Cognitive Function in the Community Setting: The Neighborhood as ‘Cognitive Reserve'?

Existing research has found a positive association between cognitive function and residence in a socioeconomically advantaged neighborhood. Yet, the mechanisms underlying this relationship have not been empirically investigated. Objective To test the hypothesis that neighborhood socioeconomic structure is related to cognitive function partly through the availability of neighborhood physical and social resources (eg, recreational facilities, community centers and libraries), which promote cognitively beneficial activities such as exercise and social integration. Methods Using data from a representative survey of community-dwelling adults in the city of Chicago (N=949 adults aged 50 and over), cognitive function was assessed with a modified version of the Telephone Interview for Cognitive Status instrument. Neighborhood socioeconomic structure was derived from US census indicators. Systematic social observation was used to directly document the presence of neighborhood resources on the blocks surrounding each respondent's residence. Results Using multilevel linear regression, residence in an affluent neighborhood had a net positive effect on cognitive function after adjusting for individual risk factors. For white respondents, the effects of neighborhood affluence operated in part through a greater density of institutional resources (eg, community centers) that promote cognitively beneficial activities such as physical activity. Stable residence in an elderly neighborhood was associated with higher cognitive function (potentially due to greater opportunities for social interaction with peers), but long term exposure to such neighborhoods was negatively related to cognition. Conclusions Neighborhood resources have the potential to promote 'cognitive reserve' for adults who are aging in place in an urban setting.