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Neighborhood racial/ethnic segregation and cognition in older adults
Author(s) -
Meyer Oanh L,
Besser Lilah M,
Booker Michaela,
Luu Elaine,
Mitsova Diana,
Tobias Michele,
Whitmer Rachel A,
Farias Sarah Tomaszewski,
DeCarli Charles S,
Mungas Dan M
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.055745
Subject(s) - gerontology , demography , episodic memory , cognition , ethnic group , population , health and retirement study , health equity , psychology , medicine , public health , neuroscience , nursing , sociology , anthropology
Background Social determinants of health, including neighborhood factors, play a key role in the health of diverse older adults. Yet few longitudinal studies have examined the role of neighborhood racial/ethnic segregation on cognitive function and cognitive decline in both Latinos and Blacks, two populations at greater risk for Alzheimer’s disease and related dementias. We examined how one measure of residential segregation is associated with cognitive outcomes in a diverse cohort. Methods We evaluated older non‐Hispanic White (NHW), Black, and Latino participants evaluated at the UC Davis Alzheimer’s Disease Research Center. Individual level addresses were geocoded at the initial visit and appended to U.S. Census 2010 data. Residential segregation was measured using the Getis‐Ord Gi* statistic; this spatial measure of clustering was created for Latino and Black clustering separately. Cognitive outcomes included validated measures of episodic memory, semantic memory, and executive function. We used mixed effects multivariate regression models to evaluate associations between segregation and cognitive function and decline, controlling for age, sex, education, cognitive status at initial visit, clinic versus community recruited, site, vascular risk score, number of visits, neighborhood SES, and population density. Results The sample included 452 participants (mean age=75, SD = 7), 64% female, and 46% NHW, 26% Black, and 21% Latino, in 309 census tracts/neighborhoods. In race‐stratified adjusted analyses, Blacks demonstrated worse episodic memory at baseline among those living in neighborhoods with a higher clustering of Blacks (ß = ‐0.046; 95% CI: ‐0.075, ‐0.016) and worse executive function at baseline among those living in neighborhoods with a higher clustering of Latinos (ß = ‐0.025; 95% CI: ‐0.042, ‐0.008). Latinos demonstrated slower annual declines on episodic memory when living in neighborhoods with a greater clustering of Blacks (ß = 0.008; 95% CI: 0.004, 0.011) and/or Latinos (ß = 0.003; 95% CI: 0.001, 0.005). NHWs had slower annual declines on semantic memory when living in neighborhoods with a greater clustering of Latinos (ß = 0.005; 95% CI: 0.001, 0.008). Conclusions There may be some benefit for Latinos and NHWs living in ethnically clustered neighborhoods. Future research is needed to further investigate these findings.