TY - JOUR
T1 - Multivariate associations between cognition and neighborhood geospatial characteristics in schizophrenia
AU - Ibrahim, Ferose Azeez
AU - Mehta, Urvakhsh Meherwan
AU - Thekkumkara, Sreekanth N.
AU - Rakesh, K. R.
AU - Swetha, G.
AU - Kumar, C. Naveen
AU - Kumar, Keshav J.
AU - Narayana, Aishwarya
AU - Ravisundar, Shashwath
AU - Satyanarayana, Padmashree
AU - Thirthalli, Jagadisha
N1 - Funding Information:
Funding Information:
We acknowledge the inputs from Dr. Eesha Sharma, Assistant Professor of Child & Adolescent Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore for her help with the statistical analysis. We also acknowledge Ms. Maria Monica Selvaraj (Conscious Design Kalpa, Bangalore) for helping us with initial site analyses for the urban site, and Ms. Tanisha Y (Conscious Design Kalpa, Bangalore) for contributing to the data analyses and mapping. This work was supported by the Department of Science and Technology ( Ministry of Science and Technology ), Cognitive Science Research Initiative grant ( SR/CSRI/143/2016 to CNK). The funding body did not have any role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/4/17
Y1 - 2023/4/17
N2 - Cognitive impairment contributes to functional impairment in schizophrenia. Yet, little is known about how environmental characteristics are related to cognition in schizophrenia. By examining how cognition and the environment are intertwined, it may be possible to identify modifiable risk and protective factors that can improve cognitive outcomes in schizophrenia. We aimed to identify multivariate associations between cognition and three geospatial characteristics (built-space density, habitable green spaces, and public spaces for social interaction) within one's immediate neighborhood among individuals with schizophrenia. We recruited participants with schizophrenia from three sites – an urban metropolitan and two towns in southern India. We administered standard cognitive assessments and performed a principal axis factoring to identify episodic memory, cognitive control, and social inference-making factors for use in further analyses. We estimated geospatial characteristics of an individual's neighborhood, i.e., up to 1 km2 around the residence, by sourcing data from Google Earth. We performed unconditional and conditional (to examine the effect of clinical covariates) canonical correlation analyses to understand the multivariate relationship between cognition and geospatial characteristics. We analyzed data from 208 participants; the first canonical cognitive variate (higher social inference-making and poorer cognitive control) shared 24% of the variance (r = 0.49; P < 0.001) with the first geospatial variate (lower built density and poorer access to public spaces). Years of education, age at onset, and place of residence significantly modulated this relationship. We observe differential associations of the built environment with social and non-social cognition in schizophrenia, and highlight the clinical and demographic characteristics that shape these associations.
AB - Cognitive impairment contributes to functional impairment in schizophrenia. Yet, little is known about how environmental characteristics are related to cognition in schizophrenia. By examining how cognition and the environment are intertwined, it may be possible to identify modifiable risk and protective factors that can improve cognitive outcomes in schizophrenia. We aimed to identify multivariate associations between cognition and three geospatial characteristics (built-space density, habitable green spaces, and public spaces for social interaction) within one's immediate neighborhood among individuals with schizophrenia. We recruited participants with schizophrenia from three sites – an urban metropolitan and two towns in southern India. We administered standard cognitive assessments and performed a principal axis factoring to identify episodic memory, cognitive control, and social inference-making factors for use in further analyses. We estimated geospatial characteristics of an individual's neighborhood, i.e., up to 1 km2 around the residence, by sourcing data from Google Earth. We performed unconditional and conditional (to examine the effect of clinical covariates) canonical correlation analyses to understand the multivariate relationship between cognition and geospatial characteristics. We analyzed data from 208 participants; the first canonical cognitive variate (higher social inference-making and poorer cognitive control) shared 24% of the variance (r = 0.49; P < 0.001) with the first geospatial variate (lower built density and poorer access to public spaces). Years of education, age at onset, and place of residence significantly modulated this relationship. We observe differential associations of the built environment with social and non-social cognition in schizophrenia, and highlight the clinical and demographic characteristics that shape these associations.
KW - Geographical information systems
KW - Living environment
KW - Neighborhood attributes
KW - Neurocognition
KW - Psychosis
KW - Social cognition
KW - Urban exposome
UR - http://www.scopus.com/inward/record.url?scp=85152746992&partnerID=8YFLogxK
U2 - 10.1016/j.ajp.2023.103593
DO - 10.1016/j.ajp.2023.103593
M3 - Article
C2 - 37084467
AN - SCOPUS:85152746992
VL - 84
M1 - 103593
ER -
