Neighborhood Disadvantage, Functional Difficulty, and Cognitive Decline among Older Mexican Americans

Area of Science:

• Gerontology
• Public Health
• Sociology

Background:

• Cognitive decline disproportionately affects older Mexican Americans.
• Understanding biopsychosocial factors is crucial for cognitive health in this demographic.
• Existing research highlights a need for studies on functional difficulty and neighborhood context.

Purpose of the Study:

• To investigate the longitudinal association between functional difficulty and cognitive decline.
• To determine the moderating effect of neighborhood disadvantage on cognitive decline among older Mexican Americans.
• To inform culturally responsive interventions for cognitive health.

Main Methods:

• Utilized four waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004-2013).
• Included 1,189 older Mexican Americans with baseline Mini-Mental State Examination (MMSE) scores ≥21.
• Employed multilevel mixed-effects regression models analyzing cognitive function (MMSE), functional difficulty (ADL/IADL), and neighborhood disadvantage indicators.

Main Results:

• Activities of daily living (ADL) limitations were significantly associated with an average MMSE score decline of 0.70.
• Participants with ADL/IADL difficulties experienced accelerated cognitive decline.
• Neighborhood disadvantage moderated the association between IADL difficulty and cognitive decline.

Conclusions:

• Neighborhood disadvantage acts as a socioeconomic stressor impacting cognitive health in functionally impaired older Mexican Americans.
• Targeted, culturally relevant neighborhood-level interventions may mitigate cognitive decline risk.
• Addressing functional limitations and neighborhood context is vital for promoting cognitive well-being in this population.