News Release

Neighborhood and cognitive performance in middle-age: Does racial residential segregation matter?

Peer-Reviewed Publication

Columbia University's Mailman School of Public Health

May 8, 2020 -- A study at Columbia University Mailman School of Public Health found that black subjects who were exposed to highly segregated neighborhoods in young adulthood exhibited worse performance in cognitive skills in mid-life. The findings are published online in JAMA Neurology.

Until this research, there had been little information on the association of racial residential segregation and cognitive function.

"Our findings support the notion that long-term exposure to residential segregation during 25 years of young adulthood is associated with worse processing speed as early as midlife," said Adina Zeki Al Hazzouri, PhD, assistant professor of epidemiology at Columbia Mailman School. "This outcome may explain black-white disparities in dementia risk at older age."

The researchers analyzed data from 1,548 black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which focuses on the development and determinants of cardiovascular disease. Participants were ages 18 to 30 at baseline in 1985 and prospectively followed over 25 years.

Measurements of racial residential segregation across six follow-up visits from the 25-year study, were categorized as high, medium, and low segregation. Cognitive function was assessed at year 25 of the ongoing, multicenter, study.

Cognitive performance was measured using three different tests representing distinct domains of cognition, including the Digit Symbol Substitution Test (DSST), a subtest of the Wechsler Adult Intelligence Scale.

Earlier studies by Zekie Al Hazzouri and colleagues had supported growing evidence that maintaining cognitive function is a lifelong process and that several of the most important risk factors may begin earlier in the life course.

"Studies examining racial residential segregation in the context of cognitive function are limited, and thus our findings contribute to an important yet sparse literature," observed Zeki Al Hazzouri. "More importantly, our research indicates that policies that address segregation and the uneven distribution of resources, may be beneficial for reducing inequities in cognitive performance."


Co-authors are Michelle Caunca and Tali Elfassy, Miller School of Medicine, University of Miami; Michelle Odden, Stanford University; M. Maria Glymour and Kristine Yaffe, University of California, San Francisco; Kiarri Kershaw, Feinberg School of Medicine, Northwestern University; Stephen Sidney, Kaiser Permanente; and Lenore Launer, National Institute on Aging.

This work was supported by grant K01AG047273 from the NIA, NIH, and grant F30NS103462 from the NINDS, NIH; contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the NHLBI, NIH; the Intramural Research Program of the NIA; and intra-agency agreement AG0005 between the NIA and NHLBI.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the seventh largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit

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