All ETDs from UAB

Advisory Committee Chair

Michael Crowe

Advisory Committee Members

Catherine Garcia

Bulent Turan

Document Type


Date of Award


Degree Name by School

Master of Arts (MA) College of Arts and Sciences


Isolation and other indicators of poor social environment have been associated with a higher risk of cognitive decline. Overall evidence for this association is mixed, with most studies being conducted in Western, educated, industrialized, rich, and democratic (aka “WEIRD”) societies. Religiosity may moderate this relationship between less robust social environments and cognition by buffering the negative effects of stress. The primary aim of this study is to assess the relationship between indicators of the social environment and psychological distress (depressive symptoms) and cognitive decline in a population-based sample of older Puerto Rican adults (n=3,557) across two time-points. Social environment included living alone (objective isolation) and familial social network (FSN; assessed through proportion of children and siblings living in PR, and total number of individuals in the family network). Psychological distress was measured using the 15-item Geriatric Depression Scale (GDS), and religiosity was measured via three variables: degree of religiosity and coping; religious engagement; and a sum of these two variables for overall religiosity. Regression analyses were based on a hypothesized model whereby isolation and FSN would have a direct relationship to cognition and an indirect relationship through psychological distress (depressive symptoms). Religiosity was examined as a moderator of the relationship between social environment and outcomes of interest. Living alone was associated with higher depressive symptoms, and this association was buffered by religiosity; there was no association between living alone and depressive symptoms in those with higher religiosity. However, none of the social indicators predicted cognition at follow-up, and religiosity did not moderate any relationships with cognitive change. Change in living situation (i.e., living alone vs. with others) was significantly associated with follow-up cognition, where those who were newly with others at follow-up had more cognitive decline compared to those who were alone at both timepoints. Results provide evidence for the isolation-psychological distress relationship, including support for religiosity as a buffer for negative effects of isolation. Further, findings highlight complex associations between cognition and living situation, whereby older people in Puerto Rico with cognitive decline are more likely to move in with others.