Neighborhood Physical Disorder Research Articles

INTERACTION BETWEEN NATIVITY AND NEIGHBORHOOD ON DEMENTIA RISK: FINDINGS FROM TEN YEARS OF NATIONAL US DATA

Abstract Prior research indicates neighborhood disadvantage increases dementia risk. There is, however, inconclusive evidence on the relationship between nativity and cognitive impairment. To our knowledge, our study is the first to analyze how nativity and neighborhood interact to influence dementia risk. Ten years of prospective cohort data (2011-2020) were retrieved from the National Health and Aging Trends Study, a nationally representative sample of 5,362 U.S. older adults aged 65+. Cox regression analyzed time to dementia diagnosis using nativity status (foreign or native-born) and composite scores for neighborhood physical disorder (litter, graffiti, vacancies) and social cohesion (know, help, trust each other), after applying sampling weights and imputing missing data. Average baseline neighborhood physical disorder was significantly higher among foreign-born (0.28) compared to native-born (0.18) older adults [t=-2.4, p=.02]. Average baseline neighborhood social cohesion was significantly lower for foreign-born (3.57) compared to native-born (4.33) older adults [t=5.5, p<.001]. After adjusting for sociodemographic, health, and neighborhood variables, foreign-born older adults had a 51% significantly higher dementia risk (aHR=1.51, 95% CI=1.19-1.90, p<.01). There were no statistically significant interactions for nativity with neighborhood physical disorder or social cohesion. Our findings suggest foreign-born older adults have higher neighborhood physical disorder and lower social cohesion compared to native-born older adults. Despite the higher dementia risk we observed for foreign-born older adults, this relationship was not moderated by either neighborhood physical disorder or social cohesion. Further research is needed to understand what factors are contributing to elevated dementia risk among foreign-born older adults.

NEIGHBORHOOD CHARACTERISTICS AND SLEEP PROBLEMS: MEDIATING ROLES OF HEALTH BEHAVIORS AND MENTAL HEALTH

Abstract Existing studies have well-documented the relationship between the neighborhood environment and health among older adults. Yet very few have focused on how the neighborhood environment predicts late-life sleep quality. Using longitudinal data (Rounds 7-9) from the National Health and Aging Trends Study, this study examined the cross-sectional and longitudinal associations between neighborhood characteristics (physical disorder and social cohesion) and sleep problems among Americans aged 65 or older, as well as whether health behaviors and mental health mediated these associations. The analytical sample included 4,029 adults aged 65 or older. Logistic regressions with a lagged dependent variable were adopted to test longitudinal associations. Longitudinal mediation analyses were also used to examine the mediation effects of health behaviors and mental health. The results suggested that neighborhood physical disorder was a significant predictor of sleep problems cross-sectionally, whereas social cohesion was both cross-sectionally and longitudinally associated with sleep problems. Moreover, mediation analysis revealed that health behaviors and mental health significantly mediated the longitudinal relationship between social cohesion and sleep problems, though the strength of the indirect effect diminished over time. These findings suggest that neighborhood physical disorder and social cohesion are significant predictors of late-life sleep problems among older Americans. The study also highlighted older adults’ resilience and adaptability to adverse neighborhood environments and the long-term health benefits of social cohesion in late-life sleep quality. Therefore, community health interventions that facilitate older adults’ physical and social activity, along with mental health programs, may help community-dwelling older adults improve their sleep quality.

ADVANCING RESEARCH ACROSS THE ADRD CONTINUUM IN UNDERREPRESENTED POPULATIONS

Abstract This symposium highlights innovative work advancing ADRD research with African Americans, Latinos, and Arab Americans. Included papers address critical issues along the ADRD spectrum from life course risk factors, through mild cognitive impairment (MCI), to dementia caregiving. Investigating links between the early-life environment and later-life ADRD risk, Dr. Tsotsoros examines cognitive correlates of adverse childhood experiences (ACEs) in two disparate samples, demonstrating the need to characterize risk pathways among older Latina women, who are at increased risk of both ACEs and ADRD. Using nationally representative data, Dr. Esiaka focuses on adult risk factors for ADRD among Black men. She shows that neighborhood physical disorder and poor sleep quality represent key risk factors for worse cognitive health in this critically understudied population. Moving along the ADRD continuum, Dr. Darwish focuses on another severely underrepresented group: Arab American immigrants with MCI. Based on in-depth work with older adults in Lebanon, she details cultural adaptations made in the development of a combined cognitive-behavioral and cognitive rehabilitation intervention for this group. Next, Dr. Bouldin uses nationally representative data on African American, Latino, and non-Latino White older adults with dementia to quantify racial/ethnic differences in the prevalence and correlates of caregiver support service use. Findings highlight both risk and resilience among dementia caregivers from minoritized racial/ethnic groups. Finally, Cerise Elliott from the National Institute on Aging (NIA) will offer perspectives on how disaggregating population subgroups through between- and within-group research designs can advance NIA’s goal of understanding and eliminating racial/ethnic inequalities across the ADRD continuum. This is an Alzheimer’s Disease and Related Dementias Interest Group Sponsored Symposium.

