Residential green spaces and neurodegenerative diseases in middle-aged and older adults: a systematic review and dose-response meta-analysis

作者：C Frank Shen, Jing Su, Liming Liu, Jing Li, Xiaowei Zhao, Zi Wang, Yanjie Jiang, Dexi Zhao · 发表于：Archives of Public Health · 年份：2026 · DOI：10.1186/s13690-026-01957-5 · 研究领域：Urban Green Space and Health、Older Adults Driving Studies、Noise Effects and Management

BACKGROUND: The potential protective role of residential green space against neurodegenerative diseases (NDs) is a topic of growing interest, yet evidence remains inconsistent. This systematic review and meta-analysis aimed to synthesize the current evidence on this association in middle-aged and older adults. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library through March 15, 2025, for observational studies that evaluated the association between objectively measured residential green space and the incidence of NDs in middle-aged and older adults. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the ROBINS-E tool. Random-effects models were used to pool multivariate-adjusted risk estimates comparing the highest versus lowest exposure categories. Subgroup analyses were conducted by disease type (Alzheimer's disease, Parkinson's disease, and cognitive impairment) and other study characteristics. In addition, a dose-response meta-analysis was performed to explore the potential nonlinear relationship between residential green space exposure and NDs risk. The certainty of evidence was assessed using the GRADE framework. RESULTS: A total of twelve studies involving over 1.7 million participants were included. Higher residential green space exposure was associated with a lower risk of NDs (pooled HR = 0.85, 95% CI: 0.79-0.91). Subgroup analyses suggested that the inverse association was generally consistent across different disease typ...