SPACE: Supportive environments for Physical and social Activity, healthy ageing and CognitivE health

The number of people worldwide living with dementia and cognitive impairment is increasing, mainly due to people living longer, so we want to figure out how where we live affects dementia and brain health as we get older. Some research suggests that where we live might influence our brain health. For example, poor air quality in towns and cities, can lead to a decline in brain health. As more of us now live in towns and cities, it is important that the environment where we live is scientifically designed and improved to maximise our brain health.

The complex social and physical environments where we live make some people more vulnerable than others to developing cognitive impairment. In other words, the factors that account for who is most likely to develop cognitive ill-health due to the environment has less to do with 'how' we live and more to do with 'where' we live. We do not know how these factors interact to make urban environments a problem for brain health, nor which are the best policies and interventions for promoting healthy ageing and brain health for our poorest communities.

Our project will provide evidence for policies and practices that provide supportive urban environments to promote healthy ageing, including promoting brain health. This could include using creative urban designs to support people to adopt and maintain healthier lifestyles such as being more active. However, this needs a strong evidence base with expert community advocates who can articulate how supportive urban environments can improve brain health.

Our research has the following steps:
1. First, with the help of stakeholders, including those from business, industry, and local government, and a review of existing research, we will represent the relationships between our biology, our lifestyles and our environment in a diagram illustrating how they likely interact to affect brain health, because visual thinking can help stakeholders better identify possible intervention sweet-spots to improve brain health.
2. By analysing data from over 8,000 older people in Northern Ireland, and linking this to information about where they live, such as the amount of air pollution, the toxins in soil, or how walkable their neighbourhoods are, we will explore how different environmental factors relate to brain health.
3. Next, we will collect new data on a subgroup of 1,000 older people including more in-depth measures of brain health and better measures of physical activity, using GPS devices worn around the waist that monitor our locations. This will allow us to explore how the urban environment influences our brain health.
4. Then, we will explore how aspects of our biology play a role in how the urban environment affects our brain health.
5. We will host workshops with local citizens to 'sense-check' our findings and co-develop promising prevention approaches. In these, we will explore the acceptability, affordability, feasibility and sustainability of new initiatives to improve the environmental influences on brain health. This might include, for example, policies on: expanding the car-free areas of the city to reduce air pollution; increasing the number of footpaths and cycle paths to encourage walking and cycling; improving public transport to reduce car use.

As a result of our research we will produce:
1. A map of the system in which our genes, lifestyle behaviours and urban environments interact to affect brain health, to help guide stakeholders towards policies and programmes that can improve brain health.
2. An evidence base exploring how where we live affects our brain health.
3. A suite of potential policies and interventions to improve brain health and promote healthy ageing 'tested' (in terms of acceptability and feasibility) with older people, business, industry, policymakers and other stakeholders.