INTERPERSONAL, COMMUNITY, AND SOCIETAL STRESSORS MEDIATE BLACK–WHITE MEMORY DISPARITIES

Abstract Psychosocial factors may contribute to racial disparities in cognitive aging beyond socioeconomic status. Contextual stressors at multiple ecological levels, which may be related to structural racism, disproportionately affect Black older adults in the U.S. and may explain increased dementia risk. This study examined the extent to which interpersonal, community, and societal level stressors independently explained Black-White disparities in memory at baseline and over time. The sample included 16,890 older Black and White adults (Mage=67.98, 22% Black) from the US Health and Retirement Study who completed psychosocial questionnaires and a word list memory task. Interpersonal, community, and societal stressors were operationalized as self-reported everyday discrimination, neighborhood physical disorder, and subjective societal status, respectively. Latent growth curves modeled memory performance over six years. Stressors were modeled simultaneously and allowed to correlate. Covariates included age, sex, education, wealth, and questionnaire year. Compared to White older adults, Black older adults experienced higher discrimination (b = -.004, SE=.001, p<.001), greater neighborhood physical disorder (b = -.012, SE=.002, p<.001), and lower perceived societal status (b = -.003, SE=.001, p=.001), each of which independently mediated the association between Black race and worse initial memory. Together, these stressors explained 11% of the racial disparity in initial memory. There was no racial disparity in memory decline. Individual experiences of stressors across multiple contextual levels contribute to racial disparities in memory, providing evidence that structural racism negatively influences dementia risk among Black older adults. Future research should consider protective factors that buffer against negative impacts of structural racism on health.

NEIGHBORHOOD AND DEPRESSION AMONG US CHINESE OLDER IMMIGRANTS: THE MEDIATION EFFECTS OF COPING

Abstract Studies have shown that neighborhood environment shapes older Americans’ aging experience and health. However, it remains largely unknown whether and how neighborhood environment influences the well-being of older Asian Immigrants. Guided by the neighborhood stress process model, this study aims to investigate (a) the associations between neighborhood environmental stressors and depression among Chinese older immigrants and (b) the potential mediation effects of intrapersonal (sense of mastery and sense of hopefulness) and interpersonal coping (social engagement) resources in such associations. This study analyzed data collected from 2,801 Chinese older immigrants in the greater Chicago area. Structural equation modeling with bootstrap resampling was used to fit path models on neighborhood environmental stressor, intra- and interpersonal coping resources, and depression. Findings showed that neighborhood social disintegration and physical disorder were associated with more depressive symptoms directly and indirectly via lower intra- and interpersonal coping resources. Specifically, older immigrants living in neighborhoods with greater social disintegration reported lower sense of mastery and social engagement, which in turn were associated with more depressive symptoms (partial mediation). Older immigrants living in neighborhoods with greater physical disorder reported lower sense of hopefulness and mastery, which subsequently were associated with more depressive symptoms (full mediation). The findings showed that neighborhood environmental stressors are risk factors for mental health of Chinese older immigrants, and coping resources may serve as pathways of the associations. The findings have implications for practice as they are helpful to inform the development of tailored psychosocial interventions to enhance coping resources in older immigrants.

Contributions of neighborhood social environment and air pollution exposure to Black-White disparities in epigenetic aging.

