Neighborhood Context and Cognitive Decline in Older Mexican Americans: Results From the Hispanic Established Populations for Epidemiologic Studies of the Elderly

Abstract

In previous research on cognitive decline among older adults, investigators have not considered the potential impact of contextual variables, such as neighborhood-level conditions. In the present investigation, the authors examined the association between 2 neighborhood-context variables-socioeconomic status and percentage of Mexican-American residents-and individual-level cognitive function over a 5-year follow-up period (1993-1998). Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-dwelling older Mexican Americans (n = 3,050) residing in the southwestern United States. Individual records were linked with 1990 US Census tract data, which provided information on neighborhood characteristics. Hierarchical linear growth-curve models and hierarchical logistic models were used to examine relations between individual- and neighborhood-level variables and the rate and incidence of cognitive decline. Results showed that baseline cognitive function and rates of cognitive decline varied significantly across US Census tracts. Respondents living in economically disadvantaged neighborhoods experienced significantly faster rates of cognitive decline than those in more advantaged neighborhoods. Odds of incident cognitive decline decreased as a function of neighborhood percentage of Mexican-American residents and increased with neighborhood economic disadvantage. The authors conclude that neighborhood context is associated with late-life cognitive function and that the effects are independent of individual-level risk factors.

Is cognitive decline in the elderly associated with contextual income? Results of a population-based study in southern Brazil

“…Sheffield & Peek 31 observed that socioeconomic disadvantage assessed by lower income neighborhoods was associated with a higher incidence of cognitive decline over a period of five years, whereas there was no association for social disadvantage, represented by low educational levels and lower occupational classes. The study by Al Hazzouri et al 30 also found that lower neighborhood socioeconomic status was significantly associated with a higher prevalence of cognitive decline, even after adjusting for individual schooling.…”

“…Only two studies with similar objectives to this one have been carried out among older adults in Latin America (both Mexican) 30,31 . Sheffield & Peek 31 observed that socioeconomic disadvantage assessed by lower income neighborhoods was associated with a higher incidence of cognitive decline over a period of five years, whereas there was no association for social disadvantage, represented by low educational levels and lower occupational classes.…”

“…The relationship between socioeconomic environment and cognitive decline may be attributed to a number of issues, including access to health services, areas for leisure and social activities, psychological and lifestyle factors 31 . In particular, the elderly are more susceptible to exposure to the environment in which they live because they usually spend more time in their communities and enjoy fewer services outside the area compared to younger people 32 .…”

Ageing and Urbanization: Can Cities be Designed to Foster Active Ageing?

“…34 When cognitive function was followed over a five year period in 3,050 participants of the Hispanic Established Populations for Epidemiologic Studies of the Elderly, odds of incident cognitive decline decreased as a function of neighbourhood percentage of Mexican American residents and increased with neighbourhood economic disadvantage. 35 The North Staffordshire Osteoarthritis Project (NorStOP) sent individuals aged 50 and over baseline and three year questionnaires. Nineteen percent of the 3,644 people without pain interference at baseline reported it at follow-up and participants living in areas of high health deprivation had an increased risk of developing pain interference.…”

Neighborhood-level Determinants of Delayed HIV Diagnosis and Survival among HIV-positive Latinos, Florida 2000-2011

“…lung, breast and colorectal cancer (Franzini & Spears, 2003, Eschbach, et al, 2005; smoking during pregnancy , infant mortality , Jenny, et al, 2001, preterm birth (Mason et al, 2010, Masi et al, 2007, and low birth weight (Masi et al, 2007, Peak & Weeks, 2002; depression (Gerst et al, 2011, Sheffield & Peek, 2009, Ostir et al, 2003; poor self-rated health (Patel et al, 2003, Shaw & Pickett, 2011; cholesterol screening ; and access to care (Haas et al, 2004). Empirical data suggest that ethnic density might work through decreased exposure to racism (Whitley et al, 2006, Becares et al, 2009) and discrimination (Whitley et al, 2006, Becares et al, 2009, Das-Munshi et al, 2010; improved social support (DasMunshi et al, 2010, Halperin & Nazroo, 2000, social cohesion (Hong et al, 2014) and social networks (Whitley et al, 2006, Becares et al, 2009, Das-Munshi et al, 2010; and increased access to care , Haas et al, 2004 and culturally appropriate resources (Whitley et al, 2006).…”