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Hurricane María (2017) highlighted how long-standing health disparities intensify post-disaster
cognitive outcomes among aging populations. Few population-based studies have quantified
how hurricane hardship relates to cognitive functioning among older Puerto Rican adults and
whether social support buffers that stress. In addition, although social support is frequently
linked to health outcomes, fewer studies have empirically assessed its role alongside disaster-
related hardship in shaping cognitive functioning particularly episodic memory as a
consequence of disaster-related hardship. This gap is relevant given projections of increased
frequency and intensity of extreme weather events, underscoring the need to understand how
disaster-related experiences are associated with health outcomes among older adults.
Specifically, the study tests whether greater exposure to hurricane-related hardship is
associated with lower episodic memory score, whether higher levels of social support are
associated with higher episodic memory scores, and whether the association between hardship
and episodic memory varies across levels of social support. This study aims to clarify how
disaster-related experiences and available support are reflected in cognitive outcomes within
the growing older adult population.
Methods: Data was drawn from Wave 3 (2021–2022) of the Puerto Rican Elder Health Conditions
(PREHCO) study, a population-based survey of community-dwelling adults aged 60 and older in
Puerto Rico (N=617). PREHCO employs a multistage, stratified sampling design to ensure
representation across geographic and socioeconomic subgroups and captures longer-term
post-disaster conditions approximately four to five years after Hurricane Maria.
Cognitive functioning was assessed using episodic memory (0-8 composite of immediate and
delayed recall) . The hurricane hardship index included prolonged services disruptions (e.g.,
loss of electricity, water, communication). Social support was measured using the Lubben
Social Network Scale (LSNS; range 0-30), a validated measure of perceived social network size
and support. Covariates included age, sex (female=1), and marital status (married/partnered
=1). Multiple linear regression models were estimated, including an interaction term to test
moderation.
Results:
The overall regression model was statistically significant (F (6,610) = 13.73, p < .001),
explaining approximately 11.9% variance in episodic memory. Greater hurricane hardship was
significantly associated with lower episodic memory scores (b = -.0.96, p= .001). Social support
was positively associated with cognitive functioning (b=0.064, p = .003). However, the
interaction between hurricane hardship and social support was not statistically significant (b= -
0.39, p = .185). The results showed that hurricane hardship was connected to older adults
and their episodic memory but not buffered by the effect of social support.
Conclusions and Implications: Findings suggest that hurricane-related hardship has a negative association with cognitive functioning among older Puerto Rican adults post-Hurricane Maria (2017). Social support was found to independently promote better cognitive outcomes but does not buffer disaster-related
stress in this context. These findings indicate that hurricane hardship and social support operate
as independent factors associated with cognitive outcomes. Reducing prolonged service
disruptions may be critical for supporting cognitive health, while maintaining social networks
remains important for overall cognitive functioning. Policy efforts should prioritize minimizing
infrastructure disruptions for older adults during disaster response. Future research should
highlight and uplift access and continuity of care to healthcare services, health information, or
community-level resources during disaster relief.