Examining Volunteering, Discrimination, and Older Adults‘ Cognitive Health Outcomes: Through a Critical Lens and Productive Aging Framework

Background and Purpose: Cognitive health is an essential part of aging, from maintaining quality of life to minimizing personal and national costs (WHO, 2022). As the older adult population expands, efforts focused on strengthening cognitive health outcomes are increasingly critical. Existing productive aging research suggests that volunteering promotes well-being and cognitive health outcomes (Gonzales et al., 2022). However, findings are inconsistent across minority racial and ethnic groups. Furthermore, limited research examines discrimination as a potential moderator for volunteering accessibility. To our knowledge, there is no known study exploring associations between volunteering, discrimination, and cognitive status using the 2020 RAND Health and Retirement Study data.

Methods: Using wave 15 from the RAND Health and Retirement Study (HRS) Longitudinal File (N= 15,336), a nationally representative panel of Americans, we examined adults over 50 years (60.05% female) who answered the Leave Behind Questionnaire and had no missing data for outcome or predictor variables (n = 4,099). Ordinal logistic regression was used to assess associations between cognitive status,volunteering intensity, and daily discrimination score. Both formal (30.06%) and informal (56.36%) volunteering was examined and cognitive status (TICS), was operationalized using the Langa-Weir classification of Normal (84.78%), Cognitive Impaired Not Dementia (CIND) (12.59%) and Dementia (2.63%). Two subgroup analyses were performed to examine differences in outcomes by race and education status.

Results: Results confirm existing literature that supports the protective relationship between volunteering and cognitive health. Both formal and informal volunteering remain significantly associated with cognitive health status (OR: 0.571, p<0.001; OR: 0.661, p<0.001) and subgroup analysis reveals nuanced findings for Non-Hispanic Black individuals (OR: 0.485, p<0.001). Both informal and formal volunteering were found to be significant and the odds ratio indicates that for every increase in formal volunteering intensity (100 to 200 hours) the odds of being in a higher category of cognitive impairment decreased by 43% (OR: 0.571; 95% CI: 0.454,0.718; p<0.001) while for every increase in informal volunteering intensity (100 to 200 hours) the odds of being in a higher category of cognitive impairment decreased by 33.9% ( OR: 0.661; 95% CI: 0.536,0.814; p<0.001). Results also indicate that as discrimination scores increase, the odds of having worse cognitive impairment increases slightly (OR: 1.057; p<0.001).

Conclusion: This study contributes to the productive aging literature by integrating discrimination into the model of volunteering, providing a nuanced lens through which to view cognitive impairment protective factors. Institutional support to encourage older adult engagement, as well as volunteering work, can have positive aspects for older adults. However, it is also critical to consider the impact of discrimination within these efforts to ensure equity in innovations. Although more research is needed to assess causality and unpack the differences among populations, it is clear we need to engage more older adults in volunteering as a means of cognitive protection.