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Relationship between Residential Segregation, Later-Life Cognition, and Incident Dementia across Race/Ethnicity

Author

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  • Daniel J. Pohl

    (Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, USA
    These authors have contributed equally to this work.)

  • Dominika Seblova

    (Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    These authors have contributed equally to this work.)

  • Justina F. Avila

    (Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA)

  • Karen A. Dorsman

    (Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75235, USA)

  • Erin R. Kulick

    (Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadephia, PA 19122, USA)

  • Joan A. Casey

    (Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10031, USA)

  • Jennifer Manly

    (Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
    Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA)

Abstract

Systemic racism leads to racial/ethnic residential segregation, which can result in health inequities. We examined if the associations between residential segregation and later-life cognition and dementia differed based on segregation measure and by participant race/ethnicity. Tests of memory ( n = 4616), language ( n = 4333), visuospatial abilities ( n = 4557), and incident dementia ( n = 4556) were analyzed in older residents of Northern Manhattan, New York (mean age: 75.7 years). Segregation was measured at the block group-level using three indices: dissimilarity, isolation, and interaction. We fit multilevel linear or Cox proportional hazards models and included a race/ethnicity × segregation term to test for differential associations, adjusting for socioeconomic and health factors. Living in block groups with higher proportions of minoritized people was associated with −0.05 SD lower language scores. Living in block groups with higher potential contact between racial/ethnic groups was associated with 0.06–0.1 SD higher language scores. The findings were less pronounced for other cognitive domains and for incident dementia. Non-Hispanic Black adults were most likely to experience negative effects of neighborhood segregation on cognition (language and memory) and dementia. All indices partly capture downstream effects of structural racism (i.e., unequal distributions of wealth/resources) on cognition. Therefore, desegregation and equitable access to resources have the potential to improve later-life cognitive health.

Suggested Citation

  • Daniel J. Pohl & Dominika Seblova & Justina F. Avila & Karen A. Dorsman & Erin R. Kulick & Joan A. Casey & Jennifer Manly, 2021. "Relationship between Residential Segregation, Later-Life Cognition, and Incident Dementia across Race/Ethnicity," IJERPH, MDPI, vol. 18(21), pages 1-16, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11233-:d:664978
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    References listed on IDEAS

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    Cited by:

    1. Liu, Chelsea & Murchland, Audrey R. & VanderWeele, Tyler J. & Blacker, Deborah, 2022. "Eliminating racial disparities in dementia risk by equalizing education quality: A sensitivity analysis," Social Science & Medicine, Elsevier, vol. 312(C).
    2. Walsemann, Katrina M. & Hair, Nicole L. & Farina, Mateo P. & Tyagi, Pallavi & Jackson, Heide & Ailshire, Jennifer A., 2023. "State-level desegregation in the U.S. South and mid-life cognitive function among Black and White adults," Social Science & Medicine, Elsevier, vol. 338(C).

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