The Impacts of Gender, Community Factors, Psychosocial Factors on Cognitive Status Among Older People Living in the Community

Background and Purpose: Cognitive impairment, such as dementia, is a major public health concern among older adults in the United States. In the past, there were research exploring associations between physical health, mental health, and cognitive status. However, despite a substantial amount of research demonstrated that environments have significant impact on older adults’ mental wellbeing, community factors are often overlooked in explaining these associations. In addition, no study considered the gender differences in these associations. Therefore, the present study examined the community, physical and mental health, and demographics predictors of cognitive status between male and female cohorts.

Methods: Utilizing the data in National Social Life, Health and Aging Project (n = 3,104; 54% female), hierarchical regression analyses were employed to identify the best association with/predictor to cognitive status between male and female older adults. Independent variables include the following predicators: community harmony, community safety, frequency of neighbor contacts, depressive symptoms, and sociodemographic factors. Parallel regression analyses were also conducted for each gender group and models were significant (P < .0001).

Results: Bivariate analyses suggested that there were no gender differences in cognitive status (Mean of MoCA Short Form = 9.89; SD = 3.33); nor were there gender differences in age (mean age = 72.95; SD=8.29), ethnic composition (76.1% whites; 15.3% Blacks, 8.6% Asian), community harmony, community safety, frequency of neighbor contacts. On the other hand, men had more education and income than women. Psychologically, older women reported a higher level of stress and depression scores than older men. Multiple regression results showed that gender has a significant independent effect and joint effect with stressors and community factors in explaining cognitive status. Parallel regression analyses found that there were common predictors of cognitive status for the two groups but variables had a differential impact on older men and older women. Specifically, IADL had a stronger effect on older men than on older women in predicting cognitive status (b = -.23 vs. b=-.10); perceived community harmony had a stronger impact on older women in explaining their cognitive status (b = .26 vs. b=.22); older women’s cognitive status benefitted more from perceived community safety than older men (b = .61 vs. b=.43). Regardless of gender, older Whites scored higher than Black and Asian elders in their cognition scores.

Conclusion and Implications: The finding provided insights on the impact of community and environmental factors on older adults’ cognitive status. The present study also highlighted the value of building an age-friendly community in supporting the cognitive status of older adults in the United States.