Association between home layout connectivity and cognitive ability in community dwelling older adults: Implication for occupational therapy

Authors

DOI:

https://doi.org/10.47818/DRArch.2021.v2si033

Keywords:

aging in place, cognitive functioning, home connectivity

Abstract

Physical environment has long been recognized within occupational therapy as a key factor contributing to residents’ functional abilities. However, the specific aspects of the physical environment that matter and the extent to which they do so remain less understood. This paper reports a quantitative study of the relationship between a characteristic of the physical home environment—the degree of interconnectedness of its rooms—and the cognitive ability of adults. Working with demographic, health, and home layout data collected from a sample of community-dwelling older adults in Atlanta, Georgia (N=72, Mage=69.5), we found that the cognitive functioning determined by the Montreal Cognitive Assessment (MoCA) score was significantly associated with the average connectivity and mean depth of the homes while controlling participants’ age and education. Regression analysis suggested home connectivity independently explained a little more than 4% of the variance in the MoCA scores. The results further revealed that the relationship may be better modeled using non-linear models, and that the increase in the numbers of circulation rings as average room connectivity rises may be partly, but not entirely, responsible for its association with cognitive ability. The study points to directions for further work, including causal modeling, based on recommendations that could be developed for homes to support older adults’ abilities to continue to reside in their own homes as they grow older.

Downloads

Download data is not yet available.

Author Biographies

  • Sonit Bafna, Georgia Institute of Technology

    Dr. Bafna studies the principles that shape the built environment and govern its relationship with social, cultural, and imaginative life. He has published empirical studies on the impact of space on human behavior, cognition, social organization, and health, as well as critical studies of architectural works that explore topics in representation, aesthetics, and interpretation. As a member of the school of architecture faculty at Georgia Tech, he teaches courses in architectural theory, analysis and interpretation, and research methods. He is currently serving as the director of the PhD program in Architecture in the College of Design. Current projects include a book titled Imaginative Reasoning in the Shaping of Buildings.

  • Kinsuk K. Maitra, Georgia State University

    Dr. Maitra is a Professor and the Chair and Professor of the Department of Occupational Therapy (OT) at Georgia State University, Atlanta, GA. He is an occupational therapist and a cognitive neuroscientist. Currently, he is working to understand the relationship between space cognition and the occupation of living in community-living older adults. He publishes in peer-reviewed national and international journals and regularly presents in national and international forums. Dr. Maitra received research support from federal agencies like the National Science Foundation (NSF) and the National Parkinson Foundation besides intramural fundings. He is a Fellow of the American Occupational Therapy Association, and he served as a Board of Trustees of the American Occupational Therapy Foundation for several years.

  • Yoonjeong Lim, Let’s Talk Therapy

    Dr. Lim is a pediatric occupational therapist at Let’s Talk Therapy, Duluth, Georgia. She is also a lead clinical instructor and supervises fieldwork students from Occupational Therapy programs. Her clinical expertise is in strengths-based approach to autism and behavior and provides family-centered practice. Dr. Lim is a member of American Occupational Therapy Association.

  • Manasi Shah, Georgia Institute of Technology

    Mansi is an architect and urban designer with 11 years of experience spanning practice, research, and teaching in India, the US, and Europe. She was mentored by Balkrishna Doshi – the 2018 Pritzker Laureate at his design laboratory in Ahmedabad, India from 2010-2014. Her research interests lie in understanding architecture’s interaction with multiple disciplines such as psychology, linguistics, and anthropology. As a visiting research scholar at Georgia Institute of Technology, she has been a part of several projects exploring the relationship between human behavior and the environment. She is currently a participant in a joint project between the architecture and psychology schools at Georgia Tech investigating the role of physical environments in post-pandemic work settings.

