Lifespan exposures to rural-urban conditions and later-life cognitive function.

INTRODUCTION: Limited research exists on life-course rural-urban residence and cognitive functions.

METHODS: This study examines associations between rural-urban residence during childhood, adulthood, residential mobility (childhood to adulthood), and later-life cognitive outcomes among U.S. adults ≥65 years of age (N = 3073) from the Health and Retirement Study-Harmonized Cognitive Assessment Protocol.

RESULTS: Linear and logistic regression showed that childhood rural residence was associated with lower memory (standardized beta (β) = -1.68, 95% Confidence Interval (CI) [-2.39, -0.97]), executive function (β = -1.20, 95% CI [-1.84, -0.55]), and language fluency (β = -0.86, 95% CI [-1.64, -0.08]). Individuals living in rural areas in childhood had a higher risk for mild cognitive impairment (MCI; odds ratio [OR] = 1.31, 95% CI [1.02, 1.69]) and dementia/MCI (OR = 1.30, 95% CI [1.04, 1.62]). Compared to lifelong urban residents; residents who lived in rural areas during childhood and/or adulthood had lower cognitive function and a higher risk of MCI.

DISCUSSION: Rural residence throughout the lifespan, especially during childhood, is linked to poorer later-life cognitive outcomes, underscoring the need for early targeted health care interventions to address rural-urban disparities.

HIGHLIGHTS: Few studies have examined the timing of rural residence on cognitive health. Rural residence across the lifespan is associated with lower cognitive function. Childhood rurality is particularly associated with lower cognitive function.