Racial disparities in many aging-related health outcomes are persistent and pervasive among older Americans, reflecting accelerated biological aging for Black Americans compared to White, known as weathering. Environmental determinants that contribute to weathering are poorly understood. Having a higher biological age, measured by DNA methylation (DNAm), than chronological age is robustly associated with worse age-related outcomes and higher social adversity. We hypothesize that individual socioeconomic status (SES), neighborhood social environment, and air pollution exposures contribute to racial disparities in DNAm aging according to GrimAge and Dunedin Pace of Aging methylation (DPoAm). We perform retrospective cross-sectional analyses among 2,960 non-Hispanic participants (82% White, 18% Black) in the Health and Retirement Study whose 2016 DNAm age is linked to survey responses and geographic data. DNAm aging is defined as the residual after regressing DNAm age on chronological age. We observe Black individuals have significantly accelerated DNAm aging on average compared to White individuals according to GrimAge (239%) and DPoAm (238%). We implement multivariable linear regression models and threefold decomposition to identify exposures that contribute to this disparity. Exposure measures include individual-level SES, census-tract-level socioeconomic deprivation and air pollution (fine particulate matter, nitrogen dioxide, and ozone), and perceived neighborhood social and physical disorder. Race and gender are included as covariates. Regression and decomposition results show that individual-level SES is strongly associated with and accounts for a large portion of the disparity in both GrimAge and DPoAm aging. Higher neighborhood deprivation for Black participants significantly contributes to the disparity in GrimAge aging. Black participants are more vulnerable to fine particulate matter exposure for DPoAm, perhaps due to individual- and neighborhood-level SES, which may contribute to the disparity in DPoAm aging. DNAm aging may play a role in the environment "getting under the skin", contributing to age-related health disparities between older Black and White Americans.

Observed neighborhood physical disorder and health behaviors in a large urban area

Observed neighborhood physical disorder and health behaviors in a large urban area

Associations between observed neighborhood physical disorder and health behaviors, New Jersey behavioral risk factor Surveillance System 2011–2016

This study tested associations between observed neighborhood physical disorder and tobacco use, alcohol binging, and sugar-sweetened beverage consumption among a large population-based sample from an urban area of the United States. Individual-level data of this cross-sectional study were from adult respondents of the New Jersey Behavioral Risk Factor Surveillance System, 2011–2016 (n = 62,476). Zip code tabulation area-level observed neighborhood physical disorder were from virtual audits of 23,276 locations. Tobacco use (current cigarette smoking or chewing tobacco, snuff, or snus use), monthly binge drinking occasions (5+/4+ drinks per occasion among males/females), and monthly sugar-sweetened beverages consumed were self-reported. Logistic and negative binomial regression models were used to generate odds ratios, prevalence rate ratios (PRR), 95 % confidence intervals (CI) by levels of physical disorder. Compared to the lowest quartile, residence in the second (PRR: 1.16; 95 % CI: 1.03, 1.13), third (PRR: 1.24; 95 % CI: 1.10, 1.40), and fourth (highest) quartile of physical disorder (PRR: 1.24; 95 % CI: 1.10, 1.40) was associated with higher monthly sugar-sweetened beverage consumption. Associations involving tobacco use and alcohol binging were mixed. Observed neighborhood disorder might be associated with unhealthy behaviors, especially sugar-sweetened beverage consumption.

Assessing Resident Perceptions of Physical Disorder on Perceptions of Crime

This paper investigates whether perceptions of neighborhood physical disorder—measured by vacant lots, vacant buildings, and overgrown vegetation—influence perceptions of crime and perceptions of the frequency or magnitude of crime events. We use ordinal logistic regression to analyze individual-level and contextual-level variables derived from a survey of 401 randomly selected residents in seven New Orleans neighborhoods. Findings show that as perceptions of physical disorder increase, so does the likelihood of perceiving violent crime as more of a neighborhood problem than property crime. As residents perceive greater physical disorder, their perception of crime level decreases. Finally, residents who perceive greater physical disorder are more likely to perceive crime levels to be stable to increasing over the previous five years. The category of “physical disorder” is inherently subjective, and future research should distinguish between social disorder and physical disorder in the evaluation of perceptions of crime. Our major contribution is to empirically demonstrate that the influence of physical disorder on crime perceptions depends upon the crime type and temporal scale under investigation.

Genetic Risk, Neighborhood Characteristics, and Behavioral Difficulties Among African American Adolescents Living in Very Low-Income Neighborhoods.

