Primary Submission Category: Aging
Neighborhood Social Cohesion and Cognitive Impairment Across Racial/Ethnic Groups in the United States
Authors: Dana Alhasan Symielle Gaston W. Braxton Jackon II Chandra Jackson
Presenting Author: Dana Alhasan*
Neighborhood social cohesion (nSC) may lower risk for cognitive impairment through social support and promoting healthy norms, for example. The disproportionate impact of cognitive impairment on minoritized racial/ethnic groups emphasizes the need to understand how modifiable factors like nSC may buffer against cognitive impairment and mitigate racial/ethnic disparities. Yet, few studies have assessed this relationship among a large, racially/ethnically diverse, and nationally representative sample of the United States population. Therefore, we used the 2018 National Health Interview Survey to determine overall and racial/ethnic-specific associations between nSC and cognitive impairment among 87,189 adults. Based on a 4-item scale from the Project on Human Development in Chicago Neighborhoods Community Survey, we categorized nSC as low, medium, and high. Cognitive impairment (yes vs. no) was based on the Washington Group Short Set on Functioning. We used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) while adjusting for sociodemographic confounders. Mean age± standard error was 47.1±0.1 years, 69.2% self-identified as NH-White, 11% as NH-Black, 14.5% as Hispanic/Latinx, and 5.4% as NH-Asian. Minoritized racial/ethnic adults were overrepresented in low nSC: 13.8% NH-Black, 19.5% Hispanic/Latinx, 5.2% NH-Asian, and 61.5% NH-White adults. More NH-Black (2.4%) and Hispanic/Latinx (2.4%) reported cognitive impairment compared to NH-White (2.2%) and NH-Asian (1.6%) adults. Low vs. high nSC was associated with a 43% higher prevalence of cognitive impairment (PR=1.43 [95% CI: 1.23-1.65]), and there were differences by race/ethnicity: NH-White (PR=1.54 [1.30-1.82]), NH-Asian (PR=1.33 [0.57-3.11]), NH-Black (PR=1.16 [0.79-1.71]), and Hispanic/Latinx (PR=1.04 [0.70-1.55]). Lower nSC was associated with poorer cognition. Improving nSC may be an intervention target to help address cognitive impairment.