Neighborhood Characteristics, Behavioral Symptoms of Cognitive Decline, and Caregivers’ Distress in Older Mexican Americans

Objectives We use person-environment (PE) fit theory to examine whether neighborhood composition is associated with behavioral symptoms of cognitive decline among older Mexican Americans and their caregivers’ distress. Methods We estimated multilevel regression models using 2011/2012 data from the Hispanic Established Population for the Epidemiological Study of the Elderly ( n = 862) linked to 2010 census tract characteristics (percent foreign born, Hispanic, and poor) from the National Neighborhood Data Archive, adjusting for care recipient and caregiver covariates. Results Residing in areas with a higher proportion of foreign-born adults was associated with fewer neuropsychiatric symptoms, particularly delusions, agitation/aggression, depression/dysphoria, and anxiety, and with lower symptom severity. Higher tract poverty was marginally associated with greater odds of aberrant motor behavior, while tract characteristics were unrelated to caregiver distress. Discussion Findings support a PE-fit interpretation in which immigrant enclaves, rather than Hispanic concentration, may influence behavioral symptom expression or their perceptions/reporting by caregivers.