Effects of neighborhood amenities, services, and built infrastructure on cognitive health: A longitudinal study of older Chinese immigrants in Chicago, United States

Neighborhoods play a critical role in cognitive health risk and resilience, particularly as most older adults prefer to age in place. Research on this topic has largely focused on neighborhood socioeconomic indicators and a limited set of physical features such as green space and walkability. Broader neighborhood amenities, services, and built infrastructure that can support cognitive stimulation, exercise, and social engagement have received less attention, particularly among older immigrant populations. To fill this important scientific gap, this study examined the effects of various neighborhood contextual features in 2,763 Chinese immigrants aged 60 years and older living in Greater Chicago, United States. We derived an overall Census tract-level Cognability Neighborhood Index (CNI) using item response theory to capture the availability of neighborhood amenities, services, and built infrastructure (e.g., museums, senior services, healthcare services, transit stops) that can support cognitive health through social and behavioral pathways. Results from the mixed-effects models show that CNI was not associated with cognitive function at baseline. However, participants who lived in neighborhoods with higher CNI scores exhibited slower cognitive decline over time. Novel study results indicate long-term cognitive health benefits of living in cognitively supportive neighborhoods in a sample of older immigrants, highlighting the potential of targeted community-based interventions and urban planning efforts to reduce dementia risk.