Neighborhood Predictors of Cognitive Training Outcomes and Trajectories in ACTIVE

Res Aging. 2017 Mar;39(3):443-467. doi: 10.1177/0164027515618242. Epub 2016 Aug 3.

Abstract

We examined the influence of neighborhood socioeconomic position (SEP), racial/ethnic composition, and living in a major city on cognitive trajectories and intervention outcomes. Data came from the Advanced Cognitive Training for Independent and Vital Elderly study ( N = 2,438). Mixed effects analyses examined the associations between neighborhood variables and memory, reasoning, speed of processing, and everyday cognition, estimating differences in initial gains (potentially related to practice) and long-term rate of change over 10 years. The effect of reasoning training on initial gain was weaker for individuals in a major city. For everyday cognition, there was a stronger initial gain for memory-trained and control participants in areas with more racial/ethnic minorities and for speed-trained and control individuals in higher SEP areas. The racial/ethnic minority effect was no longer significant after adjustment for multiple comparisons. Neighborhood factors may be more important in practice-related improvement than in long-term change.

Keywords: cognition; cognitive training; neighborhood; plasticity; social determinants.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging
  • Cognitive Behavioral Therapy / statistics & numerical data*
  • Cognitive Dysfunction / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Psychological Tests / statistics & numerical data*
  • Racial Groups / statistics & numerical data
  • Residence Characteristics / statistics & numerical data*
  • Socioeconomic Factors
  • Treatment Outcome