The impact of volunteering on cognition and cognitive decline in older diverse cohorts: KHANDLE and STAR.
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2026-01
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Abstract
Introduction
Volunteering is linked to cognitive benefits in aging, but evidence in diverse populations is limited.Methods
We examined volunteering and cognition in Kaiser Healthy Aging and Diverse Life Experiences Study/Study of Healthy Aging in African Americans participants (N = 2789) with unimpaired cognition at baseline. Volunteering and frequency of volunteering in the past year at baseline were self-reported, and cognition (executive function [EF], verbal episodic memory [VEM]) was assessed with the Spanish and English Neuropsychological Assessment Scale across 4 waves (range of follow-up: 2-6 years). Linear mixed-effect models adjusted for demographics.Results
Participants were 73.8 ± 7.8 years on average; 62% women; 45% Black, 21% White, 18% Asian, and 17% Hispanic/Latin(x); and 47% reported volunteering. Volunteers had higher baseline EF and VEM than non-volunteers, with the largest gains among those volunteering a few times per week. Volunteering was not associated with rates of cognitive decline.Discussion
Volunteering was associated with better baseline cognition but not slower decline, suggesting immediate cognitive benefits for racially and ethnically diverse older adults.Highlights
Kaiser Healthy Aging and Diverse Life Experiences Study and Study of Healthy Aging in African Americans are a racially/ethnically diverse cohort (18% Asian, 47% Black, 17% Latin[x], 21% White) reporting volunteering within 12 months prior to baseline. Late-life (55+ years) volunteering is associated with better executive function (β = 0.173, 95% confidence interval [CI]: 0.114-0.232) and verbal episodic memory (β = 0.132, 95% CI: 0.071-0.192) after adjusting for age, gender/sex, education, race/ethnicity, instrumental activities of daily living, and self-rated health. Volunteering in late life, a few times per week, is associated with the highest magnitude of executive function (β = 0.216, 95% CI: 0.128-0.305) and once per week with verbal episodic memory (β = 0.189, 95% CI: 0.082-0.297) versus no volunteering, but the magnitude did not increase with more frequent volunteering. Those who volunteered had similar domain-specific cognitive decline compared to those who did not.Type
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Lor, Yi, Hilary Colbeth, Marianne Chanti-Ketterl, Emily Hokett, Evan Fletcher, Zvinka Z Zlatar, Nancy X Chen, Nirmalbhai Tandel, et al. (2026). The impact of volunteering on cognition and cognitive decline in older diverse cohorts: KHANDLE and STAR. Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(1). p. e71169. 10.1002/alz.71169 Retrieved from https://hdl.handle.net/10161/34216.
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Marianne Chanti-Ketterl
I am a geroscientist and epidemiologist with expertise in cognitive health and neurodegenerative conditions, particularly Alzheimer’s disease and related dementias. My research program examines how the exposome influences brain health throughout the lifespan, with a specific focus on environmental exposures, alongside social, behavioral, and biological factors. My work has investigated traumatic brain injury, metabolic biomarkers, resilience, and cognitive training. Through these efforts, I aim to identify modifiable pathways that promote healthy cognitive aging, reduce risk, and delay disease progression across diverse aging populations.
A central focus of my scholarship is to improve the inclusiveness, reach, and translational impact of aging and brain health research. My work addresses persistent gaps in participation and representation among older adults from communities historically under-engaged in scientific studies, to ensure that research findings are generalizable, equitable, and relevant to the broader U.S. population. In parallel with my research program, I serve as Faculty Operational Director for the North Carolina Registry for Brain Health, where I lead statewide initiatives to expand research engagement, strengthen community and institutional partnerships, and connect older adults with brain health studies. I also coordinate the Duke Aging Center’s T32 fellowship program and am deeply committed to mentoring students, postdoctoral fellows, and early-career investigators. Across these roles, I aim to advance rigorous, community-informed science while cultivating the next generation of scholars prepared to address the complex needs of an aging society.
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