# Neighborhoods, Cognitive Aging and Modifiable Risk Factors

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $578,846

## Abstract

The role of modifiable risk factors (RF), like physical activity (PA), sleep quality, social engagement, and
cardiovascular (CV) risk is receiving greater attention to promote the cognitive health of an aging population
and reduce risk of Alzheimer's disease. Each of these risk factors is known to be influenced by environmental
sources, such as neighborhood walkability, safety, noise, and access to low-cost transportation, retail, and
healthy food sources. However, little is known about the role of neighborhood factors as drivers of cognitive
aging and risk for Alzheimer's disease. If neighborhood matters, adaptations in the use of available
infrastructures have the potential to impact thousands at a time. Those neighborhood factors that most impact
individual RF and cognitive health to reduce Alzheimer's disease risk may further differ by race and sex.
Evaluating the role of neighborhood characteristics on cognitive health is difficult to interpret from more widely
used cross-sectional data due to residual confounding. Therefore, investigating how residentially stable older
adults are affected by their local stable and changing contexts and how older adults who relocate to a new
neighborhood may respond to their new context by changing health behaviors requires long-term study during
the last 1/3 of life years prior to the onset of Alzheimer's disease. The Cardiovascular Health Study (CHS)
represents an ideal cohort for studying interactions between individual health and neighborhood risk factors for
various reasons. First, participants were well characterized for key modifiable RF, above, as well as cognition,
and mobility. Second, the cohort is nationally representative, bi-racial and spans socioeconomically diverse,
urban and rural neighborhoods, allowing us to examine the relation between individual risk and variability in
neighborhood factors. Third, our proposal seeks to address the research challenges and opportunities
articulated in the NIA Health Disparities Research Framework by examining interactions between environment,
biology and behavior. We hypothesize that long-term exposure to neighborhood disadvantage may serve as
a common cause of individual risk factors and neurocognitive and functional health, particularly in
socio-demographically at-risk groups. Specific aims are to characterize associations between long-term
neighborhood exposures and: 1) individual rates of decline and impairment in cognition and physical function;
2) individual risk factors (PA, sleep quality, social engagement and CV burden) for Alzheimer's disease, which
may mediate neighborhood differences in cognitive and functional risk, and; 3) whether specific neighborhood
exposures account for racial and sex differences in cognitive and functional risk. Addressing these questions in
the CHS provides an unmatched opportunity to examine the influence of a range of neighborhood factors on
long-term trajectories of cognitive and functional aging prior to the onset o...

## Key facts

- **NIH application ID:** 10168408
- **Project number:** 5R01AG055404-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** MICHELLE C CARLSON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $578,846
- **Award type:** 5
- **Project period:** 2018-05-15 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10168408

## Citation

> US National Institutes of Health, RePORTER application 10168408, Neighborhoods, Cognitive Aging and Modifiable Risk Factors (5R01AG055404-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10168408. Licensed CC0.

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