Abstract

INTRODUCTION: Older Black adults face higher dementia risk, but it is unclear whether social engagement offsets the effects of depression and restless sleep.

METHODS: We analyzed 1,905 Black adults aged 50+ from the 2016-2020 Health and Retirement Study (HRS). Linear mixed-effects models tested how depressive symptoms, restless sleep, and social engagement predicted baseline cognition and cognitive decline.

RESULTS: Higher depressive symptoms and restless sleep were associated with lower baseline cognition (about 0.2 and 0.5 points lower) and faster decline (β×time ≈ −0.07 and −0.05). Greater social engagement predicted higher baseline cognition (about 0.6 points higher) and slower decline (β×time ≈ 0.08). Social engagement also buffered the negative effects of depressive symptoms and restless sleep on cognitive decline but did not affect their baseline associations.

DISCUSSION: Social engagement may help older Black adults preserve cognitive health despite depression or poor sleep through accessible community, religious, and volunteer activities.

Document Type

Article

Publication Date

2026

Notes/Citation Information

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2026 The Author(s). Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association.

Digital Object Identifier (DOI)

https://doi.org/10.1002/alz.71078

Funding Information

National Institute on Aging, Grant/Award Numbers: R00AG078286 (NIA), 23AARFD-1029261, R25MH136652 (NIMH/OBSSR)

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