Does physical and social neighborhood environment matter for two-year changes in functional abilities and cognitive function in the oldest old?

ObjectivesWhile favorable physical neighborhood environments have been shown to benefit functional abilities (FA) and cognitive function (CF) in older adults, evidence on social aspects remains inconclusive. This study aimed to examine the role of both physical (quality, infrastructure, walkability) and social (place attachment, social cohesion) neighborhood characteristics for levels/changes in FA and CF among the oldest old, who were often underrepresented in previous research. Additionally, we examined whether place attachment and social cohesion mediate the associations between physical neighborhood characteristics and FA and CF outcomes.MethodsWe used data from the population-based NRW80+ survey, including two waves collected in 2017–2018 and 2019–2020. NRW80+ included the population aged 80 years or older with primary residence in North Rhine-Westphalia (Germany). Based on the structural equation framework, we estimated latent difference score models to examine levels/changes in FA (n = 840) and CF (n = 797) and to test mediation effects.ResultsHigher walkability was related to better baseline FA, and an improvement in walkability ratings was associated with less FA decline. Neighborhood quality and infrastructure were not related to FA or CF. Higher social cohesion was associated with less CF decline. No mediation effects through place attachment and social cohesion were identified.DiscussionOur findings indicate that walkable neighborhood environments may help maintain FA, while socially cohesive neighborhoods may buffer against CF decline in the oldest old. The absence of mediation effects suggests that physical and social aspects of the neighborhood may influence FA and CF through independent pathways.