Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR

Abstract

AbstractINTRODUCTIONCommunity disadvantage is associated with late‐life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change.METHODSInverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5‐99). Interactions by race tested.RESULTSMore Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = ‐0.16, 95% confidence interval [CI] = ‐0.30, ‐0.03) or adulthood (b = ‐0.14, 95% CI = ‐0.22, ‐0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p‐value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p‐value = 0.002).DISCUSSIONExamining racial differences in levels of community advantage and late‐life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.