The Price of Place: Community Wealth and Cognitive Decline among Older Adults (Tom Kemeny, University of Toronto)
Abstract:听Using a novel database on the net worth and self-reported cognitive impairment of over 1.8 million geolocated adults aged 50 and over, this paper provides the first large-scale evidence directly linking community wealth to age-related cognitive decline. The widening of geographic wealth disparities in the United States has fueled inequalities in access to public goods and amenities, positioning aggregate community wealth as a critical determinant of cognitive health. Adjusting for confounders, including household wealth and education, each standard deviation increase in community wealth is associated with a 6.7% relative risk reduction of cognitive impairment after age 50. Critically, the protective effects accompanying community wealth matter most for non-white, non-college educated, and low net worth householders, plausibly because these individuals rely more on the conditions underwritten by local affluence. While dementia-related cognitive decline currently affects one third of older adults, the economic fragmentation of American communities thus poses a growing threat to the cognitive health of Americans, particularly those from socially vulnerable and marginalized background.
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