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Neighborhood Impacts of Cognitive Health and Dementia Disparities

Understanding the impacts of neighborhood factors for cognitive health and dementia disparities within a Multi-Ethnic Cohort

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This project leverages and extends novel longitudinal neighborhood and cognition data from the Multi-Ethnic Study of Atherosclerosis (MESA). It addresses major research gaps by identifying unique patterns of neighborhood change related to the causes of prevalence and disparities in cognitive decline and dementia. This work facilitates actionable community and clinical interventions to address and remediate racial and socioeconomic inequalities derived from the unequal distribution of environmental supports for healthy aging.


Multi Ethnic Study of Atherosclerosis Coordinating Center at University of Washington; MESA field centers; MESA MIND Ancillary Study.

Research Methods

This project will undertake large-scale collection, processing, and distribution of new neighborhood data within MESA. The main objective is to identify unique patterns of neighborhood change related to the causes of prevalence and disparities in cognitive decline and dementia. The main objective will be attained by (Aim 1) characterizing dynamic, longitudinal neighborhood social and built environment variables (survey-based and GIS-derived) relevant to cognition for residential addresses of a MESA; (Aim 2) examining associations of neighborhood environmental characteristics with cognition and clinically relevant ADRD outcomes; (Aim 3) investigate determinants of disparities in ADRD outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighborhood environments.

Research Results

Hirsch, J.A., Moore, K.A., Cahill, J., Quinn, J., Zhao, Y., Bayer, F.J., Rundle, A. and Lovasi, G.S., 2020. Business Data Categorization and Refinement for Application in Longitudinal Neighborhood Health Research: a Methodology. Journal of Urban Health, Oct 1, pp.1-14.

Besser, L., Chang, L. C., Evenson, K. R., Hirsch, J., Michael, Y., Galvin, J. E., ... & Hughes, T. M. (2021). Associations between neighborhood park access and longitudinal change in cognition in older adults: The multi-ethnic study of atherosclerosis. Journal of Alzheimer's Disease, (Preprint), 1-13.

Besser, L. M., Chang, L. C., Hirsch, J. A., Rodriguez, D. A., Renne, J., Rapp, S. R., ... & Hughes, T. M. (2021). Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis. International Journal of Environmental Research and Public Health, 18(15), 7973.


Research Team:

  • Jana A. Hirsch, PhD, MES, Assistant Research Professor, Urban Health Collaborative
  • Yvonne Michael, ScD, SM, Associate Professor, Dornsife School of Public Health
  • Brisa Sanchez, PhD, Dornsife Endowed Professor of Biostatistics, Dornsife School of Public Health
  • Ana Diez Roux, MD, PhD, MPH, Dean and Distinguished University Professor of Epidemiology; Dean's Office, Epidemiology and Biostatistics, Urban Health Collaborative
  • Kari Moore, MS, Research and Data Core Co-lead, Urban Health Collaborative
  • Steve Melly, MS, MA, Geographic Information System (GIS) Specialist, Urban Health Collaborative
  • Lilah M. Besser, PhD, MSPH, Florida Atlantic University
  • Channa Buxbaum, Research Fellow, Dornsife School of Public Health
  • Sandi Shrager, Multi Ethnic Study of Atherosclerosis Coordinating Center at University of Washington
  • Steven Shea, MD, MESA field centers
  • Alain Bertoni, MD, MESA field centers
  • James Pankow, PhD, MPH, MESA field centers
  • Norrina Allen, PhD, MESA field centers
  • Teresa Seeman, PhD, MESA field centers
  • Wendy Post, MD, MS, MESA field centers
  • Timothy Hughes, PhD, MESA MIND Ancillary Study
  • Kathleen Hayden, PhD, MESA MIND Ancillary Study
  • Jose Luchsinger, MD, MESA MIND Ancillary Study


Funding provided by the National Institutes of Health National Institute on Aging.