Neighborhood resources and risk of cognitive decline among a community-dwelling long-term care population in the U.S

Min Hee Kim; Ruth Dunkle; Philippa Clarke

doi:10.1016/j.puhip.2023.100433

Neighborhood resources and risk of cognitive decline among a community-dwelling long-term care population in the U.S

Public Health Pract (Oxf). 2023 Oct 2:6:100433. doi: 10.1016/j.puhip.2023.100433. eCollection 2023 Dec.

Authors

Min Hee Kim¹, Ruth Dunkle², Philippa Clarke³

Affiliations

¹ Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
² School Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI, 48109, USA.
³ Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104-1248, USA.

Abstract

Objective: To examine the associations between neighborhood resources (i.e., number of restaurants, recreation centers, or social services for seniors and persons with disability per land area) and cognitive decline among a community-dwelling long-term care population and whether they differ by baseline cognition status.

Study design: Prospective longitudinal cohort study.

Methods: We used a longitudinal dataset that assessed over a two-year period older adults receiving state-funded home- and community-based services in Michigan Metropolitan areas (N = 9,802) and applied nonlinear mixed models with a random intercept with Poisson distribution.

Results: Cognitively intact older adults were less likely to experience cognitive decline when they resided in resource-rich neighborhoods, compared to those cognitively intact but living in neighborhoods that lacked resources. But their cognitively impaired or dementia-diagnosed counterparts did not similarly benefit from living in neighborhoods with rich resources.

Conclusions: Neighborhood resources may be an important aspect of intervention to mitigate cognitive decline before older adults become cognitively impaired.

Keywords: Alzheimer's disease and related dementias; Cognitive decline; Home- and community-based services; Neighborhood resources; interRAI-home care.