  • Yi-An Chen, Georgia State University

    Yi-An Chen is an Assistant Professor in the Department of Occupational Therapy at Georgia State University (GSU). Chen’s research interests mainly focus on upper extremity rehabilitation for people with neurological disorders (e.g., stroke and Parkinson’s disease). She has been collaborating with experts and researchers from Georgia Tech and Emory University on several different projects, with the common goal to provide patient-centered training or design to allow better independent life of patients. Chen had her clinical training and earned a Master’s degree in Occupational Therapy. She further pursued her Ph.D. in Biokinesiology at the University of Southern California, concentrating on neurorehabilitation. She completed her postdoc training at GSU Physical Therapy Department, focusing on telerehabilitation in stroke.

References

Bafna, S. (2001). Geometrical Intuitions of Genotypes. Space syntax: 3rd International Symposium, Georgia Institute of Technology, Atlanta, GA.

Bafna, S. (2003). Space Syntax:A Brief Introduction to Its Logic and Analytical Techniques. Environment and Behavior, 35(1), 17-29. https://doi.org/10.1177/0013916502238863

Bafna, S., Maitra, K., Lim, Y., Newman, W. E., & Shah, M. (2019). The Home as a Therapeutic Environment. 12th International Space Syntax Symposium, Beijing, Jiaotong University.

Ball, N. J., Mercado, E., & Orduña, I. (2019, 2019-March-06). Enriched Environments as a Potential Treatment for Developmental Disorders: A Critical Assessment [Review]. Frontiers in Psychology, 10(466). https://doi.org/10.3389/fpsyg.2019.00466

Besser, L., Galvin, J. E., Rodriguez, D., Seeman, T., Kukull, W., Rapp, S. R., & Smith, J. (2019, 2019/11/01/). Associations between neighborhood built environment and cognition vary by apolipoprotein E genotype: Multi-Ethnic Study of Atherosclerosis. Health & Place, 60, 102188. https://doi.org/https://doi.org/10.1016/j.healthplace.2019.102188

Bonaccorsi, G., Manzi, F., Del Riccio, M., Setola, N., Naldi, E., Milani, C., Giorgetti, D., Dellisanti, C., & Lorini, C. (2020, 08). Impact of the Built Environment and the Neighborhood in Promoting the Physical Activity and the Healthy Aging in Older People: An Umbrella Review. Int J Environ Res Public Health, 17(17). https://doi.org/10.3390/ijerph17176127

Cao, M., Pu, T., Wang, L., Marshall, C., He, H., Hu, G., & Xiao, M. (2017, 2017/08/01/). Early enriched physical environment reverses impairments of the hippocampus, but not medial prefrontal cortex, of socially-isolated mice. Brain, Behavior, and Immunity, 64, 232-243. https://doi.org/10.1016/j.bbi.2017.04.009

Chandrabose, M., Rachele, J. N., Gunn, L., Kavanagh, A., Owen, N., Turrell, G., Giles-Corti, B., & Sugiyama, T. (2019, 01). Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies. Obes Rev, 20(1), 41-54. https://doi.org/10.1111/obr.12759

Cleland, C., Reis, R. S., Ferreira Hino, A. A., Hunter, R., Fermino, R. C., Koller de Paiva, H., Czestschuk, B., & Ellis, G. (2019, 05). Built environment correlates of physical activity and sedentary behaviour in older adults: A comparative review between high and low-middle income countries. Health Place, 57, 277-304. https://doi.org/10.1016/j.healthplace.2019.05.007

Day, K., & Calkins, M. (2002). Design and dementia. In A. C. R. Bechtel (Ed.), The new environmental psychology handbook (pp. pp. 374-393). John Wiley and Sons.

Domènech-Abella, J., Mundó, J., Leonardi, M., Chatterji, S., Tobiasz-Adamczyk, B., Koskinen, S., Ayuso-Mateos, J. L., Haro, J. M., & Olaya, B. (2020, 03). Loneliness and depression among older European adults: The role of perceived neighborhood built environment. Health Place, 62, 102280. https://doi.org/10.1016/j.healthplace.2019.102280

Downs, R. M., & Stea, D. (1973). Image & environment: Cognitive mapping and spatial behavior. AldineTransaction.

