Social Science & Medicine

Family structure, "Kinlessness", and cognitive decline: Social connectedness and contextual variation in Europe

Cohort study of 16,045 peoplePopulations
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Abstract

The increasing global population of older adults who are unpartnered, childless, or both ("kinless") may be at enhanced risk of cognitive decline due to a lack of nuclear family ties, yet this topic has not been examined empirically. Existing theory and evidence suggests that the direct and indirect effects of social connectedness can partially offset cognitive decline, but it is unknown if connectedness can buffer cognitive disadvantage among the "kinless". These patterns may be further complicated by cross-national variation in country region, wealth, fertility, long-term care spending, and levels of connectedness. We test these hypotheses and document variation across country contexts by analyzing cognitive decline over a 7-year period (2015-2022) for 16,045 adults aged 65+ across 17 European countries using individual-level data from the Survey of Health, Ageing and Retirement in Europe (2015 and 2022) and country-level data from multiple sources. We find evidence that "kinless" older adults are at higher risk of cognitive decline, yet this risk is primarily within a small sample of Western European countries. Social connectedness is associated with less cognitive decline, and partially but minimally buffers disadvantages among the "kinless." "Kinless" older adults who are highly connected in countries with high levels of connectedness show no cognitive disadvantage. We discuss these findings in light of diverse country contexts and emphasize the need for additional empirical examinations of existing hypotheses to identify the risks and resources available to the growing global "kinless" population.

The paper

University of Maryland, Baltimore County; Johns Hopkins University

Social Science & Medicine, 19 Dec 2025

doi.org/10.1016/j.socscimed.2025.118861PubMed 41679166