Cognitive Functioning in Rural Older Adults: The Mediating Role of Perceived Social Support

Background: Aging is a multidimensional process influenced by biological, psychological, and social factors. Social support contributes to cognitive reserve by reducing stress, promoting mental engagement, and reinforcing a sense of belonging. Objective: To examine the association between perceived social support and cognitive functioning among older adults, and to investigate whether social support mediates the relationship between living arrangements and cognitive performance. Methods: The sample included 265 older adults aged 65 years and above, recruited using snowball sampling between March and July 2025 in rural communities. Instruments included the Montreal Cognitive Assessment for cognitive function and the Multidimensional Scale of Perceived Social Support for social support. Results: In this study, higher perceived social support from family, friends, and significant others was associated with better cognitive performance. Multiple regression showed that all three dimensions of social support significantly predicted MoCA scores, with the strongest effect from friends’ support. Mediation analysis revealed that perceived social support mediated the relationship between living arrangements and cognitive functioning, while the direct effect of cohabitation alone was not significant. Conclusions: These results highlight the importance of perceived social support in preserving cognitive health in older adults.