Behavioral difficulties among African American youth are disproportionately detrimental to their future well-being compared to when demonstrated by White American youth. The majority of gene-environment studies of behavior have been conducted with European ancestry samples, limiting our knowledge of these processes among African Americans. This study examined the influence of positive and negative neighborhood conditions, in the context of genetic risk, on behavioral difficulties among low-income African American adolescents. Data were from the Genes, Environment, and Neighborhood Initiative study of African American youth in high-poverty neighborhoods, n = 524, M age = 15.89, SD = 1.42. DNA samples were collected using the Oragene Discovery 500 series, and polygenic risk scores for behavioral difficulties computed. Neighborhood informal social control, social cohesion, physical disorder, and social disorder were assessed. Adolescent alcohol use, hyperactivity/inattention and conduct problems were examined as outcomes. After controlling for polygenic risk, lower levels of neighborhood social disorder and higher levels of social cohesion were associated with fewer youth-reported hyperactivity/inattention and conduct problems. Less social disorder also was associated with fewer parent-reported behavioral difficulties. Neighborhood characteristics did not moderate associations between genetic risk and the outcomes. Higher levels of positive and lower levels of negative neighborhood characteristics can be associated with lower levels of behavioral difficulties among African American youth living in poverty, even after taking into account genetic risk.

IN THE EYES OF THE BEHOLDER: RACE, PLACE, AND HEALTH

Abstract Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Given that older adults may spend more time in their neighborhoods than younger adults as they transition out of the workforce, examining associations between neighborhood physical disorder and health among older minorities is of critical importance. Using 2016-2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n= 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine links between neighborhood disorder as rated by third parties and both participant-perceived neighborhood safety and self-rated health. Study results indicated that higher neighborhood physical disorder was significantly related to more neighborhood safety concerns among non-Hispanic White and Hispanic residents, but not among non-Hispanic Blacks. On the other hand, neighborhood physical disorder was significantly associated with poorer health among all racial/ethnic groups. These patterns persisted after adjusting for education, sex, age, and census tract concentrated disadvantaged, population density, and racial/ethnic diversity. Our results indicate that community level interventions targeting neighborhood physical disorder may improve community health and minimize racial/ethnic health disparities.

WHICH NEIGHBORHOOD FEATURES MATTER MOST FOR MUSCLE STRENGTH? FINDINGS FROM THE HEALTH AND RETIREMENT STUDY

Abstract Linking data from the National Neighborhood Data Archive (NaNDA) to the 2006-2018 Health and Retirement Study (N=22,245), we fit linear mixed models to assess which of 22 built and social neighborhood environment variables predicted grip strength, a measure of total-body muscle strength. Among 22,245 respondents (mean age=63 years, SD=9.2) with up to 4 grip strength measures, neighborhood physical disorder (B= -0.25 kg, 95% CI= -0.37,-0.13), number of parks (B= 0.05 kg, 95% CI= 0.01, 0.10), number of gyms/fitness centers (B=-0.44 kg, 95% CI= -0.82, -0.07), proportion of highly developed land (B=-2.06 kg, 95% CI=-4.06, -0.07), and % urban (B=-0.66 kg, 95% CI=-1.27, -0.05) were associated with grip strength level after adjustment. No social neighborhood variables were associated with grip strength. Although preliminary, findings suggest that highly developed urbanized land may be a barrier to maintaining muscle strength in later life, but resources such as parks are associated with better outcomes.

ARE PERCEIVED NEIGHBORHOOD CHARACTERISTICS ASSOCIATED WITH CHRONIC PAIN IN MIDDLE-AGED AND OLDER ADULTS?

Abstract Neighborhoods predict many health outcomes including functional limitations and disability; however, how neighborhoods are associated with chronic pain remains poorly understood. This study uses examined the association between four perceived neighborhood characteristics (social cohesion, physical disorder, safety, and social ties) and chronic pain in a nationally representative sample of adults aged 51+ in the US. Among 14,069 participants (58.65% women; mean age 68.81) in the Health and Retirement Study (2006-2008), we investigate whether neighborhood social cohesion, neighborhood physical disorder, neighborhood safety, and neighborhood social ties were associated with odds of having moderate-severe and limiting pain using adjusted logistic regression. After adjusting socio-demographic factors (age, gender, race/ethnicity, education, wealth, marital status), residence in neighborhoods with high perceived social cohesion, safety, and more social ties were associated with lower odds of having moderate-severe and limiting pain. Perceived neighborhood physical disorder did not predict whether respondents have moderate-severe and limiting pain or not.

