Changes in Neighborhood-Level Socioeconomic Disadvantage and Older Americans’ Cognitive Functioning

Jason Settels,Anja Leist

doi:10.1093/geroni/igaa057.1561

Abstract

Most studies of later life cognitive functioning have focused on individual-level variables. While some studies have examined neighborhood-level variables as influences upon older adults’ cognitive functioning, this scholarship has neglected to consider neighborhoods in a dynamic context. The present study helps fill this research gap by considering how changing extents of neighborhood-level socioeconomic disadvantage cause changes in older residents’ cognitive functioning. We employ waves 2 (2010-2011) and 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) as our source of individual-level variables and the American Community Survey as our source of neighborhood-level variables. Our analytical sample includes 1,989 respondents who participated in both waves and were 50 to 90 years in age at wave 2 of the NSHAP. Through structural equation modelling, we find that rising neighborhood-level socioeconomic disadvantage significantly decreases older residents’ cognitive functioning, both without and after controlling for baseline neighborhood-level socioeconomic disadvantage and cognitive functioning. Furthermore, approximately 7.2% of this effect is mediated through decreases in the sizes of networks of close confidants, and roughly 8.5% of this effect occurs through increased depressive symptoms. Our findings suggest that older adults’ cognitive decline can be slowed down or prevented through improvements in their living environments. In particular, policies and programs that improve living spaces while also facilitating older residents’ development of close and supportive confidant ties are likely to be particularly effective. Our study encourages further research on how neighborhood dynamics affect older persons’ cognitive functioning.

Highlights

Cognitive functioning is a dimension of health that poses especially large concerns in later life (Langa et al, 2008; Livingston et al, 2017)
The cognitive reserve framework (Stern 2002), originally introduced to explain more effective employment of one’s neural networks and heightened capability of utilizing substitute neural pathways that help protect cognitive capacity in later life related to education (Kremen et al, 2019; Singh-Manoux et al, 2011; Stern 2002; Zhang et al, 2015), suggests that neighborhood-level opportunities for cognitive stimulation, such as availability of libraries, can contribute to delaying cognitive decline
We focus on neighborhood-level percentage of persons with incomes below the poverty line, households on public assistance, and adults unemployed, and we address eight putative mediators in the neighborhood-cognition relationship

Summary

Introduction

Cognitive functioning is a dimension of health that poses especially large concerns in later life (Langa et al, 2008; Livingston et al, 2017). Most earlier studies of these neigh borhood effects either have been cross-sectional (e.g., Ailshire and Clarke 2015; Ailshire et al, 2017; Clarke et al, 2013) or have examined how neighborhood-level variables from one point in time affected changes in cognitive capacity through time (e.g., Boardman et al, 2012; Clarke et al, 2015; Hazzouri et al, 2011; Meyer et al, 2017, 2018; Rej et al, 2015; Sheffield and Peek 2009) As such, they could not rule out reverse causation; individuals with lower cognitive reserve, based on lower levels of education and less cognitively stimulating and lower status lifetime employment (which increase vulnerability to cognitive declines through time; Kremen et al, 2019; Singh-Manoux et al, 2011; Stern 2002; Zhang et al, 2015), might choose or be forced to live in less affluent neighborhoods. Discussion: While 18.10% of the total effect occurred through these mechanisms, further pathways may work through contextual- and individual-level variables not assessed in the NSHAP

Methods

Results

Conclusion