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Midlife and Late-life Neighborhood Socioeconomic Status and Cognitive Function in Later life: Differences by race.

G. Cheng,Christina F. Mair,Jeanine M. Buchanich,Tiffany L Gary-Webb,C. Elizabeth Shaaban,Andrea L. Rosso

Published 2026 in Annals of Epidemiology

ABSTRACT

PURPOSE Evidence regarding neighborhood socioeconomic status (nSES) as an upstream determinant of cognitive outcomes has largely lacked a life-course perspective. We examined racial differences in the associations between midlife and late-life nSES and cognitive function in a cohort of 330 Black and White older Americans aged 70+. METHODS General cognitive function was measured using Modified Mini-Mental State Examination up to a 15-year follow-up. Midlife (age 49-58) and late-life (age 70-79) nSES scores were z-standardized based on five census indicators of tract-level socioeconomic characteristics. Mixed-effects linear regression examined the associations between midlife and late-life nSES and cognitive function. RESULTS Higher midlife nSES was associated with higher baseline levels of cognitive function among Black (β: 3.10, 95% CI: 0.85, 5.33), but not among White participants (β: 0.51, 95% CI: -0.88, 1.90; p for interaction: 0.037). There were no observed associations between midlife nSES and changes in cognitive function in the overall sample or in either racial group. Late-life nSES was not associated with baseline levels of cognitive function or changes in the overall sample or either racial group. CONCLUSIONS Midlife may be a critical period in which neighborhood socioeconomic exposure has a greater impact on late-life cognitive health, particularly for Black individuals.

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