STRUCTURAL DISCRIMINATORY FACTORS RELATED TO COGNITIVE FUNCTIONING AMONG OLDER HISPANICS: RESULTS FROM HRS

Abstract A growing body of research reveals how interpersonal and structural discriminatory factors undermine cognitive functioning among older Black and White adults, yet few studies have focused on older Hispanics in the United States. We examined cognitive health trajectories among 1,513 Hispanic men and women in the Health and Retirement Study (2008-2020) with mixed-effects regression. The majority (71%) of older Hispanics reported less than a college education. This older Hispanic sample often attributed everyday and major discrimination to nativity, race, age, and gender. In multivariate analyses, education, marital status, total household assets, mental health (depression), physical activity (regular vigorous exercise), and multi-morbidity (a weighted index) were all associated with cognitive functioning and in the expected directions. Surprisingly, cognitive functioning did not vary by gender. Living in neighborhoods characterized by physical disorder and social cohesion by respondents, were associated with cognitive functioning at the bivariate level, but only neighborhood physical disorder held association at the multivariate level. Perceived everyday and major discriminatory experiences were not associated with total cognition at the bivariate or multi-variate levels. Results from this study suggest interventions that target access to higher education, as well as chronic health conditions and neighborhood factors, can optimize cognitive functioning. Stratified analyses and interaction effects are needed to tease out the diversity of older Hispanic adults by nativity, acculturation, interpersonal discrimination, and cognitive health.

Effect of Social Environments on Cardiovascular Disease in the United States.

Background This study aims to examine the effect of time-variant perceived neighborhood social cohesion, perceived neighborhood physical disorder, and local crime on cardiovascular disease (CVD) incidence from 2006 through 2016. Methods and Results We obtained data from the Health & Retirement Study. Respondents aged ≥50 years and with no recorded history of CVD until 2006 (N=8826) were included and followed for 10years. Cox proportional hazards models were estimated with CVD incidence as an outcome variable and time-variant social environment factors (perceived neighborhood social cohesion, perceived neighborhood physical disorder, and local crime) as exposures, after controlling for sociodemographic factors and CVD-related risk/protective factors. Our results showed that perceived neighborhood social cohesion was associated with CVD among Black respondents, but not Hispanic and White respondents. Perceived neighborhood physical disorder and local crime rates were not associated with CVD incidence across all racial and ethnic groups. Conclusions The results demonstrate that perceptions of favorable social environments need to be considered to reduce CVD risk among Black adults. Further research is needed to identify different pathways through which living in favorable social environments benefits cardiovascular health by racial and ethnic groups.

Self-Reported Visual Difficulty and Daily Activity Limitations: The Moderating Role of Neighborhood Characteristics.

Understanding how neighborhood-level factors moderate the relationship between visual health and activity limitations could inform strategies for successful aging in place among older adults with sensory impairments. Guided by a vision loss impact framework, this study aims to examine whether neighborhood social cohesion and physical disorder moderate the association between visual difficulty and activity limitation. Secondary analyses were conducted using data from Round 5 of the National Health and Aging Trend Study. A4-level indicator was used to indicate the visual difficulty. Neighborhood social cohesion and physical disorder were each measured using a 3-item scale. Summary scores were created for daily activity limitations. Ordinary least squares regressions were performed to test the study hypotheses. The complex survey design factors were applied. Missing data were handled using multiple imputations. Older adults reporting any type of visual difficulty experienced more limitations in self-care tasks, household activities, and mobility than those without visual difficulty. Neighborhood physical disorder moderated visual difficulty and activity limitations. Specifically, visual difficulty was associated with higher risk of activity limitations among participants perceiving physical disorder in the neighborhood compared to those perceiving no physical disorder. The study findings suggest that the vision loss impact framework provides an integrative approach to identify the health needs of older adults with visual difficulty. Future research is needed to further understand the role of neighborhood in independent living among older adults with visual difficulty and to inform community-level interventions.

In the eyes of the beholder: Race, place and health.

Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, as a result of historical systemic inequities, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Degree of exposure to neighborhood disorder may alter peoples' perception of their neighborhoods, however, with those most exposed (e.g., historically marginalized racial/ethnic groups) perhaps perceiving less threat from signs of neighborhood disorder. The purpose of the present study was to examine the complex interrelationships between people and place by investigating whether exposure to neighborhood physical disorder relates to residents' (1) perceptions of neighborhood safety and (2) perceptions of their health, and (3) examining whether these links vary by race/ethnicity. Using 2016–2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n = 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine the role of neighborhood disorder in relation to both perceived neighborhood safety and self-rated health. Results indicated that greater neighborhood physical disorder was statistically significantly related to feeling less safe among non-Hispanic Whites and Hispanics, but not non-Hispanic Blacks. Regarding self-rated health, neighborhood physical disorder was statistically significantly related to poorer health among all racial/ethnic groups. These findings suggest that, despite differential interpretation of neighborhood disorder as a threat to safety, this modifiable aspect of peoples' environment is related to poor health regardless of one's race/ethnicity.

Measuring individuals’ mobility-based exposure to neighborhood physical disorder with wearable cameras

To date, most studies have assessed individual exposure to neighborhood physical disorder (NPD) through the static residence-based approach, which ignores elements of human mobility and may lead to inaccurate estimates. This study assessed individual exposure to neighborhood physical disorder through the mobility-based approach using wearable cameras. The use of this approach allowed us to leverage innovative tools to accurately assess exposure to NPD in individuals' activities in space-time. We assessed the volunteers’ exposure to neighborhood physical disorder by manually auditing pictures taken by wearable cameras on an online browser-based assessment platform. The results illustrated that wearable cameras can clearly capture the exposure while volunteers were engaged in travel behaviors. We also compared the proposed approach (mobility-based, using wearable cameras to take photos) with other approaches (with consideration of travel behaviors to varying degrees, using street view images) to demonstrate that wearable cameras can record individual exposure to neighborhood physical disorder accurately and conveniently, and the assessment results might be significantly different from those obtained by other approaches. Thus, the proposed approach is of great significance.

Neighborhood Environment and Depressive Symptoms Among Chinese Older Immigrants in the United States: The Mediation Effects of Coping Resources.

Studies have shown that neighborhood environment shapes older Americans' aging experience and health. However, it remains largely unknown whether and how neighborhood environment influences the well-being of older Asian Immigrants. Guided by the neighborhood stress process model, this study aims to investigate (a) the associations between neighborhood environmental stressors and depression among Chinese older immigrants and (b) the potential mediation effects of intrapersonal (sense of mastery and sense of hopefulness) and interpersonal coping (social engagement) resources in such associations. This study analyzed data collected from 2,801 Chinese older immigrants in the greater Chicago area. Structural equation modeling with bootstrap resampling was used to fit path models on neighborhood environmental stressor, intra- and interpersonal coping resources, and depression. Findings showed that neighborhood social disintegration and physical disorder were associated with more depressive symptoms directly and indirectly via lower intra- and interpersonal coping resources. Specifically, older immigrants living in neighborhoods with greater social disintegration reported lower sense of mastery and social engagement, which in turn were associated with more depressive symptoms (partial mediation). Older immigrants living in neighborhoods with greater physical disorder reported lower sense of hopefulness and mastery, which subsequently were associated with more depressive symptoms (full mediation). The findings showed that neighborhood environmental stressors are risk factors for mental health of Chinese older immigrants, and coping resources may serve as pathways of the associations. The implications for future research and practice were discussed.

Role of Neighborhood Physical Disorder and Social Cohesion on Racial and Ethnic Disparities in Dementia Risk.

Objectives: To analyze how neighborhood physical disorder and social cohesion are associated with racial and ethnic disparities in dementia risk. Methods: Nine years of data (2011-2019) were retrieved from the National Health and Aging Trends Study, a nationally representative U.S. older adult (age 65+) sample. Cox regression analyzed time to dementia diagnosis using composite scores for neighborhood physical disorder and social cohesion. Results: Higher baseline neighborhood physical disorder (Adjusted Hazard Ratio [aHR]=1.11, 95% Confidence Interval [CI]=1.01-1.23) and increased disorder at follow-up (aHR=1.10, 95% CI=1.01-1.19) significantly increased dementia risk. Hispanic older adults with higher physical disorder at baseline (aHR=0.62, 95% CI=0.49-0.79) and follow-up (aHR=0.81, 95% CI=0.67-0.98) had a significantly decreased dementia risk. There were no significant associations for social cohesion. Discussion: Physical but not social neighborhood characteristics are associated with dementia risk. Future research is needed to understand protective mechanisms for dementia among Hispanic older adults in neighborhoods with high physical disorder.