Association Between Multidimensional Housing Precarity and Cognitive Function Among Older Adults: Findings from the National Survey of Older Koreans, 2023

Abstract

Background Housing precarity (HP) is a fundamental determinant of well-being and health among older adults. Objective We explored the association between housing precarity and cognitive function among older adults in South Korea. Design Population-based, cross-sectional survey. Participants A nationwide community-dwelling sample of 9796 adults aged >= 65 years was analyzed. Main Measures Based on the theoretical framework established in the existing literature, HP was assessed across five dimensions: housing affordability, housing tenure, housing satisfaction, neighborhood quality, and community cohesion. The overall HP level was scored on a scale ranging from 0 to 10 and categorized into four levels: lowest, low, high, and highest. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination, 2nd edition (K-MMSE similar to 2), and z-scores were calculated. A higher K-MMSE similar to 2 score indicated better cognitive functioning. Linear regression analysis was performed to determine the association between HP and cognitive function. Beta coefficients (beta) and 95% confidence intervals (CI) were estimated. Key Results The mean age of the sample was 73.9 years, with a mean MMSE score of 24.6. Compared to participants with the lowest HP levels, those with the high or highest HP levels had lower MMSE z-scores (beta [95% CI] -0.21 [-0.27, -0.15] for high HP; and beta [95% CI] -0.29 [-0.35, -0.22] for the highest HP levels). Regarding individual indicators, insecure tenure (not owning a home), housing dissatisfaction, poor neighborhood quality, and low community cohesion were negatively associated with cognitive function. Conclusions Among older adults, high HP levels were associated with poor cognitive function.