Perceived Neighborhood Char ed Neighborhood Characteristics and Cognitiv acteristics and Cognitive Function unction among Older Adults: Examining the Role of Depression

Purpose: African American older adults have a greater risk of cognitive impairment compared
to White older adults. While some research has established that neighborhoods are an important
determinant of health, relatively little research has examined the relationship between perceived
neighborhood characteristics and cognitive functioning among older adults. Moreover, little is
known about how depression is implicated in the relationship between perceived neighborhood
characteristics and cognitive functioning, and if racial differences exist. Thus, this thesis aims to
determine the mediating and moderating role of depression in the association between perceived
neighborhood characteristics and cognitive functioning in older African American and White
adults.
Methods: I used data from the Health and Retirement Study and limited the sample to older
Black and White adults age ≥65 years (n=7,620). Cognitive functioning was measured using the
Telephone Interview for Cognitive Status (range: 0-35), with higher scores indicating better
cognitive functioning. Depression was measured as a dichotomous variable using the Center for
Epidemiologic Studies Depression Scale (CES-D). Depression scores ranged from 0 to 8 and the
≥3 cutoff was used to categorize adults with depression. Neighborhood perceptions of safety,
cleanliness, and social cohesion were measured on a scale ranging from 0 to 7 with higher scores
indicating worse perceptions. Linear regression models stratified by race were used to determine
if depression played a mediating role in the relationship between perceived neighborhood
characteristics (safety, social cohesion, and cleanliness) and cognitive functioning. The
moderating role of depression was also examined using interaction terms with each
neighborhood characteristic and depression.
Results: The results indicated that there is a negative relationship between perceived
neighborhood characteristics and cognitive functioning among White older adults. Depression
moderates the relationship between neighborhood characteristics (cleanliness, discohension) and
cognitive functioning among White older adults. However, there was no moderating effect of
depression among African American older adults. However, after controlling for neighborhood
characteristics and other covariates, depression was associated with worse cognitive functioning.
Discussion/Conclusion: Depression is associated with worse cognitive functioning for both
African American and White adults. Among White older adults with depression, there was a
more pronounced negative association between neighborhood perceptions and cognitive
functioning compared to those without depression. However, depression in African Americans
was associated with worse cognitive functioning after controlling for neighborhood
characteristics and other covariates. Therefore, depression is directly related to worse cognitive
functioning in older adults.