Early-life rural disadvantage and executive function in adulthood: The role of income and education

Background: This study examines the relationship between early-life rural residence and executive function (EF) in mid- and late-life and investigates the roles of educational attainment and childhood financial level. Design and Methods: Cross-sectional and longitudinal analyses were conducted using data from the Cognitive Project in Waves 2 and 3 of the Midlife in the United States (MIDUS) study. Structural equation modeling was employed to examine the relationships among these variables. Results: Educational attainment mediated the rural-EF relationship, and childhood financial status moderated the mediation model. The relationship between rurality and EF decline was fully mediated by education and differentially impacted by childhood financial status. Conclusions: Educational attainment is a key pathway between childhood rurality and adult EF. While rural individuals are at a disadvantage in educational attainment and score lower on measures of EF in adulthood, childhood financial level appears to be most impactful for individuals who grew up in urban environments.