Spiritual/religious coping and cognitive function of urban-rural Brazilian community-dwelling older adults

Authors

DOI:

https://doi.org/10.31211/rpics.2025.11.2.352

Keywords:

Cognitive Function, Cognitive Impairment, Spirituality, Religiosity, Aging, Older adults, Rural–urban differences, Brazil

Abstract

Background and Aim: We compared cognitive function among Brazilian older adults residing in rural versus urban settings and examined whether positive and negative spiritual/religious coping (SRC) were associated with cognitive outcomes. Method: We conducted a comparative cross-sectional analysis of two independent samples: older adults residing in rural areas of two small towns in Minas Gerais (N = 326), and older adults from the city of São Paulo (N = 400). Measures included the Mini-Mental State Examination (MMSE), the Brief Spiritual/Religious Coping Scale, and a sociodemographic/health questionnaire. Results: After controlling for sociodemographic and health covariates, rural residents had significantly higher MMSE scores than urban residents (mean difference = 7.43, p <.001).  Among rural participants, higher positive SRC was associated with better cognitive function (β = 1.6; p < .001). Among urban participants, higher negative SRC was associated with worse cognitive outcomes (β = −0.39; p = .021). Conclusions: In Brazil, rural residence may be associated with better late-life cognitive function. Positive SRC may relate to cognitive benefits, whereas negative SRC may be linked to poorer cognition—particularly in urban contexts. Findings may guide health professionals in addressing SRC with older adults, especially in large urban centers.

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References

Bertolucci, P. H. F., Brucki, S. M. D., Campacci, S. R., & Juliano, Y. (1994). O Mini-Exame do Estado Mental em uma população geral: Impacto da escolaridade. Arquivos de Neuro-Psiquiatria, 52(1), 01–07. https://doi.org/bsvgqb

Besser, L. M., McDonald, N. C., Song, Y., Kukull, W. A., & Rodriguez, D. A. (2017). Neighborhood environment and cognition in older adults: A systematic review. American Journal of Preventive Medicine, 53(2), 241–251. https://doi.org/gbqqw2

Brucki, S. M. D., Nitrini, R., Caramelli, P., Bertolucci, P. H. F., & Okamoto, I. H. (2003). Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arquivos de Neuro-Psiquiatria, 61(3B), 777–781. https://doi.org/bqmd47

Campos, C. G., Diniz, B. S., Firmo, J. O., Lima-Costa, M. F., Blay, S. L., & Castro-Costa, E. (2020). Mild and moderate cognitive impairment and mortality among Brazilian older adults in long-term follow-up: The Bambui health aging study. Brazilian Journal of Psychiatry, 42(6), 583–590. https://doi.org/m8z4

Casemiro, N. V., & Ferreira, H. G. (2020). Indicadores de saúde mental em idosos frequentadores de grupos de convivência. Revista da SPAGESP, 21(2), 83–96. https://bit.ly/4d8d6UP

Cassarino, M., & Setti, A. (2015). Environment as "Brain Training": A review of geographical and physical environmental influences on cognitive ageing. Ageing Research Reviews, 23, 167–182. https://doi.org/ggcdrh

Chang, A. Y., Skirbekk, V. F., Tyrovolas, S., Kassebaum, N. J., & Dieleman, J. L. (2019). Measuring population ageing: An analysis of the Global Burden of Disease Study 2017. The Lancet Public Health, 4(3), e159–e167. https://doi.org/gjqn6b

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.

Dominguez, L. J., Veronese, N., & Barbagallo, M. (2024). The link between spirituality and longevity. Aging Clinical and Experimental Research, 36(1), Article 32. https://doi.org/m82n

Esperandio, M. R. G., Escudero, F. T., Fernandes, M. L., & Pargament, K. I. (2018). Brazilian validation of the Brief Scale for Spiritual/Religious Coping—SRCOPE-14. Religions, 9(1), Article 31. https://doi.org/qgm5

Haney, A. M., & Lane, S. P. (2024). Religious coping is differentially associated with physiological and subjective distress indicators: Comparing cortisol and self-report patterns. Behavioral Medicine, 50(4), 312–320. https://doi.org/qgm4

Hill, P. C., Pargament, K. I., Hood Jr., R. W., McCullough, M. E., Swyers, J. P., Larson, D. B., & Zinnbauer, B. J. (2000). Conceptualizing religion and spirituality: Points of commonality, points of departure. Journal for the Theory of Social Behaviour, 30(1), 51–77. https://doi.org/bp3c83

