Life-course neighborhood contexts, social engagement, and cognitive health in later adulthood

Objective This study examined the effects of early- and later-life neighborhood contexts on social engagement and cognitive function in later life. Methods Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. The analytical sample included 6082 participants aged 60 years and older. A longitudinal growth curve model (LCGM) was employed to estimate the direct and indirect effects of early- and later-life neighborhood contexts on cognitive function through social engagement over the study period. All analyses were stratified by urban and rural neighborhoods. Results Urban neighborhoods had more facilities than rural villages, and urban residents had higher levels of social engagement. Social engagement had significant impacts on cognitive function at baseline and was associated with steeper cognitive decline over time for both urban and rural residents. Better neighborhood contexts in childhood (β = 0.110, p < .001) and more neighborhood facilities in later life (β = 0.086, p < .01) were associated with higher levels of social engagement at baseline for rural villages (ß_{neighborhood facilities} = 0.085, p < .01; βneighborhood contexts in childhood = 0.126, p < .001). Neither neighborhood contexts in childhood nor neighborhood facilities in later life have direct impacts on cognitive function after adjusting for covariates. Conclusion Social engagement in later life is significantly influenced by neighborhood contexts in early life and neighborhood facilities in later life. These findings highlight the importance of improving neighborhood contexts to encourage social engagement and support cognitive function especially for rural residents.