Sex Differences in Cognitive Health Among Older Adults in India.

TitleSex Differences in Cognitive Health Among Older Adults in India.
Publication TypeJournal Article
Year of Publication2020
AuthorsAngrisani, M, Jain, U, Lee, J
JournalJournal of the American Geriatrics Society
Volume68 Suppl 3
PaginationS20-S28
Date Published2020 Aug
ISSN Number1532-5415
KeywordsCognition, India, sex
Abstract

OBJECTIVES: To document sex differences in late-life cognitive function and identify their early-life determinants among older Indian adults.

DESIGN: Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India (LASI-DAD).

SETTING: Individual cognitive testing in hospital or household setting across 14 states of India.

PARTICIPANTS: Individuals aged 60 years and older from LASI-DAD (2017-2019) (N = 2,704; 53.5% female).

MEASUREMENTS: Given the low levels of literacy and numeracy among older Indian adults, we consider two composite cognitive scores as outcome variables. Score I is based on tests that do not require literacy or numeracy, whereas score II is based on tests that require such skills. Ordinary least squares is used to estimate models featuring a progressively increasing number of covariates. We add to the baseline specification, including a sex dummy, age, and state indicators, measures of early-life socioeconomic status (SES), early-life nutrition, as proxied by knee height, and education.

RESULTS: Across most cognitive domains, women perform significantly worse than for men: -0.4 standard deviations (SD) for score I and -0.8 SD for score II. Early-life SES, health, and education explain 90% of the gap for score I and 55% for score II. Results are similar across hospital-based and home testing.

CONCLUSION: In India, lower levels of early-life human capital investments in nutrition and education among women compared with men are associated with a female disadvantage in late-life cognitive health. This has important implications for public health policy, aiming at reducing the risk of cognitive decline and dementia-a nascent concern in India. J Am Geriatr Soc 68:S20-S28, 2020.

DOI10.1111/jgs.16732
Citation Key11046
PubMed ID32815603
Grant ListRF1 AG055273 / AG / NIA NIH HHS / United States
R01AG051125 / / National Institute on Aging, National Institutes of Health /
RF1AG055273 / / National Institute on Aging, National Institutes of Health /