Neighborhood Features and Cognitive Function: Moderating Roles of Individual Socioeconomic Status

• Published in: American journal of preventive medicine Vol. 66; no. 3; pp. 454 - 462
• Main Authors: Yang, Tse-Chuan, Kim, Seulki, Choi, Seung-won Emily, Halloway, Shannon, Mitchell, Uchechi A, Shaw, Benjamin A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-03-2024
• Subjects: Aged; Cognition; Humans; Income; Poverty; Residence Characteristics; Social Class; Socioeconomic Factors
• ISSN: 0749-3797; 1873-2607; 1873-2607
• DOI: 10.1016/j.amepre.2023.10.012

There is an interest in exploring the associations between neighborhood characteristics and individual cognitive function; however, little is known about whether these relationships can be modified by individual socioeconomic status, such as educational attainment and income.
Drawing from the 2010–2018 Health and Retirement Study, this study analyzed 10,621 older respondents (aged 65+) with a total of 33,931 person-waves. These respondents did not have dementia in 2010 and stayed in the same neighborhood throughout the study period. Cognitive function was measured with a 27-point indicator biennially, and neighborhood characteristics (i.e., walkability, concentrated disadvantage, and social isolation) were assessed in 2010. All analyses were performed in 2023.
Cognitive function is positively associated with neighborhood walkability and negatively related to concentrated disadvantage, suggesting that exposures to these neighborhood characteristics have long-lasting impacts on cognitive function. Furthermore, individual socioeconomic status modifies the relationship between neighborhood characteristics and cognitive function. Compared with those graduating from college, respondents without a bachelor's degree consistently have lower cognitive function but the educational gap in cognitive function narrows with increases in walkability (b= −0.152, SE=0.092), and widens when neighborhood concentrated disadvantage (b=0.212, SE=0.070) or social isolation (b=0.315, SE=0.125) rises. The income gap in cognitive function shrinks with increases in walkability (b= −0.063, SE=0.027).
The moderating role of socioeconomic status indicates that low-socioeconomic status older adults who also live in disadvantaged neighborhoods face a higher risk of poor cognitive function. Low-education and low-income aging adults may have the most to gain from investments to improve neighborhood characteristics.