Neighborhood age structure and cognitive function in a nationally-representative sample of older adults in the U.S.

Abstract

Recent evidence suggests that living in a neighborhood with a greater percentage of older adults is associated with better individual health, including lower depression, better self-rated health, and a decreased risk of overall mortality. However, much of the work to date suffers from four limitations. First, none of the U.S.-based studies examine the association at the national level. Second, no studies have examined three important hypothesized mechanisms - neighborhood socioeconomic status and neighborhood social and physical characteristics - which are significantly correlated with both neighborhood age structure and health. Third, no U.S. study has longitudinally examined cognitive health trajectories. We build on this literature by examining nine years of nationally-representative data from the Health and Retirement Study (2002–2010) on men and women aged 51 and over linked with Census data to examine the relationship between the percentage of adults 65 and older in a neighborhood and individual cognitive health trajectories. Our results indicate that living in a neighborhood with a greater percentage of older adults is related to better individual cognition at baseline but we did not find any significant association with cognitive decline. We also explored potential mediators including neighborhood socioeconomic status, perceived neighborhood cohesion and perceived neighborhood physical disorder. We did not find evidence that neighborhood socioeconomic status explains this relationship; however, there is suggestive evidence that perceived cohesion and disorder may explain some of the association between age structure and cognition. Although more work is needed to identify the precise mechanisms, this work may suggest a potential contextual target for public health interventions to prevent cognitive impairment.

Sex‐specific association between neighborhood characteristics and dementia: The Three‐City cohort

“…The association between proportion of people aged 60 years or older and reduced risk of incident dementia is in agreement with a recent study showing that living in a neighborhood with a higher percentage of older people (≥65 years) is related to better individual cognition at baseline [35]. This is in accordance with the hypothesis that living in these neighborhoods may be more suitable for older people (responsive services, better social interactions...) [36,37].…”

Disabilities moderate the association between neighbourhood urbanity and cognitive health: Results from the Irish longitudinal study on ageing

“…Education and social engagement are well-established protective factors for cognitive health in ageing (37), and previous studies have shown that urban-rural variations in cognitive functioning could be ascribed to differences in mental stimulation received through education (16) or through social engagement (38). However, the interactions remained significant even after controlling for educational attainment or social engagement in our multivariate models, suggesting that socioeconomic circumstances did not fully account for the association between neighbourhood urbanity and disabilities in our sample.…”

Association Between Neighborhood Cohesion and Self‐Neglect: Exploring Mental Health in Asian Americans

“…1 Existing studies have noted that self-neglect in older adults is frequently pathological in nature, with individuals with dementia, frontal lobe dysfunction, and depression often neglecting personal hygiene and living in unsanitary conditions. 5 The authors' findings thereby expand upon literature indicating the importance of social cohesion in reducing risk of cognitive decline and improving mental well-being, creating an additional connection to selfneglect. 5,6 Because the effect of neighborhood cohesion may be especially potent in immigrant communities, to understand the relationship between neighborhood cohesion and self-neglect better, future studies should examine the effect of social cohesion on cognitive decline specifically in Chinese-American immigrant older adults.…”