LOWER COMMUNITY LIVABILITY IS ASSOCIATED WITH HIGHER DEMENTIA PREVALENCE AMONG WOMEN IN SOUTH CAROLINA COUNTIES

Abstract Community livability may be associated with lower dementia prevalence through access to healthcare professionals, for example. Given the high rates of dementia among older adults with a disproportionate impact on women, there is a need to understand how community livability may buffer against dementia and mitigate gender disparities. Yet, few studies have considered community livability as an exposure. Therefore, our exploratory study determined county-level associations between community livability and dementia prevalence by gender in South Carolina (SC). We retrieved county-level dementia prevalent cases in 2016 among ≥50 years old (N=46) from the SC Alzheimer’s Disease Registry. Community livability data (categorized into tertiles) were obtained from the American Association of Retired Persons’ Livability Index in 2018, which included seven domains: housing, neighborhood, transportation, physical environment, healthcare access, social engagement, and economic as well as educational opportunity. We conducted OLS regression analysis adjusting for county-level rurality to estimate beta coefficients and p-values. The study included 48.6% women (n=622) and 51.4% men (n=656). In adjusted analyses, low vs. high livability was associated with higher dementia prevalence (B=0.38; p-value=0.31). Although not statistically significant, the findings are in the expected direction. Low vs. high livability was associated with higher dementia among women (B=0.11; p-value=0.69), but lower dementia among men (B= -0.78; p-value=0.07). Our novel findings regarding communities with higher livability being associated with lower dementia highlight the potential health benefits of enhancing the livability of communities and is a first step towards future research to better understand this understudied relationship.