Rural depopulation and the rural-urban gap in cognitive functioning among older adults

Area of Science:

• Gerontology
• Public Health
• Rural Health Disparities

Background:

• Cognitive impairment is a growing concern with an aging population.
• While rural-urban disparities in physical health are documented, cognitive health differences are less understood.
• Population decline in rural areas may exacerbate existing health inequities.

Purpose of the Study:

• To investigate rural-urban differences in cognitive health among older adults.
• To examine the moderating role of county population decline on cognitive functioning.
• To identify specific populations at higher risk for cognitive decline.

Main Methods:

• Utilized nationally representative Health and Retirement Study data (2000-2016).
• Employed hierarchical linear models to analyze cognitive functioning in adults aged 50+.
• Merged individual data with county-level characteristics, including population change.

Main Results:

• Rural older adults exhibited lower cognitive functioning compared to their urban counterparts.
• A significant interaction effect was found between rural residence and county depopulation (P < .001).
• The cognitive penalty for rural living was 40% greater in depopulating counties, independent of numerous covariates.

Conclusions:

• Findings underscore significant cognitive health disparities between rural and urban older adults.
• Population decline in rural areas disproportionately impacts cognitive health, worsening existing disparities.
• Targeted interventions are crucial for depopulating rural areas to mitigate cognitive health inequities.