Hosseini, S., Chaurasia, A., & Oremus, M. (2017). The effect of religion and spirituality on cognitive function: A systematic review. The Gerontologist, 59(2), e76–e85. https://doi.org/m8z5

Hyun, J., Hall, C. B., Katz, M. J., Derby, C. A., Lipnicki, D. M., Crawford, J. D., Guaita, A., Vaccaro, R., Davin, A., Kim, K. W., Han, J. W., Bae, J. B., Röhr, S., Riedel-Heller, S., Ganguli, M., Jacobsen, E., Hughes, T. F., Brodaty, H., Kochan, N. A., & Trollor, J. (2022). Education, occupational complexity, and incident dementia: A COSMIC collaborative cohort study. Journal of Alzheimer's Disease, 85(1), 179–196. https://doi.org/m8z6

Instituto Brasileiro de Geografia e Estatística. (2017). Classificação e caracterização dos espaços rurais e urbanos do Brasil: Uma primeira aproximação. IBGE. https://bit.ly/3LACslZ

Instituto Brasileiro de Geografia e Estatística. (2020). Regiões de influência das cidades: REGIC 2018. IBGE. https://bit.ly/44fxBge

Jang, H., Hill, N. L., Turner, J. R., Bratlee-Whitaker, E., Jeong, M., & Mogle, J. (2024). Poor-quality daily social encounters, daily stress, and subjective cognitive decline among older adults. Innovation in Aging, 8(6), Artigo igae038. https://doi.org/m82p

Jung, J., Lee, C. H., Shin, K., Roh, D., Lee, S.-K., Moon, Y. S., Jon, D.-I., & Kim, D. H. (2019). Specific association between religiosity and cognitive functions in Alzheimer's Disease. American Journal of Alzheimer's Disease & Other Dementias, 34(4), 254–260. https://doi.org/m82b

Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health. Oxford University Press.

Koenig, H. G. (2022). Religion, spirituality, and health: A review and update. Advances in Mind-Body Medicine, 36(1), 4–12.

Krause, N. (2006). Religious involvement, gratitude, and change in depressive symptoms over time. The International Journal for the Psychology of Religion, 16(1), 55–72.

Li, B., Guo, Y., Deng, Y., Zhao, S., Li, C., Yang, J., Li, Q., Yan, Y., Li, F., Li, X., & Rong, S. (2022). Association of social support with cognition among older adults in China: A cross-sectional study. Frontiers in Public Health, 10. https://doi.org/gqwdzx

Li, S., Stampfer, M. J., Williams, D. R., & VanderWeele, T. J. (2016). Association of religious service attendance with mortality among women. JAMA Internal Medicine, 176(6), 777–85. https://doi.org/ghdxh3

Li, X.-Y., Zhang, M., Xu, W., Li, J.-Q., Cao, X.-P., Yu, J.-T., & Tan, L. (2020). Midlife modifiable risk factors for dementia: A systematic review and meta-analysis of 34 prospective cohort studies. Current Alzheimer Research, 16(14), 1254–1268. https://doi.org/ggk3dj

Lucchetti, G., Lucchetti, A. L. G., & Koenig, H. G. (2011). Impact of spirituality/religiosity on mortality: Comparison with other health interventions. Explore, 7(4), 234–238. https://doi.org/qdvb

Nelson, I., Kezios, K., Elbejjani, M., Lu, P., Yaffe, K., & Zeki Al Hazzouri, A. (2022). Associations of religious service attendance with cognitive function in midlife: Findings from The CARDIA Study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 78(4), 684–694. https://doi.org/m82c

Nunes, B., Silva, R. D., Cruz, V. T., Roriz, J. M., Pais, J., & Silva, M. C. (2010). Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal. BMC Neurology, 10(1), Article 42. https://doi.org/dpshq4

Passarelli-Araujo, H. (2025). Loneliness in Brazil: A silent threat to public health. Cadernos de Saúde Pública, 41(7). https://doi.org/qgm6

Paanalahti, M., Alt Murphy, M., Holmström Rising, M., & Viitasara, E. (2022). Functioning and disability in community-living people with perceived cognitive impairment or dementia: A mixed methods study using the World Health Organization Disability Assessment Schedule. Journal of Rehabilitation Medicine, 55, Article jrm00352. https://doi.org/grjk3d

Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. Guilford Press.

Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients. Archives of Internal Medicine, 161(15), 1881-5. https://doi.org/bncr8h

Pargament, K., Feuille, M., & Burdzy, D. (2011). The Brief RCOPE: Current psychometric status of a Short Measure of Religious Coping. Religions, 2(1), 51–76. https://doi.org/fjwfz8

Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2009). Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine, 12(10), 885–904. https://doi.org/fp28h4

Quinn, B., & Connolly, M. (2023). Spirituality in palliative care. BMC Palliative Care, 22(1), Article 1. https://doi.org/m82r

Rhee, T. G., Shim, S. R., Manning, K. J., Tennen, H. A., Kaster, T. S., d'Andrea, G., Forester, B. P., Nierenberg, A. A., McIntyre, R. S., & Steffens, D. C. (2024). Neuropsychological assessments of cognitive impairment in major depressive disorder: A systematic review and meta-analysis with meta-regression. Psychotherapy and Psychosomatics, 93(1), 8–23. https://doi.org/gtkmtf

Rivoli, F. M. S., Galhardo, A. P. G. M., Lucchetti, G., Esper, L. A., Ribeiro, Y. L., Santos, G. d. S., José, H., Sousa, L., Low, G., & Vitorino, L. M. (2025). One year changes in depressive symptoms and cognitive function among Brazilian older adults attending primary care. Healthcare (Basel), 13(7), Article 807. https://doi.org/qdvc

Rosmarin, D. H., Pargament, K. I., & Koenig, H. G. (2020). Spirituality and mental health: Challenges and opportunities. The Lancet Psychiatry, 8(2), 92–93. https://doi.org/m82k

Russ, T. C., Batty, G. D., Hearnshaw, G. F., Fenton, C., & Starr, J. M. (2012). Geographical variation in dementia: Systematic review with meta-analysis. International Journal of Epidemiology, 41(4), 1012–1032. https://doi.org/f378jt

Salardini, A., Himali, J. J., Abdullah, M. S., Chaudhari, R., Young, V., Zilli, E. M., McGrath, E. R., Gonzales, M. M., Thibault, E. G., Salinas, J., Aparicio, H. J., Himali, D., Ghosh, S., Buckley, R. F., Satizabal, C. L., Johnson, K. A., DeCarli, C., Fakhri, G. E., Vasan, R. S., Beiser, A. S., & Seshadri, S. (2025). Elevated serum cortisol associated with early‐detected increase of brain amyloid deposition in Alzheimer's disease imaging biomarkers among menopausal women: The Framingham Heart Study. Alzheimer's & Dementia, 21(4), Article e70179. https://doi.org/qdvd

Saldiva, P. (2018). Vida Urbana e Saúde: Os desafios dos habitantes das metrópoles. Editora Contexto: São Paulo, Brazil.

Silva, M., & Vitorino, L. M. (2020). Religiosidade e espiritualidade na prática clínica da enfermagem: revisão da literatura e desenvolvimento de protocolo. HU Revista, 44(4), 469–479. https://doi.org/m82s

Vitorino, L. M., Low, G., & Vianna, L. A. C. (2016). Linking spiritual and religious coping with the quality of life of community‑dwelling older adults and nursing home residents. Gerontology & Geriatric Medicine, 2, Article 2333721416658140. https://doi.org/gcdxk8

Vitorino, L. M., Lucchetti, G., Leão, F. C., Vallada, H., & Peres, M. F. P. (2018). The association between spirituality and religiousness and mental health. Scientific Reports, 8(1), Article 17233. https://doi.org/gfqzkm

Vitorino, L. M., Low, G., & Lucchetti, G. (2019). Is the physical environment associated with spiritual and religious coping in older age? Evidence from Brazil. Journal of Religion and Health, 58(5), 1648–1660. https://doi.org/m82q

Vitorino, L. M., Lucchetti, A. L. G., & Lucchetti, G. (2022). The role of spirituality and religiosity on the cognitive decline of community-dwelling older adults: A 4-year longitudinal study. Aging & Mental Health, 27(8), 1526–1533. https://doi.org/m8z9

Wilker, E. H., Osman, M., & Weisskopf, M. G. (2023). Ambient air pollution and clinical dementia: Systematic review and meta-analysis. BMJ, 381, Article e071620. https://doi.org/gr7wx2

Published

2025-11-30

How to Cite

Vitorino, L. M., Low, G., Campos, M. A., Costa, V. P., Santos, G. de S., França, A. B., Vianna, L. A. C., Lemes, A. A., Alckmin-Carvalho, F., & Guerra, Z. F. (2025). Spiritual/religious coping and cognitive function of urban-rural Brazilian community-dwelling older adults. Portuguese Journal of Behavioral and Social Research, 11(2), 1–13. https://doi.org/10.31211/rpics.2025.11.2.352

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Original Paper