Residential context and cognitive aging: Differences by urbanicity across the retirement transition

Cognitive aging is shaped by biological and social processes that unfold across the life course and the contexts in which they occur. Retirement may coincide with faster cognitive decline. Because cognitively supportive resources differ across places, this study assesses whether residential context (urban, suburban, rural/ex-urban) moderates cognitive trajectories before and after retirement.

Data were drawn from the U.S. Health and Retirement Study (2000-2020; n = 3,675). We estimated within-person change in cognition before and after retirement and included interaction terms to test modification by residential context. To reduce compositional differences across contexts, we applied inverse probability of treatment weighting and estimated piecewise linear mixed-effects models with random intercepts and slopes.

Cognitive decline was observed before and after retirement, with faster decline following retirement. Post-retirement decline was steepest in rural areas (-0.194 points/year), followed by suburban (-0.184) and urban (-0.164) settings. Pairwise contrasts indicated steeper post-retirement decline in rural than urban areas (β = -0.031 points/year), or 0.31 points over 10 years; urban-suburban differences were small. Results were similar after combining urban and suburban respondents.

Retirement may represent a turning point during which geographic inequalities in cognitive aging widen. Faster post-retirement decline in rural contexts may reflect reduced access to social, environmental, and institutional resources, but these pathways were not directly tested and should be interpreted as plausible explanations. Findings point to the potential importance of place-based strategies to mitigate spatial disparities in cognitive aging among retirees.