Early-life neighborhood resources and later-life cognitive function

Background: Recent work suggests that walkability and park access in later life may promote healthier cognitive function. However, few studies have examined how exposure to these factors early in life may be relevant for later-life cognitive function. Furthermore, few studies have examined modification by key factors such as socioeconomic status (SES). Methods: Using the St. Louis Baby Tooth Study (n = 3,099), we evaluated the association between early-life park access/walkability (mean age = 7.7, sd = 1.9) and later-life cognitive function (mean age = 63.6, sd = 3.6). Exposures were derived by linking prospectively collected childhood addresses to historical street map data. Walkability was measured as a composite of intersection density, point of interest density, and population density. Park access was measured as a composite of park density, park proportion, and park proximity. Later-life cognitive function was measured using the TestMyBrain cognitive battery. Generalized estimating equations estimated the associations between park access/walkability and later-life cognitive function. Additional analyses separately examined the components of each exposure and explored effect modification by age, sex, and SES. Results and conclusion: Neither the composite score of early-life walkability or park access were significantly associated with later-life cognitive function in our full sample. However, lower population density (β = -0.07; 95% CI: -0.13, −0.02) and higher intersection density (β = 0.05; 95% CI: 0.02, 0.08) were each associated with higher later-life cognitive function. Additionally, associations for park access and walkability were modified by SES, with stronger beneficial associations among more advantaged individuals. In conclusion, higher exposure to walkability and park access in early-life may be associated with higher later-life cognitive function in some contexts.