Community wealth protects cognitive health for older adults

Using a new database on the net worth and self-reported cognitive impairment for almost two million adults, this paper provides the first large-scale evidence linking community wealth to age-related cognitive decline. This assessment is timely as widening geographic wealth gaps in the USA fuel disparities in access to public goods and amenities, positioning community wealth as a critical determinant of cognitive health. Conditioning on personal wealth and other risk factors, we find that a standard deviation increase in community wealth is associated with a 6.7% relative risk reduction in cognitive impairment across the national population of older adults, rising to 13.7% for those residing in the poorest fifth of communities. Community wealth matters more than relative inequality, and its associated protective effects are larger for non-white, non-college educated, and low net worth householders. This is plausibly because these individuals rely more on the public goods and services underwritten by local affluence. The economic fragmentation of American communities thus poses a growing threat to the cognitive health of Americans, especially among those from socially vulnerable and marginalized backgrounds.