Cognability across adulthood: A qualitative investigation of neighborhoods and cognitive health behaviors.

While geographic variation in Alzheimer's Disease and Related Dementias (ADRD) rates suggests that environmental factors are important in the development of dementia, understanding of specific neighborhood sites that impact dementia risk is limited, especially in early and mid adulthood. This paper extends Cognability to a life course perspective to conceptualize how neighborhoods may support cognitive health behaviors including physical activity, diet, cognitive stimulation, and socialization across adulthood. The Neighborhoods and Health at All Ages Study employed stationary and mobile interviews (August 2023-March 2024) across the Minneapolis-St. Paul (MN) metropolitan area. Participants were on average 42 years old (range: 23-75). About half (53 %) identified as female, 40 % male, and 7 % nonbinary. Participants reflected diverse racial and ethnic backgrounds, including Asian (22 %), Hispanic (22 %), non-Hispanic White (18 %), Multiracial (17 %), Black/African American (15 %), American Indian/Alaska Native (3 %), and Other/Missing (3 %). Reflexive thematic analysis identified ten neighborhood services and amenities that support cognitive health behaviors: parks and paths, recreation centers, eateries, grocers and food markets, retail stores, civic and social organizations, religious organizations, arts and cultural sites, libraries, and educational sites. The study captured nuanced, intersectional perspectives from adults with varied socioeconomic, racial/ethnic, and gender identities to illuminate how use and salience of neighborhood services and amenities vary across adulthood. As the global dementia burden grows and disparities widen, our results help inform upstream community-level interventions to create more equitable neighborhoods that reduce ADRD risk and support lifelong cognitive health and wellbeing.