Racial/ethnic variation of neighborhood social cohesion, loneliness, and cognitive functioning among midlife and older U.S. adults.

OBJECTIVES: Racial/ethnic disparities in cognition and dementia are well established. Social determinants of health researchers have identified neighborhood context as one potential contributor to these disparities, including neighborhood social context. Neighborhood social cohesion, in particular, may help to reduce loneliness and thereby improve cognitive aging among midlife and older adults. However, access to high-quality and cohesive neighborhood settings varies by race/ethnicity in the United States, as too may the association of neighborhood social cohesion with well-being outcomes such as loneliness. This study has 3 primary aims: (a) to determine whether neighborhood social cohesion protects against loneliness differently across racial/ethnic groups; (b) to determine whether loneliness is associated with accelerated cognitive decline; and (c) whether the combination of (a) and (b) means that neighborhood social cohesion protects against cognitive decline differently across racial/ethnic groups.

METHODS: This study uses 3-wave longitudinal data from the 2010 to 2020 waves of the Health and Retirement Study (N = 7,879). Structural equation modeling using full information maximum likelihood methods to address missing data was used to simultaneously address our research questions.

RESULTS: Neighborhood social cohesion was associated with reduced loneliness only among non-Hispanic White participants. Loneliness was associated with cognitive decline among all racial/ethnic groups. As a result, loneliness mediated a significant indirect effect of neighborhood social cohesion on cognitive functioning among non-Hispanic White participants only.

DISCUSSION: Although loneliness was associated with greater declines in cognition over time across all racial/ethnic groups, only non-Hispanic White participants' cognitive trajectories benefited from living in socially cohesive neighborhoods, via reduced loneliness.