Rural-Urban Differences in Cognition: Findings From the Advanced Cognitive Training for Independent and Vital Elderly Trial

• Published in: Journal of aging and health 2023-10, Vol.35 (9_suppl), p.107S-118S
• Main Authors: Steinberg, Nessa, Parisi, Jeanine M., Feger, Danielle M., Clay, Olivio J., Willis, Sherry L., Ball, Karlene K., Marsiske, Michael, Harrell, Erin R., Sisco, Shannon M., Rebok, George W.
• Format: Article
• Language: English
• Subjects: Older people
• ISSN: 0898-2643; 1552-6887
• DOI: 10.1177/08982643221102718

Objectives We examined associations between three geographic areas (urban, suburban, rural) and cognition (memory, reasoning, processing speed) over a 10-year period. Methods: Data were obtained from 2539 participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. Multilevel, mixed-effects linear regression was used to estimate cognitive trajectories by geographical areas over 10 years, after adjusting for social determinants of health. Results: Compared to urban and suburban participants, rural participants fared worse on all cognitive measures—memory (B = −1.17 (0.17)), reasoning (B = −1.55 (0.19)), and processing speed (B = 0.76 (0.19)) across the 10-year trajectory. Across geographic areas, greater economic stability, health care access and quality, and neighborhood resources were associated with better cognition over time. Discussion: Findings highlight the importance of geographical location when examining cognition later in life. More research examining place-based life experiences is needed to make the greatest impact on geographically diverse communities.