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. 2025 Jan-Feb:61:614-621.
doi: 10.1016/j.gerinurse.2024.12.037. Epub 2025 Jan 7.

Exploring social determinants of healthcare and cognition levels among diverse older adults

Zahra Rahemi  1 , Juanita-Dawne R Bacsu  2 , Sophia Z Shalhout  3 , Maryam S Sadafipoor  4 , Matthew Lee Smith  5 , Swann Arp Adams  6
Affiliations

Exploring social determinants of healthcare and cognition levels among diverse older adults

Zahra Rahemi et al. Geriatr Nurs. 2025 Jan-Feb.

Abstract

Background: The purpose was to investigate the impact of social determinants of health on healthcare utilization among older adults in two cognition groups: normal and dementia/impaired cognition.

Methods: We used cross-sectional data from the Health and Retirement Study (N = 16,339) to assess healthcare utilization: hospital stay, nursing home stay, hospice care, and doctor visits. The respondents were classified into two cognition groups using the Langa-Weir approach.

Results: A cohort comparison between normal (mean age = 66.1) and dementia/impaired cognition (mean age = 71.9) groups revealed dementia/impaired group included more individuals from racial and ethnic minorities (42.7 % Black/Other, 20.8 % Hispanic) compared to the normal cognition (24.7 % Black/Other, 12.1 % Hispanic). They experienced longer hospital, nursing home, and hospice stays and varied doctor visit frequencies. These differences were influenced by race, age, marital status, education, and rurality.

Conclusion: Social determinants of health play an important role in predicting disparities in healthcare utilization among older adults across cognition levels.

Keywords: Cognition; Doctor visits; Health and retirement study; Hospice; Hospital; Nursing home.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

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