{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:45:12Z","timestamp":1782927912628,"version":"3.54.5"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":124,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01AG078406"],"award-info":[{"award-number":["K01AG078406"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Educational attainment and mid-to-later-life social engagement are modifiable risk factors for dementia, yet limited research examines how these factors intersect to shape dementia risk. This study estimates the extent to which social engagement may act as a pathway through which education influences incident dementia, and which forms of social engagement may most reduce educational differences in incident dementia among older adults in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>We used survival and counterfactual decomposition analyses of the 2011\u20132018 National Health and Aging Trends Study to assess whether, and to what extent, different forms of social engagement mediate and interact with the effect of educational attainment on incident dementia. We compared total and controlled direct effects to assess how educational differences in incident dementia may shift under hypothetical scenarios of having large discussion networks and prior-month engagement in social activities among older adults with higher and lower levels of education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Going out for enjoyment, visiting with friends\/family, volunteering, and organized group activities were significant partial mediating pathways in the association between education and incident dementia. When prior-month volunteering, organized group activity attendance, and a large network size were modeled as mediators, educational differences in incident dementia were attenuated and became statistically nonsignificant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>Findings suggest increasing older adults\u2019 participation in volunteering and group activities, as well as larger discussion networks, may reduce educational disparities in dementia risk. Future research should investigate the mechanisms driving these results and whether they extend to other social activities not examined in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geroni\/igag051","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:26:12Z","timestamp":1777638372000},"source":"Crossref","is-referenced-by-count":0,"title":["Is social connection the key to prevention? Educational attainment, incident dementia, and the role of later-life social engagement"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1634-660X","authenticated-orcid":false,"given":"Alyssa W","family":"Goldman","sequence":"first","affiliation":[{"name":"Department of Sociology, Boston College , Chestnut Hill, Massachusetts,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2385-7854","authenticated-orcid":false,"given":"Hyungmin","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Sociology, Center for Studies in Demography and Ecology, University of Washington , Seattle, Washington,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-4231","authenticated-orcid":false,"given":"Reza","family":"Tayari Ashtiani","sequence":"additional","affiliation":[{"name":"Department of Sociology, Boston College , Chestnut Hill, Massachusetts,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026070112520666200_igag051-B1","doi-asserted-by":"publisher","first-page":"S311","DOI":"10.1093\/geronb\/60.6.S311","article-title":"Social networks among men and women: The effects of age and socioeconomic status","volume":"60","author":"Ajrouch","year":"2005","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B2","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1002\/ana.21509","article-title":"Prodromal Alzheimer\u2019s disease: Successive emergence of the clinical symptoms","volume":"64","author":"Amieva","year":"2008","journal-title":"Annals of Neurology"},{"key":"2026070112520666200_igag051-B3","doi-asserted-by":"publisher","first-page":"237802311879721","DOI":"10.1177\/2378023118797217","article-title":"Higher education, bigger networks? Differences by family socioeconomic background and network measures","volume":"4","author":"Andersson","year":"2018","journal-title":"Socius: Sociological Research for a Dynamic World"},{"key":"2026070112520666200_igag051-B4","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/S1474-4422(06)70417-3","article-title":"The effect of social networks on the relation between Alzheimer\u2019s disease pathology and level of cognitive function in old people: A longitudinal cohort study","volume":"5","author":"Bennett","year":"2006","journal-title":"The Lancet Neurology"},{"key":"2026070112520666200_igag051-B5","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1080\/13607863.2018.1488940","article-title":"Educational level and its Association with the domains of the Montreal Cognitive Assessment Test","volume":"23","author":"Borda","year":"2019","journal-title":"Aging & Mental Health"},{"key":"2026070112520666200_igag051-B6","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.1093\/geronb\/gbaa193","article-title":"Cross-lagged modeling of cognition and social network size in the Sydney Memory and Ageing Study","volume":"76","author":"Casey","year":"2021","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B7236755","doi-asserted-by":"publisher","first-page":"733","DOI":"10.4054\/demres.2024.50.26","article-title":"The