Given the diversity of environmental exposures over the life course, cross-disciplinary collaboration and expertise is critical. The GECC focuses on six key, interconnected domains: extreme weather, physical environment, social environment, policy environment, community services environment, and life experiences, as well as two core teams dedicated to methodological issues and dissemination.

Extreme Weather Environment

The extreme weather environment domain considers the impacts of a wide range of relevant hazards on healthy aging, including rising outdoor temperatures and risks posed by smoke from wildfires, flooding, episodes of extreme heat, and other extreme weather events. This is an important area of focus since extreme weather is rapidly changing and weather events have been associated with higher rates of death and healthcare utilization among the general population, but especially those with dementia. Older adults with poorer cognition are particularly vulnerable to extreme weather events and stressors since they are often less mobile, are on a fixed income, may be taking medications that interfere with thermoregulation, and have chronic diseases. Extreme weather hazards can vary dramatically across individuals for reasons including age, occupation, and living conditions. Therefore, activities focused on extreme weather mitigation, adaptation, and resilience can profoundly impact the health of people with cognitive declines and dementia. Extreme weather environment domain is co-led by Dr. Gregory Wellenius (Boston University) and Kevin Lane (Boston University).

Physical Environment

The natural and built environment where we live, work, exercise, and socialize can have important influences on health. Some features of the physical environment can be harmful to health like air pollution and noise. Yet, other aspects like visibility of trees and lakes or access to transportation, parks, benches, restrooms, and safe communities can improve health. Since much of the physical environment can be modified, this is a critical area of importance to reduce the risks of dementia or improve the well-being of those with dementia. The Physical Environment domain is co-led by Dr. Jeffrey Brook (University of Toronto) and Dr. Michael Brauer (University of British Columbia).

Social Environment

The social environment includes a person's workplace, neighborhood, society, and groups to which they belong. It can be characterized by how people relate to each other and the structures of the community. Features of social processes include things like social connections, support networks, and trust among people. Many of these factors are linked to health conditions associated with dementia like hypertension and cardiovascular diseases, but more research is needed to understand how they affect brain health. The Social Environment domain is led by Dr. Maggie Hicken (University of Michigan).

Policy Environment

The policy domain covers a broad scope of government policies that influence key determinants of health and AD/ADRD outcomes throughout life. This may include public health policies (e.g., policies affecting tobacco and alcohol purchase and use, nutritional labelling, urban design and walkability policies); health system policies (e.g., policies shaping the organization, financing, and delivery of healthcare services); physical environmental policy (e.g., air quality and pollution control, noise pollution reduction, access to green spaces), and social policies (e.g., education policy, employment and workplace policies, income security and protection). Given this wide range of influential policies, variations across jurisdictions and time periods serve as natural experiments, allowing researchers to study how different policies affect healthy aging and AD/ADRD risk factors, and ultimately informing more targeted and effective interventions. To make progress in this domain, the GECC focuses on three main aims: reaching consensus on key policies affecting health and AD/ADRD outcomes, developing standardized methods for policy data collection, and creating robust analytical approaches to examine policy variations across temporal and spatial dimensions. The Policy Environment domain is co-led by Prof. Mauricio Avendano (University of Lausanne) and Dr. David Knapp (University of Southern California).

Community Services Environment

The community services domain focuses on care and support systems, including healthcare, senior services, and emergency preparedness. These services significantly influence healthy aging and AD/ADRD risks, care, and resilience for individuals and populations, while also moderating the impacts of other domains. Research in this domain focuses on developing frameworks and innovative methods for measuring the availability and accessibility of diverse services, going beyond mere presence to assess their quality, quantity, and access. This comprehensive approach aims to deepen our understanding of how community services impact health and AD/ADRD outcomes, providing crucial insights for developing effective interventions to improve access and quality of care. The Community Services Environment domain is co-led by Dr. HwaJung Choi (University of Michigan) and Mr. David Van Riper (University of Minnesota).

Life Experiences

The life experiences domain explores how a range of experiences – from well-studied categories like education and caregiving, to less-studied aspects such as migration, stress and day-to-day experiences – shape health and well-being across the lifespan and relate to AD/ADRD outcomes. Primarily focused on individual and family level experiences, this domain employs novel approaches to understanding these occurrences across space and time. For example, time-related research in this domain examines how the cumulative effects of life experiences differ from isolated risk factors, takes into account how certain experiences have different impacts over time, and considers how the duration of an important life experience or when it occurs in the life course changes its import. This domain also intersects with the social environment, policy landscape, and community services domains to provide a holistic understanding of how various life experiences influence health and wellbeing as individuals and populations age. The Life Experiences domain is led by Dr. Sarah Flood (University of Minnesota).

Methods

The methods core tackles cross-domain methodological challenges focused on measuring exposures and their associations with AD/ADRD outcomes. Topics of interest to the methods group include methods and approaches for summarizing and analyzing high-dimensional and complex exposome data, including index construction methods, the application of mixture methods to jointly model combinations of exposures, and the use of machine learning methods to capture complex interplay between different exposome components. The group will also tackle challenges related to consideration of life course data on exposures from birth and early childhood to late life, developing and discussing common approaches to understand and evaluate sensitive periods and cumulative exposures across time. Additionally, the methods core will consider topics focused on minimizing bias in causal analyses of the exposome and AD/ADRD outcomes, including the incorporation and consideration of measurement error, selection bias in studies of older adults, and evidence triangulation and synthesis. By tackling high-priority challenges relevant to multiple domains, the methods core will provide crucial insights to guide measure construction and subsequent analytic projects across the coordinating center. The methods core is led by Dr. Emma Nichols (University of Southern California).

Dissemination

The dissemination core is co-led by Dr. Lorna Thorpe (NYU Grossman School of Medicine), Mr. Bas Weerman (University of Southern California), and Dr. Kevin Lane (Boston University).