Neighborhood Socioeconomic Status and Cognitive Trajectories in a Diverse Longitudinal Cohort

ABSTRACT

Objectives: Although individual-level socioeconomic status is associated with poor outcomes, less is known regarding how the social context might affect cognitive outcomes. We examined the effect of neighborhood socioeconomic status (NSES) on baseline cognitive function and trajectories of decline.

Methods: The sample (N = 480) came from a longitudinal cohort recruited to study cognitive function. Mixed effects models examined the influence of NSES on baseline and rate of change in executive function, semantic memory, and episodic memory.

Results: NSES was positively associated with semantic memory scores at baseline, but not with executive function or episodic memory in adjusted models, nor was it associated with cognitive change in longitudinal analyses. In exploratory analyses, for individuals with dementia, those with higher NSES declined faster in executive function and semantic memory than did those with lower NSES.

Conclusions: Results suggest that NSES has limited effects independent of personal characteristics; however, findings showed a complex relation of NSES and decline, with NSES effects observed only for individuals with dementia. Results are discussed in the context of cognitive reserve.

Clinical Implications: Clinical assessments of individuals who present with cognitive impairment might benefit from an understanding of the neighborhood context from which patients come.

keywords:

• Aging
• cognitive decline
• dementia
• education
• income

Notes

¹ Multi-level models were run and results are similar to the current analysis strategy.

² All models adjust for person-level covariates on both intercepts (baseline) and slopes (decline).

3. High and low NSES is operationalized as 1 standard deviation above the mean and 1 standard deviation below the mean, respectively.