Neighborhood-based social capital and cognitive function among older adults in five low- and middle-income countries: Evidence from the World Health Organization Study on global AGEing and adult health

Objectives: This study aims to investigate which neighborhood-based social capital components are associated with a higher level of cognitive function in LMICs. Methods: This international population-based study used cross-sectional survey data from the World Health Organization's Study on global AGEing and adult health (SAGE), a study of adults aged 50 years or older in China, Ghana, India, the Russian Federation, and South Africa from 2007 through 2010 (N = 29 528). Associations between neighborhood-based social capital indicators (trust in neighbors, perceived neighborhood safety, and community participation) and cognitive function were examined using ordinary least squares regressions and random-effects meta-analyses. Results: Results of the meta-analyses of within-country effects indicated that trust in neighbors were positively associated with cognitive function across India, Russia, and Ghana, but negatively associated in South Africa (β = −0.041, SE =.013, P <.01) and no effect in China (P >.05). The significant effect of perceived neighborhood safety was only found in South Africa (β = 0.051, SE =.007, P <.001) and China (β = 0.030, SE =.005, P <.001). Community participation approached a null effect in South Africa (P >.05). Discussion: Different indicators of neighborhood-based social capital, which are well-established protective resources for cognitive function, may have varied relationships with cognitive function cross-nationally. This finding provides a better understanding of the mechanisms by which neighborhood social capital may contribute to better cognitive function in LMICs than high-income countries, potentially due to differences in neighborhood environments, health systems, and availability of public resources.