School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA.
Department of Public Health Sciences, University of California Davis, Davis, California, USA.
Alzheimers Dement. 2024 Feb;20(2):904-913. doi: 10.1002/alz.13511. Epub 2023 Oct 10.
Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change.
Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66-100; adulthood ADI 5-99). Interactions by race tested.
More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002).
Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.
社区劣势与晚年认知能力有关。很少有研究探讨其对认知/认知变化方面的种族差异的贡献。
逆概率加权模型估计了由于居住在较不利社区而导致的认知/认知变化的预期平均差异，这些社区被定义为区域剥夺指数（ADI）的前五个五分位数：童年时期的 66-100；成年时期的 ADI 为 5-99。通过种族进行交互作用测试。
更多的黑人参与者居住在较不利的社区。如果所有参与者都居住在较不利的童年（b=-0.16，95%置信区间[CI]为-0.30，-0.03）或成年（b=-0.14，95%CI为-0.22，-0.04）社区，语义记忆将会更低。种族交互作用表明，在黑人参与者中，较不利的童年社区与较高的口头情景记忆相关（交互作用 p 值=0.007），而较不利的成年社区与较低的语义记忆相关（交互作用 p 值=0.002）。
研究种族差异和社区优势水平以及晚年认知衰退是揭示社区对认知差异影响的关键步骤。
