Associations of Neighborhood Gentrification Status and Cognitive Decline in the Health and Retirement Study

Abstract

AbstractBackgroundGentrification, characterized by in‐migration of high socioeconomic (SES) residents into formerly disinvested neighborhoods, may impair late‐life cognitive function of existing residents. We hypothesized that disinvestment of neighborhood economic resources and reinvestment via gentrification both increase risk of cognitive decline among marginalized older adults.MethodWe analyzed 17,613 Health and Retirement Study participants (aged 51‐101), 67% Non‐Hispanic White) with data on our outcomes of interest: biennial scores on immediate and delayed word recall batteries (2010‐2016). With 2000 Census data, we operationalized census tract disinvestment based on disproportionately high proportions of minority residents, low SES, and renters for the corresponding county. We defined gentrification among disinvested tracts as greater than county‐median increases in White and college‐educated residents, household income, and housing costs between the 2000 Census and 2008‐2012 American Community Survey. We fit linear mixed models to evaluate associations of gentrification with cognitive level and change. We also evaluated racial‐ethnic differences in cognitive function by residence in tracts that were 1) not disinvested in 2000, 2) remained disinvested, or 3) gentrified by 2012. All models were adjusted by individual‐level age, gender, race‐ethnicity, educational attainment, marital status, home ownership, health insurance coverage, and memory score practice effects.Result56% of participants lived tracts that were disinvested in 2000; by 2012, 34% of disinvested tracts gentrified. Baseline memory performance was worse in invested (e.g., mean immediate = 4.9) than in initially disinvested tracts that either gentrified (mean = 5.3) or remained disinvested (mean = 5.4) (p<0.02 for test of mean differences). Neighborhood disinvestment from 2000‐2012 compared to investment in 2000 was associated with better 6‐year immediate recall trajectories among White participants (β; 95% CI: 0.18; 0.01, 0.39) but not among their Hispanic/Latino counterparts (‐0.14; ‐0.29, ‐0.01; p‐value for interaction compared to White participants = 0.04). We observed similar patterns for delayed recall (p‐value for interaction comparing Hispanic/Latino to White participants = 0.05). Neighborhood disinvestment or gentrification was not associated with recall trajectories among Black participants.ConclusionDifferential findings by race in this nationally representative sample indicate that disinvestment and gentrification do not equally impact older adult cognitive health.