Kim Yeonwoo, Jang Soeun
Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA.
School of Social Work, University of Texas at Arlington, Arlington, Texas, USA.
Innov Aging. 2025 Mar 14;9(6):igaf031. doi: 10.1093/geroni/igaf031. eCollection 2025.
Cognitive impairment is a significant public health challenge, particularly as the aging population continues to grow. Individuals from lower socioeconomic backgrounds are at greater risk for cognitive decline, contributing to persistent socioeconomic disparities. While research has predominantly focused on individual-level factors influencing cognitive health, the role of favorable residential environments in mitigating these disparities remains less studied. This study investigates the longitudinal association between time-variant neighborhood social cohesion and cognitive impairments over 6 years, and its moderating effect on the relationship between socioeconomic status and cognitive impairment, exploring its potential to reduce socioeconomic disparities in cognitive decline.
We analyzed data from the Health and Retirement Study collected in 2012, 2014, 2016, 2018, and 2020. Our sample included respondents aged 50 and older who were not cognitively impaired at baseline, allowing us to identify those who developed cognitive impairment after 2012 ( = 11 026).
Multilevel logistic regression models showed that higher levels of perceived neighborhood social cohesion were associated with a lower likelihood of cognitive impairment (OR = 0.96, 95% CI = 0.95, 0.97, < .001). Additionally, greater educational attainment and higher family income were associated with lower risks of cognitive impairment. Interaction tests showed that the protective role of neighborhood social cohesion was particularly stronger for individuals from lower socioeconomic backgrounds.
These findings highlight the importance of promoting neighborhood social cohesion as a part of multilevel public health strategies to mitigate cognitive decline and address health disparities in older adults. Further research is warranted to explore the mechanisms underlying these associations and to identify effective approaches for enhancing neighborhood social cohesion in communities with low-socioeconomic individuals, ultimately informing multilevel public health interventions.
认知障碍是一项重大的公共卫生挑战，尤其是在老年人口持续增长的情况下。社会经济背景较低的个体认知能力下降的风险更高，这导致了持续存在的社会经济差距。虽然研究主要集中在影响认知健康的个体层面因素，但有利的居住环境在减轻这些差距方面的作用仍较少被研究。本研究调查了6年间随时间变化的邻里社会凝聚力与认知障碍之间的纵向关联，及其对社会经济地位与认知障碍关系的调节作用，探讨其在减少认知能力下降方面社会经济差距的潜力。
我们分析了2012年、2014年、2016年、2018年和2020年收集的健康与退休研究数据。我们的样本包括50岁及以上且在基线时未出现认知障碍的受访者，从而使我们能够识别出2012年后出现认知障碍的人群（n = 11026）。
多水平逻辑回归模型显示，较高水平的邻里社会凝聚力与较低的认知障碍可能性相关（OR = 0.96，95% CI = 0.95，0.97，P <.001）。此外，受教育程度越高和家庭收入越高与认知障碍风险越低相关。交互检验表明，邻里社会凝聚力的保护作用对社会经济背景较低的个体尤为明显。
这些发现凸显了促进邻里社会凝聚力作为多层次公共卫生策略一部分的重要性，以减轻老年人的认知能力下降并解决健康差距问题。有必要进一步研究探索这些关联背后的机制，并确定在社会经济地位较低个体的社区中增强邻里社会凝聚力的有效方法，最终为多层次公共卫生干预提供依据。
