Thriving in Place: Multidimensional Neighborhood Typologies and Cognitive Function Among Older Americans

BackgroundNeighborhood physical, social, and service environments are increasingly recognized as important contextual factors related to cognitive health; however, few studies have examined how these features collectively shape cognitive outcomes. This study aimed to classify neighborhood typologies based on a constellation of neighborhood features and investigate their associations with cognitive function among US older adults. MethodsWe conducted a cross-sectional analysis of 6,480 participants from the 2016 wave of the Health and Retirement Study. Neighborhood features were derived from the 2015 National Neighborhood Data Archive, including measures of neighborhood deprivation, service facilities, food access, healthcare, and environmental hazards. The Partitioning Around Medoids (PAM) machine learning clustering algorithm was used to classify neighborhood typologies. Multilevel regression analyses were performed to examine the associations between neighborhood typologies and cognitive function. ResultsFour neighborhood typologies were identified: (1) low deprivation, green neighborhood, (2) mid-SES, high hazard neighborhood, (3) high-amenity neighborhood, and (4) disadvantaged neighborhood. Regression results revealed significant disparities in cognitive function across neighborhood typologies. Older residents in high-amenity neighborhoods characterized by extensive facilities and cognitively stimulating services demonstrated better cognitive function ({beta} = 3.85, 95% CI: 1.23-6.47) compared to those in disadvantaged, resource-scarce neighborhoods, after adjustment for individual-level characteristics. ConclusionsThe identified neighborhood typologies reveal an unequal distribution of amenities and hazards, which may help account for considerable inequities in late-life cognitive health. Tailored community initiatives addressing amenity availability and environmental hazards could be pivotal in promoting cognitive health and supporting aging in place.