Urbanicity and cognitive functioning in later life.

Abstract

Prior research has shown disparities in cognitive functioning across the rural-urban continuum. We examine individual- and contextual-level factors to understand how and why urbanicity shapes cognitive functioning across older adulthood. Using a nationally representative sample from 1996 to 2016 waves of the Health and Retirement Study (HRS) and growth curve models, we assess urban-suburban-exurban differences in older adult cognitive functioning. Results demonstrate that older adult men and women living in exurban areas, and older adult men in suburban areas, have lower cognitive functioning scores compared to their urban peers. Educational attainment and marital status contribute to but do not fully explain these differences. There were no differences in the trajectory over age, suggesting that urbanicity disparities in cognition occur earlier in life, with average differences remaining the same across older adulthood. Differences in cognitive functioning across urbanicity are likely due to factors accumulating prior to older adulthood.