Loneliness Moderates the Association between Neighborhood Disadvantage and Cognitive Function Among Older Adults

Objective: Neighborhood disadvantage has been linked to reduced cognitive performance and cognitive decline among older adults; however, potential moderators of this association, such as loneliness, have not been well studied. Therefore, the objective of the study was to examine associations between neighborhood disadvantage and cognitive function, and whether associations are moderated by self-reported loneliness. Methods: Data were analyzed from the Healthy Heart and Mind Study, a cross-sectional study with data collection ranging from October 2016 to January 2020 in New Castle County, DE and surrounding areas. The analysis included 136 older adults (36% male) with a mean age of 68.04. Neighborhood disadvantage was assessed using the Area Deprivation Index (ADI), which provided state and national rankings of neighborhood deprivation. Cognitive function was assessed with the Verbal Fluency Test (executive function), the Visual Reproductions Test (short- and long-term visuospatial memory), the Logical Memory Test (verbal memory), and Digit Span Forward and Backward (working memory). Loneliness was measured with the UCLA Loneliness Scale. Descriptive statistics were calculated and linear regression analyses were run, adjusted for age, sex, and education. Results: Results showed that higher state and national ADI scores (more disadvantage) were associated with worse short-term visuospatial memory. Loneliness moderated the relationship between national ADI scores and short-term visuospatial memory. Conclusions: Overall, our findings suggest that older adults living in more disadvantaged neighborhoods in and surrounding New Castle County, De may be susceptible to poor visuospatial memory performance, and the relationship may vary based on low or high self-reported loneliness. Policy Implications: Our findings suggest a need to increase exploration of the role of neighborhood factors in older adult cognitive functioning. Health policies focused on ameliorating individual-level risk factors for cognitive dysfunction and decline may need to be expanded to target neighborhood-level factors and the intersection of neighborhood, loneliness, and social ties.