“Kinlessness”, friend and family support, and cognitive function by region and urbanicity in the United States

Family structure and social support are important determinants of cognitive health in later life, yet little is known about how their associations with cognition vary across geographic contexts. This study examines how cognitive function among older adults varies by family structure, region, and urbanicity, with particular attention to the buffering effects of friend and extended family support. Using data from the Health and Retirement Study (2006–2018; N = 19,976 respondents and 40,885 observations), we used multilevel mixed-effects models to analyze repeated measures of cognitive function across family structures, with a particular focus on older adults without partners or children (“kinless”). Fully adjusted results reveal that being unpartnered and/or childless is generally not associated with cognitive disadvantage except in specific geographic contexts, particularly in the West among unpartnered parents living in exurban areas and unpartnered childless adults living in suburban areas. In contrast, friend support is associated with better cognitive function in nearly all contexts, with especially consistent associations across the South, whereas extended family support shows no independent association with cognition. However, interaction analyses suggest that friend support may buffer cognitive disadvantage among “kinless” older adults in the urban West, while extended family support may buffer disadvantage among unpartnered parents in the exurban South. Together, these findings suggest that the cognitive consequences of family structure may be context dependent and that different forms of social support may play distinct compensatory roles for older adults aging with limited family ties.