non-car dependent neighborhoods may benefit most from high greenness. CONCLUSIONS: High greenness, compared to low greenness, is associated with lower 5-year AD incidence. Residents who are younger and/or who reside in lower-income, walkable neighborhoods may benefit the most from high greenness. These findings suggest that consistently high greenness at the Census block-level, may be associated with reduced odds of AD incidence at a population level.

The role of families in adolescent HIV prevention: a review.

Recent research has highlighted the significant contribution families make in the prevention of HIV risk behaviors among adolescents. As the most proximal and fundamental social system influencing child development, families provide many of the factors that protect adolescents from engaging in sexual risk behaviors. Among these are positive family relations, effective communication about sexuality and safer sexual behaviors, enhancement and support of academic functioning, and monitoring of peer activities. HIV risk behaviors occur in a social context, and it is becoming clear that the earliest and most effective way to intervene is in the context where one initially learns about relationships and behavior--the family. Both the Centers for Disease Control and Prevention and the National Institute for Mental Health have taken steps to support and emphasize research that will further elucidate our understanding of the role of families in HIV prevention. This article uses Ecodevelopmental Theory to guide and organize the findings of this promising research area. Within this context, and with special attention to the comorbidity of adolescent problem behaviors, this article reviews empirical research on the role of families in HIV prevention, discusses current intervention efforts that involve families and ecosystems, and addresses prospects and implications for future research and interventions.