Association Between Changes in Perceived Neighborhood and Cognitive Performance Within Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Black Adults

Abstract

Highlights Public health relevance—How does this work relate to a public health issue? This work highlights the importance of examining changes in contextual factors (i.e., perceived neighborhood characteristics) as they relate to cognitive function. Public health significance—Why is this work of significance to public health? As Black adults are at a disproportionate risk for diagnosis of Alzheimer’s disease and related dementias and more likely to face sociocontextual events (e.g., gentrification, cultural displacement) across the life course, the study findings highlight the role of perceived neighborhood characteristics and cognitive function. Changes in perceived neighborhood characteristics (e.g., positive and negative) related to various domains of cognitive functioning in opposing ways, emphasizing the need to focus on the role of changing perceived neighborhood characteristics as they relate to cognitive functioning, particularly in a sample of socioeconomically diverse mid-life-to-older Black adults. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Study findings highlight new potential research directions to explore, such as the potential connection between changes in neighborhood perceptions and cognitive functioning. Understanding how changes in neighborhood perceptions relate to health outcomes like cognitive function is a necessary step toward understanding how these factors can shape resource availability and improve public policy. Abstract Perceived neighborhood characteristics are related to cognitive performance. However, limited studies have examined how changes in neighborhood characteristics relate to cognitive performance, particularly among Black adults who are likely to experience changes in their residential social and physical environments. This study examined the association between changes in perceived neighborhood quality and concurrent, cross-sectional cognitive performance. An analytic sample of 592 Black adults (Mage = 56.22; 58% female) recruited from 13 predetermined neighborhoods in Baltimore City, Maryland, from the ongoing prospective Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, was included. In the adjusted models, uncorrected multivariable regression indicated that increases in neighborhood disorder were associated with worse attention and visual orientation (β = 0.17, p < 0.001), while increases in social cohesion and social control were associated with better performance in several tasks relating to memory, attention, executive function/reasoning, and visual orientation (βs = −0.12–−0.10, p < 0.05). Interestingly, increasing social control was also associated with slower performance on a measure of executive functioning and reasoning (β = 0.12, p < 0.05). However, after controlling for multiple comparisons, only the association between neighborhood disorder and attention and visual orientation remained significant. Study findings serve as a springboard for future research linking changes in perceived neighborhood quality and concurrent, cross-sectional cognitive performance. These results may also lend support to the investment in neighborhoods as a pathway toward better understanding the association between neighborhood perception and cognitive performance, which may relate to reductions in cognitive decline and in the likelihood of dementia among Black adults who are at greatest risk for late-course diagnosis.