Gender Disparity in Late-life Cognitive Functioning in India: Findings from the Longitudinal Aging Study in India

Overview

Journal J Gerontol B Psychol Sci Soc Sci

Specialties Geriatrics
Psychology
Social Sciences

Date 2014 Mar 14

PMID 24622150

Citations 31

Authors

Jinkook Lee

Regina Shih

Kevin Feeney

Kenneth M Langa

Affiliations

Soon will be listed here.

Abstract

Objectives: To examine gender disparities in cognitive functioning in India and the extent to which education explains this disparity in later life.

Methods: This study uses baseline interviews of a prospective cohort study of 1,451 community-residing adults 45 years of age or older in four geographically diverse states of India (Karnataka, Kerala, Punjab, Rajasthan). Data collected during home visits includes cognitive performance tests, and rich sociodemographic, health, and psychosocial variables. The cognitive performance tests include episodic memory, numeracy, and a modified version of the Mini-Mental State Examination.

Results: We find gender disparity in cognitive function in India, and this disparity is greater in the north than the south. We also find that gender disparities in educational attainment, health, and social and economic activity explain the female cognitive disadvantage in later life.

Discussion: We report significant gender disparities in cognitive functioning among older Indian adults, which differ from gender disparities in cognition encountered in developed countries. Our models controlling for education, health status, and social and economic activity explain the disparity in southern India but not the region-specific disparity in the northern India. North Indian women may face additional sources of stress associated with discrimination against women that contribute to persistent disadvantages in cognitive functioning at older ages.

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References

Ganguli M, Chandra V, Gilby J, Ratcliff G, Sharma S, Pandav R . Cognitive test performance in a community-based nondemented elderly sample in rural India: the Indo-U.S. Cross-National Dementia Epidemiology Study. Int Psychogeriatr. 1996; 8(4):507-24. DOI: 10.1017/s1041610296002852. View

Seeman T, Lusignolo T, Albert M, Berkman L . Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychol. 2001; 20(4):243-55. DOI: 10.1037//0278-6133.20.4.243. View

Kalaria R, Maestre G, Arizaga R, Friedland R, Galasko D, Hall K . Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol. 2008; 7(9):812-26. PMC: 2860610. DOI: 10.1016/S1474-4422(08)70169-8. View

Mathuranath P, Cherian J, Mathew R, George A, Alexander A, Sarma S . Mini mental state examination and the Addenbrooke's cognitive examination: effect of education and norms for a multicultural population. Neurol India. 2007; 55(2):106-10. DOI: 10.4103/0028-3886.32779. View

Sen A . Missing women--revisited. BMJ. 2003; 327(7427):1297-8. PMC: 286281. DOI: 10.1136/bmj.327.7427.1297. View

Colcombe S, Kramer A . Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003; 14(2):125-30. DOI: 10.1111/1467-9280.t01-1-01430. View

Stern Y . What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc. 2002; 8(3):448-60. View

Butler S, Ashford J, Snowdon D . Age, education, and changes in the Mini-Mental State Exam scores of older women: findings from the Nun Study. J Am Geriatr Soc. 1996; 44(6):675-81. DOI: 10.1111/j.1532-5415.1996.tb01831.x. View

Zunzunegui M, Alvarado B, Beland F, Vissandjee B . Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med. 2008; 68(2):235-42. DOI: 10.1016/j.socscimed.2008.10.031. View

10.

Bonaiuto S, Rocca W, Lippi A, Giannandrea E, Mele M, Cavarzeran F . Education and occupation as risk factors for dementia: a population-based case-control study. Neuroepidemiology. 1995; 14(3):101-9. DOI: 10.1159/000109785. View

11.

Maurer J . Education and male-female differences in later-life cognition: international evidence from Latin America and the Caribbean. Demography. 2011; 48(3):915-30. DOI: 10.1007/s13524-011-0048-x. View

12.

Jotheeswaran A, Williams J, Prince M . The predictive validity of the 10/66 dementia diagnosis in Chennai, India: a 3-year follow-up study of cases identified at baseline. Alzheimer Dis Assoc Disord. 2010; 24(3):296-302. PMC: 2929463. DOI: 10.1097/WAD.0b013e3181d5e540. View

13.

Stern Y, Gurland B, Tatemichi T, Tang M, Wilder D, Mayeux R . Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. 1994; 271(13):1004-10. View

14.

McDonough P, WALTERS V . Gender and health: reassessing patterns and explanations. Soc Sci Med. 2001; 52(4):547-59. DOI: 10.1016/s0277-9536(00)00159-3. View

15.

van Boxtel M, Buntinx F, Houx P, Metsemakers J, Knottnerus A, Jolles J . The relation between morbidity and cognitive performance in a normal aging population. J Gerontol A Biol Sci Med Sci. 1998; 53(2):M147-54. DOI: 10.1093/gerona/53a.2.m147. View

16.

Evans D, Beckett L, Albert M, Hebert L, Scherr P, Funkenstein H . Level of education and change in cognitive function in a community population of older persons. Ann Epidemiol. 1993; 3(1):71-7. DOI: 10.1016/1047-2797(93)90012-s. View

17.

Mathuranath P, George A, Cherian P, Alexander A, Sarma S, Sarma P . Effects of age, education and gender on verbal fluency. J Clin Exp Neuropsychol. 2003; 25(8):1057-64. DOI: 10.1076/jcen.25.8.1057.16736. View

18.

Yount K . Gender, resources across the life course, and cognitive functioning in Egypt. Demography. 2008; 45(4):907-26. PMC: 2834387. DOI: 10.1353/dem.0.0034. View

19.

Lee S, Buring J, Cook N, Grodstein F . The relation of education and income to cognitive function among professional women. Neuroepidemiology. 2005; 26(2):93-101. PMC: 1361359. DOI: 10.1159/000090254. View

20.

Walker S, Wachs T, Grantham-McGregor S, Black M, Nelson C, Huffman S . Inequality in early childhood: risk and protective factors for early child development. Lancet. 2011; 378(9799):1325-38. DOI: 10.1016/S0140-6736(11)60555-2. View