We will develop a conceptual framework via a systematic review of mechanisms of exposure-outcome relationships between urban environment factors and cognitive health across the life course, and incorporate the perspective and knowledge of local stakeholders using participatory Group Model Building (GMB). The findings of the systematic reviews and GMB workshops will be triangulated using an adapted Contribution Analysis approach in order to define our conceptual framework. The framework will provide a clear, comprehensive, multi-perspective basis to inform data analyses in the next WPs, as well as the interpretation and integration of their results. 

We will link existing NICOLA cohort data (Wave 1+2) with spatial environment data to quantify characteristics of the urban environments  associated with brain and cognitive health to examine: i) associations of urban environment characteristics with levels of cognitive health; ii) the extent to which these associations are explained by lifestyle behaviours (physical activity, social engagement) and physiological markers, thereby ‘unlocking the power of location’.  

Work Package 3 builds on an existing study called NICOLA 65+ Memory and Thinking Research Study https://www.qub.ac.uk/sites/NICOLA/ConnectedResearchStudies/NICOLA65MemoryandThinkingResearchStudy/ where the team are carrying out detailed cognitive assessments on 1,000 older adult participants.  

The SPACE project invites these participants to also wear two devices for seven days to capture more detailed information about how individuals engage with their local environment: 

1. The first device is an accelerometer, which is used to measure how active participants are. It measures both physical activity and how energetic this movement is, as well as when a person is sedentary (sitting or not moving)
   
   
2. The second device is a GPS monitor, which can identify the location of a participant using satellites

This is useful information to combine because we can then identify an individuals’ activity space, which is the local area that an individual moves or travels through during their daily life. From this, we can categorise specific types of places, such as green space, a pavement, or home. We can identify types of travel, such as walking or driving, as well as the amount of time spent indoors versus outdoors.  

We also invite participants to carry out an eye test, to identify their clarity of vision, as well as how easily they can differentiate between light and dark. We can use this data to assess if there are any relationships between the amount that someone is active and their vision.  

Combined with the cognitive health data from the NICOLA 65+ Memory and Thinking Research Study and urban environment data from Work Package 3, we can explore patterns and relationships between participants’ urban environment and their cognitive health.  

Work Package 4 builds on novel data generated through work packages 2 & 3 to explore the impact of environmental features at a biological level.

We will explore biological features associated with poorer health outcomes due to environment stressors such as air, traffic and noise pollution, and compare these to resilience factors that promote healthy ageing such as social connectivity.

For example, when people come together and interact socially with good support networks, that may help them deal better with stress or depression & is that is reflected by specific biological markers. 

Using the rich biological data within NICOLA, we will explore the underlying biological mechanisms that show how a person’s complex environment influences their cognitive health. 

SPACE will help demonstrate the biological benefits of supportive urban environments that promote healthy ageing and cognitive health.

This work package will involve researchers, research users, older people and a range of stakeholders to determine how best to change population health.  

Firstly, we will hold a series of workshops to: bring together the evidence gathered in work packages 1-4; to gain feedback on possible intervention “sweet spots”; and come to an agreement on the best ways towards reaching the common goal of promoting cognitive health.  

Secondly, we plan to implement Citizen Juries with older people, those across the life course and those from disadvantaged communities, to ‘sense-check’ the acceptability, utility, applicability, affordability and feasibility of possible prevention approaches and policies identified in step one.  

Thirdly, to ensure that our findings are shared with national and international audiences, we will hold a Pathway to the Future workshop involving stakeholders from our Business/Industry and Older peoples advisory boards, and others such as urban planners/designers, urban regeneration and public health specialists, to help us interpret how our findings might apply to other contexts.  

Finally, we will undertake a survey of researchers working in the field of built environment/health of older adults to identify and evaluate the strategies used for knowledge exchange to local, national and international audiences. This will be accompanied by a parallel survey of the potential users of this research (those working in the built environment, older adults advocacy groups, business/industry, decision making, service providers etc.) – identified through snowballing of our extensive networks. The results of these surveys will help inform and refine our communication and engagement strategy.