Fischer, A. (2016, 2016/05/01/). Environmental enrichment as a method to improve cognitive function. What can we learn from animal models? Neuroimage, 131, 42-47. https://doi.org/https://doi.org/10.1016/j.neuroimage.2015.11.039

Gati, I., & Tversky, A. (1984, Jul). Weighting common and distinctive features in perceptual and conceptual judgments. Cogn Psychol, 16(3), 341-370. https://doi.org/10.1016/0010-0285(84)90013-6

Hertzog, C., Kramer, A. F., Wilson, R. S., & Lindenberger, U. (2008). Enrichment Effects on Adult Cognitive Development:Can the Functional Capacity of Older Adults Be Preserved and Enhanced? Psychological Science in the Public Interest, 9(1), 1-65. https://doi.org/10.1111/j.1539-6053.2009.01034.x

Hillier, B., Hanson, J., & Peponis, J. (1984). What Do We Mean by Building Function? . In I. C. J. S. Powell, & S. Lera (Ed.), Designing for Building Utilisation (pp. pp. 61–72). Spon.

Hund, A. M. (2016, 2016/03/01/). Visuospatial working memory facilitates indoor wayfinding and direction giving. Journal of Environmental Psychology, 45, 233-238. https://doi.org/https://doi.org/10.1016/j.jenvp.2016.01.008

Kielhofner, G., Lippincott, W., & Wilkins. (2008). Model of human occupation : theory and application. http://ot.lwwhealthlibrary.com.p.atsu.edu/book.aspx?bookid=1089

Koski, L., Xie, H., & Finch, L. (2009, Sep). Measuring cognition in a geriatric outpatient clinic: Rasch analysis of the Montreal Cognitive Assessment. J Geriatr Psychiatry Neurol, 22(3), 151-160. https://doi.org/10.1177/0891988709332944

Kühn, S., Düzel, S., Eibich, P., Krekel, C., Wüstemann, H., Kolbe, J., Martensson, J., Goebel, J., Gallinat, J., Wagner, G. G., & Lindenberger, U. (2017, 2017/09/20). In search of features that constitute an “enriched environment” in humans: Associations between geographical properties and brain structure. Scientific Reports, 7(1), 11920. https://doi.org/10.1038/s41598-017-12046-7

Law, M. (1991, Oct). 1991 Muriel Driver lecture. The environment: a focus for occupational therapy. Can J Occup Ther, 58(4), 171-180. https://doi.org/10.1177/000841749105800404

Leggio, M. G., Mandolesi, L., Federico, F., Spirito, F., Ricci, B., Gelfo, F., & Petrosini, L. (2005, 2005/08/30/). Environmental enrichment promotes improved spatial abilities and enhanced dendritic growth in the rat. Behavioural Brain Research, 163(1), 78-90. https://doi.org/https://doi.org/10.1016/j.bbr.2005.04.009

Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Larson, E. B., Ritchie, K., Rockwood, K., Sampson, E. L., Samus, Q., Schneider, L. S., Selbæk, G., Teri, L., & Mukadam, N. (2017, Dec). Dementia prevention, intervention, and care. Lancet, 390(10113), 2673-2734. https://doi.org/10.1016/S0140-6736(17)31363-6

Marquardt, G., Johnston, D., Black, B. S., Morrison, A., Rosenblatt, A., Lyketsos, C. G., & Samus, Q. M. (2011). Association of the Spatial Layout of the Home and ADL Abilities Among Older Adults With Dementia. American Journal of Alzheimer's Disease & Other Dementias®, 26(1), 51-57. https://doi.org/10.1177/1533317510387584

Nahemow, L., & Lawton, M. P. (1974). Towards an Ecological Theory of Adaptation and Aging. In W. F. E Preiser (Ed.), Environmental Design Research (pp. pp. 24–32). Dowden, Hutchinson, and Ross.

Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005, Apr). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 53(4), 695-699. https://doi.org/10.1111/j.1532-5415.2005.53221.x

O’Keefe, J., & Nadel, L. (1978). The Hippocampus as a Cognitive Map. Oxford University Press.

Pan, H., Liu, Y., & Chen, Y. (2021, Jan). The health effect of perceived built environment on depression of elderly people in rural China: Moderation by income. Health Soc Care Community, 29(1), 185-193. https://doi.org/10.1111/hsc.13081

Peponis, J., & Wineman, J. (2002). Spatial Structure of Environment and Behavior. In R. B. Bechtel & A. Churchman (Eds.), Handbook of environmental psychology (p. 27`1-291). J. Wiley & Sons.

Peponis, J., Wineman, J., Rashid, M., Kim, S. H., & Bafna, S. (1997). On the Description of Shape and Spatial Configuration inside Buildings: Convex Partitions and Their Local Properties. Environment and Planning B: Planning and Design, 24(5), 761-781.

Roe, J., Mondschein, A., Neale, C., Barnes, L., Boukhechba, M., & Lopez, S. (2020). The Urban Built Environment, Walking and Mental Health Outcomes Among Older Adults: A Pilot Study. Front Public Health, 8, 575946. https://doi.org/10.3389/fpubh.2020.575946

Rossetti, H. C., Lacritz, L. H., Cullum, C. M., & Weiner, M. F. (2011, Sep 27). Normative data for the Montreal Cognitive Assessment (MoCA) in a population-based sample. Neurology, 77(13), 1272-1275. https://doi.org/10.1212/WNL.0b013e318230208a

Turner, A., Doxa, M., O'Sullivan, D., & Penn, A. (2001). From Isovists to Visibility Graphs: A Methodology for the Analysis of Architectural Space. Environment and Planning B: Planning and Design, 28(1), 103-121. https://doi.org/10.1068/b2684

Tversky, B. (2003). Structures Of Mental Spaces:How People Think About Space. Environment and Behavior, 35(1), 66-80. https://doi.org/10.1177/0013916502238865

Tversky, B., & Hemenway, K. (1984, Jun). Objects, parts, and categories. J Exp Psychol Gen, 113(2), 169-197. https://www.ncbi.nlm.nih.gov/pubmed/6242749

U.S. Census Bureau. (2019a). Selected Economic Characteristics, 2015 - 2019 American Community Survey 5-Year Data Profile. Retrived from: https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP2003&g=2310M2500US12060.

U.S. Census Bureau. (2019b). Selected Social Characteristics in the United States, 2015 - 2019 American Community Survey 5-Year Data Profile. Retrieved from: https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP2002&g=2310M2500US12060.

Watts, A., Ferdous, F., Diaz Moore, K., & Burns, J. M. (2015). Neighborhood Integration and Connectivity Predict Cognitive Performance and Decline. Gerontology and Geriatric Medicine, 1, 2333721415599141. https://doi.org/10.1177/2333721415599141

Yu, J., Yang, C., Zhang, S., Zhai, D., Wang, A., & Li, J. (2021, Jan). The Effect of the Built Environment on Older Men's and Women's Leisure-Time Physical Activity in the Mid-Scale City of Jinhua, China. Int J Environ Res Public Health, 18(3). https://doi.org/10.3390/ijerph18031039

Downloads

  • PDF
    • | Abstract Views 0 | PDF Downloads 0

Published

2021-12-31

Issue

Vol. 2 No. (Special Issue) (2021)

Section

Space Syntax

License

Copyright (c) 2021 Sonit Bafna, Kinsuk K. Maitra, Yoonjeong Lim, Manasi Shah, Yi-An Chen

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Association between home layout connectivity and cognitive ability in community dwelling older adults: Implication for occupational therapy. (2021). Journal of Design for Resilience in Architecture and Planning, 2((Special Issue), 18-33. https://doi.org/10.47818/DRArch.2021.v2si033