importance of education for understanding variability of dementia onset in the United States.","volume":"50","author":"Cha,","journal-title":"Demographic Research"},{"key":"2026070112520666200_igag051-B7","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1215\/00703370-12231508","article-title":"How does the risk of dementia change with each additional year of education?","volume":"62","author":"Cha,","journal-title":"Demography"},{"key":"2026070112520666200_igag051-B8","doi-asserted-by":"publisher","first-page":"e14316","DOI":"10.1002\/alz.14316","article-title":"Late-life social activity and subsequent risk of dementia and mild cognitive impairment","volume":"21","author":"Chen","year":"2025","journal-title":"Alzheimer\u2019s & Dementia"},{"issue":"7921","key":"2026070112520666200_igag051-B9","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1038\/s41586-022-04997-3","article-title":"Social capital II: Determinants of economic connectedness","volume":"608","author":"Chetty","year":"2022","journal-title":"Nature"},{"key":"2026070112520666200_igag051-B10","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1093\/geront\/gnaa070","article-title":"Patterns and predictors of transitions across residential care settings and nursing homes among community-dwelling older adults in the United States","volume":"60","author":"Chyr","year":"2020","journal-title":"The Gerontologist"},{"key":"2026070112520666200_igag051-B11","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1037\/0021-843X.112.4.558","article-title":"Testing mediational models with longitudinal data: Questions and tips in the use of structural equation modeling","volume":"112","author":"Cole","year":"2003","journal-title":"Journal of Abnormal Psychology"},{"key":"2026070112520666200_igag051-B12","doi-asserted-by":"publisher","first-page":"S20","DOI":"10.1093\/geronb\/gbx135","article-title":"Educational differences in the prevalence of dementia and life expectancy with dementia: Changes from 2000 to 2010","volume":"73(suppl_1)","author":"Crimmins","year":"2018","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B13","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1093\/ije\/dyy236","article-title":"Med4way: A Stata command to investigate mediating and interactive mechanisms using the four-way effect decomposition","volume":"48","author":"Discacciati","year":"2019","journal-title":"International Journal of Epidemiology"},{"key":"2026070112520666200_igag051-B14","doi-asserted-by":"publisher","first-page":"76S","DOI":"10.1177\/08982643241308450","article-title":"Subjective cognitive impairment (SCI) and future dementia risk in the National Health and Aging Trends Study (NHATS) During 2012\u20132019","volume":"37(3-4_suppl)","author":"Drabo","year":"2025","journal-title":"Journal of Aging and Health"},{"key":"2026070112520666200_igag051-B15","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1093\/geronb\/gbad088","article-title":"Education, social engagement, and cognitive function: A cross-lagged panel analysis","volume":"78","author":"Du","year":"2023","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B16","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.socscimed.2014.05.007","article-title":"The mix matters: Complex personal networks relate to higher cognitive functioning in old age","volume":"125","author":"Ellwardt","year":"2015","journal-title":"Social Science and Medicine"},{"key":"2026070112520666200_igag051-B17","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1177\/08982643211029716","article-title":"Trends in dementia prevalence, incidence, and mortality in the United States (2000\u20132016)","volume":"34","author":"Farina","year":"2022","journal-title":"Journal of Aging and Health"},{"key":"2026070112520666200_igag051-B18","doi-asserted-by":"publisher","first-page":"115220","DOI":"10.1016\/j.socscimed.2022.115220","article-title":"Cognability: An ecological theory of neighborhoods and cognitive aging","volume":"309","author":"Finlay","year":"2022","journal-title":"Social Science & Medicine"},{"key":"2026070112520666200_igag051-B19","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1177\/0022146514568669","article-title":"Healthy time use in the encore years: Do work, resources, relations, and gender matter?","volume":"56","author":"Flood","year":"2015","journal-title":"Journal of Health and Social Behavior"},{"key":"2026070112520666200_igag051-B20","doi-asserted-by":"publisher","first-page":"e0261532","DOI":"10.1371\/journal.pone.0261532","article-title":"Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study","volume":"16","author":"Fluharty","year":"2021","journal-title":"PLOS ONE"},{"key":"2026070112520666200_igag051-B21","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/S1474-4422(04)00767-7","article-title":"An active and socially integrated lifestyle in late life might protect against dementia","volume":"3","author":"Fratiglioni","year":"2004","journal-title":"The Lancet Neurology"},{"key":"2026070112520666200_igag051-B22","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1212\/01.wnl.0000172958.95282.2a","article-title":"The AD8: A brief informant interview to detect dementia","volume":"65","author":"Galvin","year":"2005","journal-title":"Neurology"},{"key":"2026070112520666200_igag051-B23","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1093\/geront\/gnaa112","article-title":"Educational