Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan.
Am J Prev Med. 2022 Oct;63(4):574-581. doi: 10.1016/j.amepre.2022.04.016. Epub 2022 Jun 9.
Few studies have examined the impacts of neighborhood SES and individual ethnicity and SES characteristics on cognitive function in aging populations. Hispanics/Latinx are more likely to have cognitive impairment and be community dwellers than non-Hispanic Whites. Neighborhood factors can have greater impacts on the relationship between Hispanics/Latinx and cognitive function. This study examines these relationships in Nueces County, Texas.
A mixed-effects regression analysis of data from 1,140 older adults participating in the Brain Attack Surveillance in Corpus Christi - Cognitive project from 2018 to 2020 was completed. Cognitive function was measured with the Montreal Cognitive Assessment, a cognitive screening measure. Participant addresses were geocoded to obtain census tracts, which were proxies for neighborhoods. Neighborhood SES was measured by household median income, percentage of Hispanic/Latinx residents, and percentage of residents aged ≥65 years with Medicaid, all from the American Community Survey. Interactions were used to examine the impact of neighborhood SES on ethnicity and cognitive function.
The sample consisted of 62.5% Hispanic/Latinx and 37.5% non-Hispanic White participants. Results from the F-statistics, test of effects, indicate that being older (F=45.04; p<0.001), being a man (F=4.35; p<0.050), having low education (F=40.83; p<0.001), completing the Montreal Cognitive Assessment test in Spanish (F=15.35; p<0.001), and being Hispanic/Latinx (F=20.84; p<0.001) were all associated with lower Montreal Cognitive Assessment scores. Neighborhood income was positively associated (F=6.95; p<0.050) with Montreal Cognitive Assessment scores. Neighborhood income (β=0.32; p<0.050) and percentage with Medicaid (β=0.06; p<0.050) independently moderated the associations between ethnicity and Montreal Cognitive Assessment scores.
Findings suggest that neighborhood SES could further impact cognitive function independent of individual characteristics. This could be attributed to minimal resources in communities with lower SES, impacting policies and programs for older individuals, particularly those with worse cognitive function.
很少有研究考察邻里社会经济地位和个体族裔及社会经济地位特征对老年人群认知功能的影响。与非西班牙裔白人相比,西班牙裔/拉丁裔更有可能认知受损和居住在社区中。邻里因素可能对西班牙裔/拉丁裔与认知功能之间的关系产生更大的影响。本研究在德克萨斯州努埃塞斯县进行。
对 2018 年至 2020 年期间参加科珀斯克里斯蒂脑攻击监测-认知项目的 1140 名老年人进行数据的混合效应回归分析。认知功能采用蒙特利尔认知评估进行测量,这是一种认知筛查测量方法。参与者的地址进行地理编码,以获取代表邻里的普查区。邻里社会经济地位通过家庭中位数收入、西班牙裔/拉丁裔居民比例和有医疗补助的≥65 岁居民比例进行衡量,均来自美国社区调查。采用交互作用检验来考察邻里社会经济地位对族裔和认知功能的影响。
样本由 62.5%的西班牙裔/拉丁裔和 37.5%的非西班牙裔白人组成。F 统计量检验结果表明,年龄较大(F=45.04;p<0.001)、男性(F=4.35;p<0.050)、受教育程度较低(F=40.83;p<0.001)、用西班牙语完成蒙特利尔认知评估测试(F=15.35;p<0.001)和西班牙裔/拉丁裔(F=20.84;p<0.001)均与较低的蒙特利尔认知评估分数相关。邻里收入与蒙特利尔认知评估分数呈正相关(F=6.95;p<0.050)。邻里收入(β=0.32;p<0.050)和医疗补助比例(β=0.06;p<0.050)独立调节了族裔与蒙特利尔认知评估分数之间的关系。
研究结果表明,邻里社会经济地位可能会对认知功能产生独立于个体特征的进一步影响。这可能归因于社会经济地位较低的社区资源匮乏,影响了针对老年人,尤其是认知功能较差的老年人的政策和计划。