Cognitive Health of Older Indians: Individual and Geographic Determinants of Female Disadvantage

Abstract

India is experiencing a rapid demographic and epidemiologic transition. Among a growing aging population, non-communicable diseases, including dementia, are increasingly prevalent, but our understanding of cognitive health is quite limited. Recent studies suggest that women in developed countries perform as well or better than men on cognitive functioning tests, though research from developing countries shows the opposite. This gender disparity in developing settings may be attributable to that fact that women are traditionally not given equal access to education, health services, economic opportunity, and social engagement. Furthermore, in countries such as India, discrimination against women may play a role in the gender disparity. To address this issue, we examine cognitive function of older Indians, using cross-sectional data from the 2010 pilot round of the Longitudinal Aging Study in India, fielded across Punjab and Rajasthan in the north and Kerala and Karnataka in the south. We found gender disparities in cognitive function and suggest that female cognitive disadvantage could be explained by disparities in education, health and social engagement in southern India. However, female disadvantage persisted in northern states where discrimination against women has been notably acute even after controlling for education and other key risk factors of poor cognitive function.

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

“…This finding is in line with other research on cognition and aging in LMICs that has found substantial gender differentials in cognitive decline (Lee et al, 2014, 2011; Lei et al, 2014; Maurer, 2011; Zhang, 2006). Despite differences in levels, CH has similar associations with well-being, mental health, and physical health outcomes for both men and women.…”

Regional disparities in adult height, educational attainment, and late-life cognition: Findings from the Longitudinal Aging Study in India (LASI)

“…For cognitive ability, LASI administered tests for word recall (both immediate and delayed), a modified version of the Min-Mental State Exam, and serial 7s (see Lee et al, 2011, for a comprehensive description). We create a summary index for these cognitive tests, ranging from 0 to 32.…”

Differential item functioning in the cognitive screener used in the Longitudinal Aging Study in India

“…Newer versions of the Hindi MMSE have been sometimes used by some researchers (Tiwari et al, 2009). A similarly adapted cognitive screening tool has been used in the important Indian epidemiological study on agingthe Longitudinal Aging Study in India (Lee et al, 2011).…”

“…It was pretested in the Indian population and has since been used to study health, demography, family, social activities, pre-retirement health behavior, work, pension, and cognition. A cognitive screen was used to assess episodic memory (immediate and delayed word recall) and global cognitive function (date, name of prime minister, reverse counting from 20, and serial sevens) (Lee et al, 2011). Although the screen itself had not been validated prior to the test, many of its items have been used in India earlier (Ganguli et al, 1996;Langa et al, 2008;Mathuranath et al, 2007;Tiwari et al, 2009).…”