Psychological distress mediates the associations between neighborhood social cohesion (NSC) and cognitive performance in older adults

The aim of the current study is to test how psychological distress mediates the associations between neighborhood social cohesion (NSC) and cognitive performance including episodic memory, semantic verbal fluency, fluid reasoning, and numeracy in older adults. Nine multiple regressions were used to analyze the associations between NSC and cognitive performance, NSC and psychological distress, and psychological distress and cognitive performance respectively based on data from 4922 older adults with a mean age of 66.51 (S.D. = 8.27) years old and 47.01% males from Understanding Society: the UK Household Longitudinal Study (UKHLS). Moreover, a mediation analysis was conducted by the mediation toolbox on MATLAB 2018a (https://github.com/canlab/MediationToolbox). The current study found that NSC is positively related to all cognitive measures but negatively related to psychological distress, whereas psychological distress is negatively associated with all cognitive performance. Moreover, there was a complete mediation effect of psychological distress on the positive association between NSC and semantic verbal fluency and the association between NSC and fluid reasoning. However, NSC only partially mediated the positive associations between NSC and episodic memory and numeracy respectively. From a policy standpoint, findings from the current study contribute evidence that reinforces the need for program designers and policymakers to join the WHO's global efforts to build age-friendly communities, which promotes NSC, then leads to reduced psychological distress, and thus better cognitive functions among the elderly. Preserving cognitive functions may in turn reduce health care burdens.