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Perceived Neighborhood Characteristics and Cognitive Functioning among Diverse Older Adults: An Intersectional Approach.

ABSTRACT: Unfavorable neighborhood conditions are linked to health disparities. Yet, a dearth of literature examines how neighborhood characteristics contribute to cognitive health in diverse samples of older adults. The present study uses an intersectional approach to examine how race/ethnicity, gender, and education moderate the association between neighborhood perceptions and cognitive functioning in later life. We used data from adults ≥65 years old (n = 8023) in the 2010-2016 waves of the nationally representative Health and Retirement Study (HRS). We conducted race/ethnicity-stratified linear regression models where cognitive functioning, measured using the 35-point Telephone Interview Cognitive Screen (TICS), was regressed on three neighborhood characteristics-cleanliness, safety, and social cohesion. We examine whether there is heterogeneity within race/ethnicity by testing if and how the relationship between neighborhood characteristics and cognitive functioning differs by gender and education. Among White adults, worse neighborhood characteristics were associated with lower cognitive functioning among those with less education. However, for Black adults, poor perceived quality of one's neighborhood was associated with worse cognitive functioning among those with more years of education compared to those with fewer years of education. Among Mexicans, perceived neighborhood uncleanliness was associated with lower cognitive functioning among those with less education, but higher cognitive functioning for those with higher levels of education. Thus, this study contributes to the literature on racial/ethnic disparities in cognitive aging disparities by examining neighborhood contextual factors as determinants of cognitive functioning. In particular, we find that higher education in the context of less favorable neighborhood environments does not confer the same benefits to cognitive functioning among all older adults.

SUBMITTER: Thierry AD

PROVIDER: S-EPMC7967341 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background and objectivesSocial disconnectedness and loneliness pose significant challenges for older Chinese immigrants. Yet, it remains unclear whether they are associated with an increased risk of cognitive decline in this population. This study aimed to investigate the association of social disconnectedness and loneliness with cognitive functioning and examine the moderation role of neighborhood contexts.Research design and methodsThis longitudinal analysis examined a sample of individuals aged 60 years and older from the Population Study of Chinese Elderly in Chicago (N = 2,044). Global cognition was assessed using the averaged z-scores of cognitive performance tests. Social disconnectedness was constructed using 5 indicators about structural aspects of social relationships. Loneliness was assessed with the R-UCLA loneliness scale. Neighborhood socioeconomic status (NSES) and neighborhood segregation index were constructed using 2010-2014 American Community Survey data at the census tract level. Individual perceptions about neighborhood environments were used to construct neighborhood cohesion index and neighborhood disorder index (NDI). Latent growth curve models with adjusted cluster robust standard errors were estimated.ResultsMore loneliness was associated with a higher level of initial cognitive functioning (B = 0.030, p < .01), but also with a faster decline rate over time (B = -0.007, p < .01) after adjusting for covariates. High NSES and less neighborhood segregation buffered the negative effects of loneliness on cognitive decline, respectively. High NDI amplified the positive relationship between loneliness and initial functioning, but accelerated the rate of cognitive decline associated with loneliness.Discussion and implicationsThe study revealed that perceived loneliness, but not social disconnectedness, is a risk factor for cognitive decline among older Chinese immigrants. Living in a neighborhood with low socioeconomic status, more segregation, and high disorder elevated the detrimental effect of loneliness on long-term cognitive decline. Further research needs to investigate the complex interplay between social relationships, neighborhood environment, and cognition.

Project description:BackgroundGrowing research documents associations between neighborhood social cohesion with better health and well-being. However, other work has identified social cohesion's "dark side" and its ability to promote negative outcomes. It remains unclear if such diverging findings are attributable to differences in study design, or other reasons. To better capture its potential heterogeneous effects, we took an outcome-wide analytic approach to examine perceived neighborhood social cohesion in relation to a range of health and well-being outcomes.MethodsData were from 12,998 participants in the Health and Retirement Study-a large, diverse, prospective, and nationally representative cohort of U.S. adults age >50. Multiple regression models evaluated if social cohesion was associated with physical health, health behavior, psychological well-being, psychological distress, and social well-being outcomes. All models adjusted for sociodemographics, personality, and numerous baseline health and well-being characteristics. To evaluate the effects of change in cohesion, we adjusted for prior social cohesion. Bonferroni correction was used to account for multiple testing.ResultsPerceived neighborhood social cohesion was not associated with most physical health outcomes (except for reduced risk of physical functioning limitations and better self-rated health) nor health behavior outcomes (except for more binge drinking). However, it was associated with numerous subsequent psychosocial well-being (i.e., higher: positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; reduced likelihood of infrequent contact with friends) and psychological distress outcomes (i.e., lower depression, hopelessness, negative affect, loneliness) over the 4-year follow-up period.ConclusionsWith further research, these results suggest that perceived neighborhood social cohesion might be a valuable target for innovative policies aimed at improving well-being.

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Perceived Neighborhood Characteristics and Cognitive Functioning among Diverse Older Adults: An Intersectional Approach.

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