B-203: The Interplay of Stress Exposure Over the Life Course and Perceived Neighborhood Characteristics in Late-Life Cognition

Abstract

Objective: Positive perceptions of neighborhood quality have been linked to lower dementia risk; however, their potential in buffering stress-related cognitive impairment has yet to be explored. Method/Data Selection: Using a sample of 251 cognitively unimpaired community-dwelling older adults from the Einstein Aging Study in Bronx, NY (77.28±4.77y; 66.9% female; 15.23±3.54y education; 52% non-White), self-reported adversity (number of events, perceived severity) was assessed using the Stress and Adversity Inventory (STRAIN) in three domains: adversity in prenatal development, childhood (< 18yrs), and adulthood. Perceived neighborhood quality (aesthetics, safety, social cohesion) was evaluated for childhood and adulthood. Subjective cognitive concerns (SCC) were measured using the Cognitive Change Index and objective cognition (episodic memory, attention, executive functioning, language, visuospatial/visuoconstructional ability) with neuropsychological testing. Linear regressions examined associations between stress and self-perceived/objective cognitive functioning, accounting for moderation by neighborhood characteristics, adjusting for age, gender, education, and race/ethnicity. Results/Data Synthesis: Using 95%CI, severity of childhood adversity (p=0.025) and number and severity of adversity in adulthood (ps< 0.005) predicted higher SCC. Number of prenatal adversity predicted lower episodic memory under worse childhood physical environments (p=0.007). Within higher adulthood neighborhood social cohesion, adult adversity count predicted poorer episodic memory (p=0.008), and adult adversity severity predicted greater SCC (p=0.045). Within increased adulthood neighborhood safety, adulthood adversity count predicted greater SCC (p=0.038) and poorer episodic memory (p=0.013), and adulthood severity predicted greater SCC (p=0.038). Conclusions: Higher-quality childhood neighborhoods may buffer stress-related memory decline. However, in higher-quality adulthood neighborhoods, adversity predicted increased SCC and poorer objective memory. Results inform understanding of how neighborhood environments influence the expression of stress-related cognitive vulnerabilities in older adulthood.