Over 59 million people, or 20% of the United States population, live in rural communities.1,2 Significant health disparities have been linked to rural residence, including higher rates of premature mortality3 and chronic disease (e.g., hypertension),4 as well as overall poorer health status, as compared with urban areas.5 Therefore, more research is needed on a broad range of health-related topics regarding the aging population, especially women, living in rural U.S. regions. This study sought to contribute to the literature on rural women's health by examining the relationship between thyroid functioning and cognition in a sample of rural-dwelling women. The link between thyroid function and cognition is a topic that has intrigued scientists for the past two decades. It is commonly understood that thyroid functioning plays an important role in cognition over one's lifetime,6 with several prospective studies linking markers of thyroid functioning with cognitive decline. In the Kungsholmen Project, thyroid-stimulating hormone (TSH) levels within the normal range, but not FT4 (free T4), were associated with decline in cognition.7,8 However, in the Women's Health and Aging Study and the MRC Cognitive Functioning and Aging Study, FT4 levels, but not TSH, were associated with greater risk of cognitive decline.9,10 When looking at risk for Alzheimer's disease (AD), low TSH has been found to be a risk factor for AD, independent of cerebrovascular factors.11 In the Framingham Study, low and high levels of TSH were associated with increased incidence of AD in women, but not in men.12 Combined, these results provide strong evidence for the link between cognitive functioning and thyroid markers; however, they also point to the potential differential impact of different markers of thyroid functioning on neuropsychological domains.