ArticleAlzheimer's & dementia. Behavior & socioeconomics of aging2025
The impact of tract- and county-level segregation on 10-year cognitive and everyday functioning outcomes of Black/African American older adults in the ACTIVE study.
Article in Alzheimer's & dementia. Behavior & socioeconomics of aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Locus of control moderates the effects of residential segregation on everyday functioning in Black older adults from the Advanced Cognitive Training for Independent and Vital Elderly study.Neuropsychology · 2026Article
- Individual-Level Factors Associated With 10-Year Incidence of Alzheimer Disease and Related Dementias in the VA Million Veteran Program.Neurology · 2026Article
- Life course neighborhood conditions and change: a 20-year examination of neighborhood context and associations with Alzheimer's disease biomarkers in late life.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveThe present study used structural equation modeling (SEM) to examine the impact of tract- and county-level segregation on 10-year cognitive and functional outcomes of Black/African American older adults enrolled in the Advanced Cognitive Training for Independent and Vital Elderly study.
methodsAddresses for 695 participants were geocoded and linked with decennial census data to calculate segregation. Higher levels of segregation were indicated by higher levels of dissimilarity (uneven spatial distribution between Black and non-Hispanic White [NHW] residents) and lower levels of interaction (less exposure to NHW residents). Cognitive composites (memory, processing speed, and reasoning) and performance on an everyday functioning measure administered at baseline, post-intervention, 1-, 2-, 3-, 5-, and 10-year follow-up were the outcomes.
findingsHigher segregation, indicated by lower tract and county-level interaction, was associated with better cognitive and everyday functioning levels but faster rates of decline. Higher segregation, indicated by higher county-level dissimilarity, was associated with better cognitive and everyday functioning levels but accelerated rates of decline. No associations between segregation characterized by tract-level dissimilarity and outcomes were observed.
conclusionsSegregation may restrict access to important resources, and this disadvantage may accelerate cognitive and everyday functioning declines. However, segregation may also increase cultural capital and social resources that have a positive impact on levels of cognitive and everyday functioning performance. Results also revealed that the magnitude and consistency of segregation effects differ across geospatial levels of analysis and highlight that targeted interventions at multiple levels may help reduce racial disparities in Alzheimer's disease and related dementias.
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