{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:30:00Z","timestamp":1786714200876,"version":"build-2736575974"},"posted":{"date-parts":[[2026,8,12]]},"group-title":"Public and Global Health","reference-count":34,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We examined whether perceived stress and sleep quality mediate the association between social support and later cognition among adults in the United States.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used longitudinal Midlife in the United States (MIDUS) data. Social support (1995\u20131996) was modeled as a latent construct indicated by family and friend support. Perceived stress and sleep quality were measured in the MIDUS 2 Biomarker Project (2004\u20132009), and cognition was assessed in MIDUS 2 and MIDUS 3. Structural equation models evaluated parallel indirect pathways, adjusting for MIDUS 2 cognition and covariates.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Higher social support was associated with lower perceived stress (\u03b2=\u22120.32, 95% CI:\u22120.41, \u22120.23) and better sleep quality (\u03b2=\u22120.25, 95% CI:\u22120.35, \u22120.15). Greater perceived stress was associated with lower cognition (\u03b2=\u22120.06, 95% CI:\u22120.11, \u22120.01), whereas sleep quality was not associated with cognition. Direct and total social support-cognition associations were not statistically significant. A small positive indirect association through perceived stress was identified (\u03b2=0.02, 95% CI:0.00, 0.04); no indirect association through sleep quality was identified.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Findings are consistent with a possible psychosocial pathway through perceived stress, although the effect was modest and total and direct associations were not statistically significant. Sleep quality showed no statistically significant indirect association.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.08.10.26360099","type":"posted-content","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:10:52Z","timestamp":1786579852000},"source":"Crossref","is-referenced-by-count":0,"title":["Pathways from Social Support to Cognition Among Adults in the United States: A Longitudinal Mediation Analysis of Perceived Stress and Sleep Quality"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0695-414X","authenticated-orcid":false,"given":"Soomin","family":"Ryu","sequence":"first","affiliation":[{"name":"Department of Public Health, College of Health Sciences, University of Missouri, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjin L.","family":"Tracy","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Science, College of Education and Human Development, University of Missouri, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth","family":"Miller","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Psychological Sciences, University of Missouri, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill A.","family":"Kanaley","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idethia Shevon","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Health Sciences, University of Missouri, Columbia, MO, 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