Personal networks and cognitive health across rural-urban contexts

Abstract Objectives Prior research often reports geographic cognitive health disparities in later life, including across rural-urban contexts. Yet few studies have examined the role of personal social networks in shaping these geographic disparities. This study investigates whether social networks moderate or mediate the association between geographic context and cognitive health. Methods We use data from the Social Environment and Cognitive Health in Urban and Rural Areas study, which is a state representative sample of adults aged 55 and older. A latent measure of social bridging (i.e., connections to weak and diverse ties) was extracted using personal network data. Cognitive health was measured using the Montreal Cognitive Assessment (MoCA). Rurality was defined using the Indiana County Classification. Moderation and mediation pathways were tested using linear regression models. Results There were no observed rural-urban differences in MoCA scores. Yet the association between social bridging and MoCA was significantly stronger among rural participants compared to urban participants. Rural participants with the lowest levels of social bridging performed significantly worse on the MoCA compared to urban participants with similar bridging levels. These geographic disparities were not present when comparing rural and urban participants with high levels of social bridging. Discussion The ability to personally bridge social ties within a network appears to play a more critical role in the cognitive health of rural residents, who live in communities with fewer structural opportunities for social stimulation, compared to urban residents.