Neighborhood Influences on Cognitive Level and Training Gains in the ACTIVE Study

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DESCRIPTION (provided by applicant): A growing body of research supports the role of neighborhood characteristics in the lives of older adults. Low neighborhood-level socioeconomic status has been associated with poorer physical health, reduced rates of physical activity, increased incidence of depression and psychological stress, and less neighborhood-based social support networks and social engagement. Many of these health and well being outcomes have also been identified as correlates of late life cognition. Yet few studies to date have specifically investigated the role of the neighborhood as a unique source of explanatory variance in cognitive aging. The current study seeks to supplement data collected in the NIH-funded ACTIVE (Advanced Cognitive Training with Independent and Vital Elders) study with additional neighborhood-level data derived from publicly available data sets. ACTIVE offers a unique opportunity to examine the association of neighborhood-level characteristics not only with baseline cognitive level, but also with response to cognitive training. In ACTIVE, 2,802 adults aged 65-96 from six US catchment area completed a baseline cognitive assessment and were randomized to one of three ten-session cognitive intervention programs or a no- contact control condition. An immediate posttest repeated most of the cognitive assessments to assess training-related change. Combining spatial and statistical analysis using geographic information systems (GIS), the proposed study seeks to investigate 1) whether neighborhood-level socioeconomic position (SEP) is related to initial cognitive level and training response in ACTIVE participants and 2) whether the number of neighborhood facilities supporting physical and psychosocial health mediates the relationship between neighborhood SEP and the ACTIVE cognitive outcomes. By innovatively bridging the social epidemiology and cognitive aging traditions, this proposal seeks to improve our understanding of the contextual factors influencing individual differences in late life cognition. PUBLIC HEALTH RELEVANCE: By exploring the influence of the neighborhood context on cognition in late life, targets may be identified for effective neighborhood level interventions, and/or individual strategy instruction in more optimal utilization of neighborhood resources.