Association Between Neighborhood Cohesion and Self-Neglect in Chinese-American Older Adults

Objectives: To examine the association between neighborhood cohesion and risk of self-neglect in a community-dwelling Chinese-American older population. Setting: Community. Participants: Chinese-American older adults aged 60 and older interviewed from 2011 to 2013 (N = 3,159). Design: Data were drawn from the Population Study of Chinese Elderly, a cross-sectional community-engaged study in the greater Chicago area. Measurements: Self-neglect was assessed with systematic observations of a participant's personal and home environment. Neighborhood cohesion was measured using six questions. Results: After controlling for potential confounders, greater neighborhood cohesion was significantly associated with lower risk of overall self-neglect (odds ratio (OR) = 0.87, 95% confidence interval (CI) = 0.77–0.98) and moderate to severe self-neglect (OR = 0.70, 95% CI = 0.58–0.85) but not significantly associated with mild self-neglect (OR = 0.94, 95% CI = 0.82–1.09). Regarding the phenotypes of self-neglect, greater neighborhood cohesion was significantly associated with lower risk of poor personal hygiene (OR = 0.80, 95% CI = 0.67–0.96) and need for home repair (OR = 0.70, 95% CI = 0.60–0.83) but not significantly for hoarding (OR = 1.04, 95% CI = 0.89–1.21), unsanitary conditions (OR = 0.88, 95% CI = 0.76–1.02), and inadequate utilities (OR = 1.00, 95% CI = 0.77–1.31). Conclusion: This study highlights the association between greater neighborhood cohesion and lower risk of overall self-neglect in Chinese-American older adults. Enhancing neighborhood cohesion may enhance elder self-neglect prevention and intervention.