H - 09 Neighborhood Disadvantage, Education Quality, and Cognitive Function in Community-Dwelling Black and White Older Adults with Metabolic Syndrome

Abstract Objective Low education quality is a risk factor for late-life cognitive decline and is often associated with living in a socioeconomically disadvantaged neighborhood, particularly among racialized older adults. This study examined the relationships among neighborhood disadvantage, education quality, and cognitive function from a larger pilot study of older adults at risk for cognitive decline due to metabolic syndrome. Participants and Methods Participants were 46 older adults (64.0% women, 39.1% Black, mean age = 72.4 years) who completed a neuropsychological assessment, including measures of speeded word generation (NACC Verbal Fluency Test) and problem-solving (WCST-64). Education quality was estimated via word recognition (WRAT-IV Word Reading). Neighborhood disadvantage was examined using the Area Deprivation Index. Results Greater neighborhood disadvantage was associated with fewer years of education, lower education quality, and lower performance on word generation and problem-solving. Mediation analyses indicated that the direct effect of neighborhood disadvantage on word generation was not significant, whereas the indirect effect mediated by education quality was significant (b = −0.180, t = −2.684). The total effect of neighborhood disadvantage on problem solving was significant (b = −0.134, p = 0.027), but the direct and indirect effects were not. Conclusions Neighborhood disadvantage was selectively associated with cognitive measures heavily influenced by executive function, namely using an efficient word generation strategy, and incorporating feedback to guide problem-solving. However, the effect of neighborhood disadvantage on cognition may be best explained by its association with reduced education quality. Neighborhood disadvantage can be a modifiable risk factor through improved education quality to mitigate risk of cognitive decline.