People living in regional or remote areas may be at lower risk of developing Alzheimer's disease, according to our recent research.
Using data from more than 260,000 adults in New South Wales aged 45 or older, we found people living in regional or remote areas of the state with a 6 to 19 percent lower risk of being diagnosed with Alzheimer's disease over 11 years . their counterparts in the city.
We identified Alzheimer's disease diagnosed using the first prescription of a group of drugs collectively referred to as cholinesterase inhibitors and memantine. These are prescribed after someone earns a minimum mental status examination score consistent with Alzheimer's disease, which is then confirmed by a specialist.
Some previous research suggests that people living in rural areas may be at a greater risk of developing Alzheimer's disease. But our results tell a different story.
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The Role of Air Pollution
Research tells us that air pollution is bad for health. Emerging research suggests that air pollution may also play a role in the development of Alzheimer's disease.
The problem is not just what you can see in the air. The tiny particles you can not see are the most damaging. Once you breathe, they can enter the bloodstream and travel to all the major organs, including the brain.
People living in Australia's largest cities are generally exposed to higher levels of air pollution, which could partly help explain why we find a greater risk of Alzheimer's disease in the city's inhabitants.
But it is unlikely to be the only factor.
What is happening in the brain?
Let's consider the path by which many scientists believe that Alzheimer's disease can develop and then work backwards.
Many scientists, though not all, suggest that Alzheimer's disease coincides with – and may be caused by – an abnormal build-up of a specific type of protein, called beta-amyloid peptide, in the brain.
Accumulating large amounts of amyloid beta peptide can create plaques that cause inflammation, destroy synapses, kill neurons and result in the death of brain cells consistent with Alzheimer's disease.
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If this hypothesis is correct, we are looking for ways to reduce the abnormal accumulation of beta-amyloid. Admittedly, this is a big "if" given largely disappointing results of drug tests focused on clearing amyloid beta so far.
Research on mice suggests that sleep can help clear beta amyloid.
Studies in humans also suggest that regular physical activity and social interactions may help reduce the risk of developing Alzheimer's disease, potentially via beta-amyloid reduction.
These things can be more difficult in cities
It is not always easy to get a good night's sleep. Studies suggest that environmental factors that co-occur in urban areas, such as chronic noise, air quality and heat, can influence how much you sleep and feel invigorated when you wake up.
Urban planning may influence participation in physical activity. Car-centered urban sprawl, for example, remains a major barrier to getting people to move and move in many Australian cities.
Meanwhile, men and women over 65 living in Australia's major cities are more likely to report a lack of social support than their regional peers.
All of these factors, including air pollution, may contribute some explanation to the results of our study.
But it is important to note that accessibility to health care can play an important role. People in NSW regional and remote usually have to travel greater distances and have fewer options than those based in cities. This can lead to delays in the detection of Alzheimer's disease, which would affect our results.
Connect with nature, wherever you are
Living in the vicinity of more green space has been associated with better cognition among adults living in Spain, Scotland and England.
These studies are supported by decades of experimental studies showing
Contact with nature can provide relief from stress and lower blood pressure.
Public green spaces have the added benefit of providing spaces for outdoor social and physical recreation and can also help improve our sleep.
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Green space tends to be more abundant in regional and remote areas compared to major cities, which may help explain why we find a high risk of Alzheimer's disease in large cities.
But no matter if you live in the countryside or in the city, try to use whatever green space you have around you. Relax in the garden or make regular visits to the local parks – your older self will thank you for it.