Normative Data on Cognitive Performance in Urban and Rural Populations of Kazakhstan: A Cross-Sectional Analysis

Abstract Objectives. Evidence on cognitive performance among older adults in Kazakhstan and Central Asia remains limited. This study aimed to establish normative values for neuropsychological tests among adults living in urban and rural areas of Kazakhstan, stratified by age and educational attainment. Methods. This cross-sectional study included 1,648 adults aged 50–75 years randomly selected from urban and rural communities in Central and East Kazakhstan between 2012 and 2016. Four standardized neuropsychological tests assessed verbal memory and learning, verbal fluency, attention, and concentration. Normative values were calculated separately by urban-rural residence, age group, and educational level. Results. Cognitive performance generally declined with increasing age and was higher among participants with greater educational attainment. Urban residents demonstrated higher mean scores than rural residents on immediate word recall (18.98 vs. 16.49), animal naming (18.17 vs. 16.37), and delayed word recall (6.32 vs. 5.71), whereas rural residents scored higher on letter cancellation (22.06 vs. 19.76; all p < 0.001). Age-, education-, and residence-specific percentile norms were established for all four cognitive tests. Discussion. This study provides some of the first population-based normative data for multiple cognitive domains among urban and rural adults in Kazakhstan. These reference values may support the interpretation of cognitive assessments in comparable Central Asian populations, although further validation and studies involving older age groups are needed.