Cognitive function and the social environment: A multilevel approach

Considerable research highlights the importance of the social environment for cognitive function. The present study blends insights from two parallel literatures to explore the dynamic role of social environments that exist at the community level and personal level. Guided by this framework, we merge survey data from the Person-to-Person Health Interview Study-a state representative sample of individuals (n = 679) residing across 41 counties-with secondary data on the civic and social organizations that exists across all counties. Two personal network variables (bridging potential and density) were constructed using four name generating prompts. Multilevel linear models were used to assess variation in cognitive function as measured by the Montreal Cognitive Assessment. We test three potential pathways: (1) Additive pathway where civic organizations and personal network structure are independently associated with cognitive function. (2) Mediating pathway where networks mediate the association between organizations and cognitive function. (3) Moderating pathway where personal networks moderate the association between organizations and cognitive function. We find that civic organizations were not independently associated with cognitive function nor were they predictive of the network structure variables. There was, however, a significant interaction between organizations and networks such that greater access to civic organizations was associated with better cognitive function only among respondents with loosely-knit networks as measured by network bridging potential and density. These results highlight the need to consider multiple levels of the social environment. Indeed, the previously documented associations between the community environment and cognitive function appear to exist only among residents who exhibit the ability to occupy non-overlapping social circles within their personal networks.