benefits and cognitive health life expectancies: Racial\/ethnic, nativity, and gender disparities","volume":"61","author":"Garcia","year":"2021","journal-title":"The Gerontologist"},{"key":"2026070112520666200_igag051-B24","doi-asserted-by":"publisher","first-page":"e70029","DOI":"10.1002\/bsa3.70029","article-title":"Associations between U.S. county-level social infrastructure and dementia among Medicare beneficiaries, 2020","volume":"1","author":"Goldman","year":"2025","journal-title":"Alzheimer\u2019s & Dementia: Behavior & Socioeconomics of Aging"},{"key":"2026070112520666200_igag051-B25","doi-asserted-by":"publisher","DOI":"10.1177\/07334648251386107","article-title":"Assessing the mediating roles of global sensory impairment, social isolation, and loneliness in the association between education and cognitive function","volume":"07334648251386107","author":"Goldman","year":"2025","journal-title":"Journal of Applied Gerontology"},{"key":"2026070112520666200_igag051-B26","doi-asserted-by":"publisher","first-page":"100275","DOI":"10.1016\/j.wss.2025.100275","article-title":"Exploring place-based loneliness interventions: A realist review","volume":"8","author":"Gryp","year":"2025","journal-title":"Wellbeing, Space and Society"},{"key":"2026070112520666200_igag051-B27","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1093\/geronb\/gbab015","article-title":"The importance of improving educational attainment for dementia prevalence trends from 2000 to 2014, among older non-Hispanic Black and White Americans","volume":"76","author":"Hayward","year":"2021","journal-title":"Journals of Gerontology - Series B Psychological Sciences and Social Sciences"},{"key":"2026070112520666200_igag051-B28","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1017\/S1355617711000531","article-title":"Late-life social activity and cognitive decline in old age","volume":"17","author":"James","year":"2011","journal-title":"Journal of the International Neuropsychological Society"},{"key":"2026070112520666200_igag051-B29","volume-title":"Classification of Persons by Dementia Status in the National Health and Aging Trends Study","author":"Kasper","year":"2013"},{"key":"2026070112520666200_igag051-B30","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jamainternmed.2016.6807","article-title":"A comparison of the prevalence of dementia in the United States in 2000 and 2012","volume":"177","author":"Langa","year":"2017","journal-title":"JAMA Internal Medicine"},{"issue":"10452","key":"2026070112520666200_igag051-B31","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission","volume":"404","author":"Livingston","year":"2024","journal-title":"The Lancet"},{"key":"2026070112520666200_igag051-B32","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1529100620920576","article-title":"Education and cognitive functioning across the life span","volume":"21","author":"L\u00f6vd\u00e9n","year":"2020","journal-title":"Psychological Science in the Public Interest"},{"key":"2026070112520666200_igag051-B33","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1186\/s12889-015-2426-6","article-title":"Social activity, cognitive decline and dementia risk: A 20-year prospective cohort study","volume":"15","author":"Marioni","year":"2015","journal-title":"BMC Public Health"},{"key":"2026070112520666200_igag051-B34","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1093\/geronb\/gbu002","article-title":"An investigation of activity profiles of older adults","volume":"69","author":"Morrow-Howell","year":"2014","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B35","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.annepidem.2015.10.006","article-title":"Instrumental variable approaches to identifying the causal effect of educational attainment on dementia risk","volume":"26","author":"Nguyen","year":"2016","journal-title":"Annals of Epidemiology"},{"key":"2026070112520666200_igag051-B36","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1353\/sof.2004.0049","article-title":"Volunteerism during the transition to adulthood: A life course perspective","volume":"82","author":"Oesterle","year":"2004","journal-title":"Social Forces"},{"key":"2026070112520666200_igag051-B37","volume-title":"Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General\u2019s Advisory on the Healing Effects of Social Connection and Community","author":"Office of the Surgeon General (OSG)","year":"2023"},{"key":"2026070112520666200_igag051-B38","doi-asserted-by":"publisher","first-page":"00221465251356611","DOI":"10.1177\/00221465251356611","article-title":"A life course perspective on cognitive aging: The interplay between early and later life stimulating environments","author":"Peng","year":"2025","journal-title":"Journal of Health and Social Behavior"},{"key":"2026070112520666200_igag051-B39","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/J.NEUROBIOLAGING.2022.01.004","article-title":"Cognitively stimulating environments and cognitive reserve: The case of personal social networks","volume":"112","author":"Peng","year":"2022","journal-title":"Neurobiology of Aging"},{"key":"2026070112520666200_igag051-B40","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1002\/alz.12443","article-title":"Why the cognitive \u201cfountain of youth\u201d may be upstream: Pathways to dementia risk and