Midlife and late-life neighborhood socioeconomic status and cognitive function in later life: Differences by race

Evidence regarding neighborhood socioeconomic status (nSES) as an upstream determinant of cognitive outcomes has largely lacked a life-course perspective. We examined racial differences in the associations between midlife and late-life nSES and cognitive function in a cohort of 330 Black and White older Americans aged 70 + .

General cognitive function was measured using Modified Mini-Mental State Examination up to a 15-year follow-up. Midlife (age 49-58) and late-life (age 70-79) nSES scores were z-standardized based on five census indicators of tract-level socioeconomic characteristics. Mixed-effects linear regression examined the associations between midlife and late-life nSES and cognitive function.

Higher midlife nSES was associated with higher baseline levels of cognitive function among Black (β: 3.10, 95 % CI: 0.85, 5.33), but not among White participants (β: 0.51, 95 % CI: -0.88, 1.90; p for interaction: 0.037). There were no observed associations between midlife nSES and changes in cognitive function in the overall sample or in either racial group. Late-life nSES was not associated with baseline levels of cognitive function or changes in the overall sample or either racial group.

Midlife may be a critical period in which neighborhood socioeconomic exposure has a greater impact on late-life cognitive health, particularly for Black individuals.