Lifespan exposures to rural–urban conditions and later-life cognitive function

INTRODUCTION

Limited research exists on life-course rural–urban residence and cognitive functions.

METHODS

This study examines associations between rural–urban residence during childhood, adulthood, residential mobility (childhood to adulthood), and later-life cognitive outcomes among U.S. adults ≥65 years of age (N = 3073) from the Health and Retirement Study-Harmonized Cognitive Assessment Protocol.

RESULTS

Linear and logistic regression showed that childhood rural residence was associated with lower memory (standardized beta (β) = –1.68, 95% Confidence Interval (CI) [–2.39, –0.97]), executive function (β = –1.20, 95% CI [–1.84, –0.55]), and language fluency (β = –0.86, 95% CI [–1.64, –0.08]). Individuals living in rural areas in childhood had a higher risk for mild cognitive impairment (MCI; odds ratio [OR] = 1.31, 95% CI [1.02, 1.69]) and dementia/MCI (OR = 1.30, 95% CI [1.04, 1.62]). Compared to lifelong urban residents; residents who lived in rural areas during childhood and/or adulthood had lower cognitive function and a higher risk of MCI.

DISCUSSION

Rural residence throughout the lifespan, especially during childhood, is linked to poorer later-life cognitive outcomes, underscoring the need for early targeted health care interventions to address rural–urban disparities.

Highlights

• Few studies have examined the timing of rural residence on cognitive health.
• Rural residence across the lifespan is associated with lower cognitive function.
• Childhood rurality is particularly associated with lower cognitive function.