Overlooked link between sensory environments and long-term health
As interest grows in how environmental factors shape long-term health, researchers
are beginning to examine sensory experiences, such as noise, light and overstimulation,
as more than momentary discomforts. Instead, these exposures may play a measurable
role in shaping behavioral patterns and neurological health outcomes over time. This
is an area the Sensory Research Institute at UNT Health Fort Worth is actively exploring as it expands its research footprint.
For Gregory Knell, Ph.D., MS, an assistant professor of population and community health at the UNT Health College of Public Health, this represents an emerging frontier in public health research. His work highlights how sensory environments — long overlooked in epidemiological studies — may help explain disparities in physical activity, sleep and cognitive health, particularly among autistic individuals.
We asked Knell to share more about his research and the connection between sensory science and population health.
Your research focuses on health behaviors and population-level outcomes. How do you see sensory environments — such as noise, light or overstimulation — shaping those behaviors and, in turn, long-term health?
“My research focuses primarily on physical functioning and health behaviors at the population level, so I approach sensory environments as one dimension of the broader social and physical context that shapes how people move, engage and function across the lifespan. We know from the health behavior literature that environmental factors and stressors (e.g., noise, crowding and overstimulation) influence stress physiology, sleep quality and physical activity levels. Each of these has consequences for long-term health outcomes. What emerging research highlights, and what I find intriguing from a population health standpoint, is the possibility that for individuals with autism, those environmental stressors may not just be behavioral inconveniences. Rather, they may be biologically meaningful exposures that accumulate over a lifetime and potentially contribute to neurodegeneration risk. This is still a developing area of scientific inquiry, but it could reframe the sensory environment as a population health factor, rather than only a clinical issue.”
To what extent are sensory factors currently accounted for in public health research, and where do you see the biggest gaps in understanding their impact?
“I would say that sensory factors have been understudied in public health and epidemiological research, which I believe is a significant gap. In my own work looking at physical functioning as a biomarker for cognitive decline in older adults, and in physical activity and sleep patterns in adolescents, the tools we use rarely capture the sensory environment as an exposure. We’re good at measuring what people do. We have less understanding about the conditions under which they do it. For autistic adults specifically, that omission may be especially consequential. If sensory overload suppresses physical activity, disrupts sleep or elevates chronic stress, then our standard health behavior models are likely underestimating what’s driving poor outcomes in this group. The biggest gap, from my perspective, is longitudinal studies that follow autistic individuals across the lifespan and measure sensory exposures alongside behavioral and biological outcomes.”
How could collaboration with organizations focused on sensory science help translate your findings into practical interventions in schools, workplaces or urban design?
“My research doesn’t generate sensory science findings directly, but I think that’s actually where the collaboration opportunity lies. My work in population-level epidemiological research helps establish who is at elevated risk and for what outcomes (e.g., cognitive decline, physical inactivity, sleep disruption). Meanwhile, sensory scientists provide a mechanistic understanding of why certain environments drive those outcomes. Partnerships like that can translate epidemiological findings into actionable programs. For example, if I find that autistic adolescents have significantly worse physical activity and sleep profiles, and sensory researchers can link that to specific environmental exposures, then architects, urban planners and school administrators have a much stronger evidence base for intervention. The same logic applies to workplaces and public spaces. What’s missing right now is data that connects environmental exposures to long-term health outcomes at the population level.”
Do you see sensory-informed approaches — such as modifying environments or reducing overstimulation — as a viable pathway for prevention in neurological or mental health conditions?
“I think sensory-informed approaches need to be studied from a prevention standpoint, but we need to be precise about what we mean by ‘prevention’ and for whom. In my work, one of the central questions is whether we can identify modifiable factors early enough to meaningfully alter brain disease trajectories. Recent research suggests that, for autistic individuals, the biological roots of neurological decline may begin earlier than traditional diagnostic timelines suggest. If proven, this may strengthen the case for upstream environmental interventions rather than waiting for clinical symptoms to emerge. If chronic sensory overload contributes to stress dysregulation, sleep disruption and physical inactivity — which are all established risk factors for cognitive decline — then reducing that burden is potentially a strategy for neurodegeneration. That said, this needs to be further tested, and the evidence base needs to be strengthened. Mechanistic findings do not always translate to the population level.”
What kinds of data or tools would be most valuable in integrating sensory science into large-scale epidemiological research?
“Integrating sensory science with traditional epidemiological methods such as longitudinal cohort research, along with some of the work we’ve done in the Institute for Translational Research using biomarker assessments and neuroimaging, seems like a natural starting point. Wearables that capture environmental and physiological data passively over time seem like a practical bridge. I’d like to learn from sensory scientist colleagues about which tools are ready for large-scale use. As epidemiologists, our strengths lie in population-level research designs that can identify cause and effect and in developing techniques to measure health states at the population level while minimizing error. I think weaving those strengths into sensory research frameworks could help test these hypotheses in larger, more diverse samples.”
As research evolves, where do you see the greatest opportunity to connect individual sensory experiences with broader population health outcomes?
“The best opportunity is using existing cohort studies that are already following people over time. These have the infrastructure in place to measure and track physical functioning, cognitive decline, sleep and activity levels across diverse populations. The missing piece is treating sensory experiences as a measured exposure within those frameworks. This will allow us to begin testing some of the connections that a recent Washington Post article explored. My previous work has found that physical functioning measures can serve as accessible, scalable indicators of underlying neurological health. It’s possible that sensory experiences may operate similarly, as something observable and measurable that reflects underlying biological processes.”
The Washington Post article you mentioned highlights emerging evidence of shared biological pathways between autism and Alzheimer’s disease. From a public health perspective, how should researchers interpret these findings in terms of risk across the lifespan?
“From an epidemiological standpoint, these findings are preliminary. The shared biological pathways described in the article, particularly around synaptic function and cellular clearance, are compelling and warrant serious scientific attention. However, mechanistic overlap does not necessarily translate into evidence of population-level risk. To make further statements about risk across the lifespan, there will need to be well-designed longitudinal studies with adequate follow-up among representative samples of autistic adults that account for potential confounding. The article cites two studies that found around a 2.6 times higher risk of dementia in autistic populations. This is notable, but the research is still early, and more rigorous studies are needed before drawing strong conclusions. The takeaway is that the evidence supports prioritizing this as a research area and improving clinical surveillance for cognitive decline in autistic adults.”
“The implications for screening and care planning are significant. First, it would require earlier and more systematic monitoring in autistic adults, a population already underserved in routine clinical care. Second, standard cognitive screening tools may not perform equally well in autistic populations, where communication differences and cognitive variation can make them less reliable. There would need to be work to validate tools for that population, which is a significant methodological challenge. From a long-term care standpoint, most dementia care settings are not designed with autistic adults in mind, and most autism services are not designed with aging in mind. That gap will become increasingly visible as the first large cohorts of diagnosed autistic adults move into their 50s and 60s.”
How might insights from this research shape future efforts to integrate environmental and lifestyle factors into our understanding of neurological disease risk?
“Neurology has historically focused on what happens inside the brain, while public health has focused on behaviors and environments outside of it. This research suggests those perspectives need to be more integrated. Environmental and lifestyle factors — including physical activity, sleep, stress exposure and potentially sensory environment — may contribute to risk that builds over a lifetime. We have the tools to measure both exposures and outcomes at scale using cohort studies, wearable technology, biological markers and neuroimaging. There is a need for funding studies that treat neurological disease as a lifespan phenomenon rather than a late-life event, and that include populations such as autistic adults who have historically been left out of this research.”
For more information, visit the Sensory Research Institute’s website.