Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA.
Department of Sociology and Anthropology, Missouri State University, Springfield, MO 65897, USA.
Int J Environ Res Public Health. 2021 Mar 6;18(5):2661. doi: 10.3390/ijerph18052661.
Unfavorable neighborhood conditions are linked to health disparities. Yet, a dearth of literature examines how neighborhood characteristics contribute to cognitive health in diverse samples of older adults. The present study uses an intersectional approach to examine how race/ethnicity, gender, and education moderate the association between neighborhood perceptions and cognitive functioning in later life. We used data from adults ≥65 years old ( = 8023) in the 2010-2016 waves of the nationally representative Health and Retirement Study (HRS). We conducted race/ethnicity-stratified linear regression models where cognitive functioning, measured using the 35-point Telephone Interview Cognitive Screen (TICS), was regressed on three neighborhood characteristics-cleanliness, safety, and social cohesion. We examine whether there is heterogeneity within race/ethnicity by testing if and how the relationship between neighborhood characteristics and cognitive functioning differs by gender and education. Among White adults, worse neighborhood characteristics were associated with lower cognitive functioning among those with less education. However, for Black adults, poor perceived quality of one's neighborhood was associated with worse cognitive functioning among those with more years of education compared to those with fewer years of education. Among Mexicans, perceived neighborhood uncleanliness was associated with lower cognitive functioning among those with less education, but higher cognitive functioning for those with higher levels of education. Thus, this study contributes to the literature on racial/ethnic disparities in cognitive aging disparities by examining neighborhood contextual factors as determinants of cognitive functioning. In particular, we find that higher education in the context of less favorable neighborhood environments does not confer the same benefits to cognitive functioning among all older adults.
不利的邻里环境与健康差距有关。然而，很少有文献研究邻里特征如何在不同样本的老年人中促进认知健康。本研究采用交叉方法，研究种族/民族、性别和教育如何调节邻里感知与晚年认知功能之间的关系。我们使用了来自全国代表性的健康与退休研究（HRS）2010-2016 年各波次中≥65 岁成年人的数据（n=8023）。我们进行了种族/民族分层线性回归模型，其中认知功能使用 35 分电话访谈认知筛查（TICS）进行测量，回归于三个邻里特征——清洁度、安全性和社会凝聚力。我们通过检验邻里特征与认知功能之间的关系是否因性别和教育而不同，来检查种族/民族内部是否存在异质性。在白人成年人中，较差的邻里特征与教育程度较低的人认知功能较差有关。然而，对于黑人成年人来说，与教育程度较低的人相比，对自己邻里质量的较差感知与教育程度较高的人认知功能较差有关。在墨西哥裔成年人中，感知到的邻里不清洁与教育程度较低的人认知功能较差有关，但与教育程度较高的人认知功能较高有关。因此，本研究通过研究邻里环境因素作为认知功能的决定因素，为种族/民族在认知老化差异方面的文献做出了贡献。特别是，我们发现，在不利的邻里环境背景下，较高的教育并不能为所有老年人的认知功能带来相同的益处。
