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We reviewed 39 primary studies examining associations between dimensions of social connectedness and cognitive function\/cognitive impairment in rural adults (\u2265 40 years). Most studies (56%) focused on a single dimension of social connectedness and most (82%) were cross\u2010sectional. Sixty\u2010seven percent examined social isolation, 44% examined social support, 23% examined social engagement, and 18% examined loneliness. Social connectedness was frequently associated with cognitive outcomes (\u2265 90% of studies), with isolation and loneliness appearing detrimental and engagement and support appearing protective. Most were conducted in Asia (62%), with the remainder in North America (18%), Africa (18%), and Europe (5%). This review highlights four interrelated but distinct domains of social connectedness and underscores the need for longitudinal, multidimensional, and context\u2010specific research to inform strategies promoting cognitive resilience in rural populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71401","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:07:01Z","timestamp":1776334021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Social connectedness and cognitive outcomes in rural middle\u2010 to older\u2010age adults"],"prefix":"10.1002","volume":"22","author":[{"given":"Juyoung","family":"Park","sequence":"first","affiliation":[{"name":"College of Nursing University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilah M.","family":"Besser","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Brain Health University of Miami School of Medicine  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Tourelle","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Brain Health University of Miami School of Medicine  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Williams","sequence":"additional","affiliation":[{"name":"C.E. Lynn College of Nursing Florida Atlantic University  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Cook","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Computer Science Washington State University  Pullman Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Mitsova","sequence":"additional","affiliation":[{"name":"Department of Urban and Regional Planning Florida Atlantic University  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl","family":"Magzamen","sequence":"additional","affiliation":[{"name":"Department of Environmental and Radiological Health Sciences Colorado State University  Fort Collins Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-0877","authenticated-orcid":false,"given":"Lisa","family":"Wiese","sequence":"additional","affiliation":[{"name":"C.E. 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