resilience through social connectedness","volume":"18","author":"Perry","year":"2022","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2026070112520666200_igag051-B41","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1093\/GERONT\/GNAB112","article-title":"Social networks and cognitive function: An evaluation of social bridging and bonding mechanisms","volume":"62","author":"Perry","year":"2022","journal-title":"The Gerontologist"},{"key":"2026070112520666200_igag051-B42","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1093\/geronb\/gbab192","article-title":"Social networks and cognitive reserve: Network structure moderates the association between Amygdalar volume and cognitive outcomes","volume":"77","author":"Perry","year":"2022","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B43","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1093\/geronb\/gbx110","article-title":"Longitudinal associations between formal volunteering and cognitive functioning","volume":"73","author":"Proulx","year":"2018","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B44","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.gerinurse.2023.10.020","article-title":"The relationship between volunteering and cognitive performance in older adults: A systematic review","volume":"55","author":"Sharifi","year":"2024","journal-title":"Geriatric Nursing"},{"key":"2026070112520666200_igag051-B45","doi-asserted-by":"publisher","first-page":"k4925","DOI":"10.1136\/bmj.k4925","article-title":"Intellectual engagement and cognitive ability in later life (the \u201cuse it or lose it\u201d conjecture): Longitudinal, prospective study","volume":"363","author":"Staff","year":"2018","journal-title":"BMJ"},{"key":"2026070112520666200_igag051-B46","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1016\/j.neuropsychologia.2009.03.004","article-title":"Cognitive reserve","volume":"47","author":"Stern","year":"2009","journal-title":"Neuropsychologia"},{"key":"2026070112520666200_igag051-B47","doi-asserted-by":"publisher","first-page":"104847","DOI":"10.1016\/j.archger.2022.104847","article-title":"Sense of meaning and purpose in life and risk of incident dementia: New data and meta-analysis","volume":"105","author":"Sutin","year":"2023","journal-title":"Archives of Gerontology and Geriatrics"},{"key":"2026070112520666200_igag051-B48","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1146\/annurev-devpsych-121318-085204","article-title":"Cognitive Aging and Dementia: A Life-Span Perspective","volume":"1","author":"Tucker-Drob","year":"2019","journal-title":"Annual Review of Developmental Psychology"},{"key":"2026070112520666200_igag051-B49","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1017\/S0144686X0300134X","article-title":"Network size and support in old age: Differentials by socio-economic status in childhood and adulthood","volume":"23","author":"Van Groenou","year":"2003","journal-title":"Ageing and Society"},{"key":"2026070112520666200_igag051-B50","doi-asserted-by":"publisher","first-page":"S308","DOI":"10.1093\/geronb\/55.5.S308","article-title":"Differential benefits of volunteering across the life course","volume":"55","author":"Van Willigen","year":"2000","journal-title":"The Journals of Gerontology: Series B"},{"key":"2026070112520666200_igag051-B51","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1097\/EDE.0000000000000121","article-title":"A unification of mediation and interaction: A 4-way decomposition","volume":"25","author":"VanderWeele","year":"2014","journal-title":"Epidemiology"},{"issue":"1","key":"2026070112520666200_igag051-B52","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1146\/annurev-publhealth-032315-021402","article-title":"Mediation analysis: A practitioner\u2019s guide","volume":"37","author":"VanderWeele","year":"2016","journal-title":"Annual Review of Public Health"},{"key":"2026070112520666200_igag051-B53","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1177\/0898264319852835","article-title":"Seven-year trajectories of depressive symptoms and their predictors among older Americans","volume":"32","author":"Xiang","year":"2020","journal-title":"Journal of Aging and Health"},{"key":"2026070112520666200_igag051-B54","doi-asserted-by":"publisher","first-page":"294","DOI":"10.15195\/v12.a14","article-title":"Inequality and social ties: Evidence from 15 U.S. data sets","volume":"12","author":"Young","year":"2025","journal-title":"Sociological Science"}],"container-title":["Innovation in Aging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/innovateage\/advance-article-pdf\/doi\/10.1093\/geroni\/igag051\/68210441\/igag051.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/innovateage\/article-pdf\/10\/7\/igag051\/68210441\/igag051.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/innovateage\/article-pdf\/10\/7\/igag051\/68210441\/igag051.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:53:12Z","timestamp":1782924792000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/innovateage\/article\/doi\/10.1093\/geroni\/igag051\/8667279"}},"subtitle":[],"editor":[{"given":"Yong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":55,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6,16]]}},"URL":"https:\/\/doi.org\/10.1093\/geroni\/igag051","relation":{},"ISSN":["2399-5300"],"issn-type":[{"value":"2399-5300","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"igag051"}}