{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:44:53Z","timestamp":1787021093442,"version":"build-2736575974"},"reference-count":34,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec id=\"S2056472425000456_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Subjective cognitive decline (SCD) is defined as self-reported increase in confusion or memory loss. There is limited research on the interplay between rural\u2013urban residence and education on SCD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425000456_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Examine rural\u2013urban differences in SCD, and whether education moderates this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425000456_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Respondents aged \u226545 years were queried about SCD in the 2022 Behavioral Risk Factor Surveillance System data, creating a sample size of 63 890. A logistic regression analysed the association between rural\u2013urban residence and SCD, and moderation was tested by an interaction with education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425000456_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SCD was more common among rural (12.0%) compared with urban (10.7%) residents. Rural residence was associated with 9% significantly higher odds of SCD compared with urban residence after adjusting for sociodemographic and health covariates (adjusted odds ratio (aOR) = 1.09,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01). There was a negative relationship between education level and SCD, including the association of college degree with 15% lower odds of SCD compared with less than high school degree (aOR = 0.85,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01). Education was a significant moderator, with higher education associated with lower odds of SCD for urban, but not rural, residents.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425000456_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rural setting and lower education were associated with higher odds of SCD, but higher education was protective for only urban residents. These results indicate that higher education may be a gateway for more opportunities and resources in urban settings, with cascading impacts on cognition. Future research should examine reasons for the diverging cognitive benefits from education depending on rural\u2013urban residence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2025.45","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T08:17:22Z","timestamp":1744877842000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Diverging cognitive benefits from education between rural and urban middle-aged and older adults in the USA"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2243-1990","authenticated-orcid":false,"given":"Roger","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0811-1678","authenticated-orcid":false,"given":"Amer","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"S2056472425000456_ref20","doi-asserted-by":"crossref","first-page":"114044","DOI":"10.1016\/j.socscimed.2021.114044","article-title":"The effects of education on cognition in older age: evidence from genotyped siblings","volume":"280","author":"Fletcher","year":"2021","journal-title":"Soc Sci Med"},{"key":"S2056472425000456_ref21","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/1529100620920576","article-title":"Education and cognitive 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e88"}}