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. 2020 Aug;68 Suppl 3(Suppl 3):S20-S28.
doi: 10.1111/jgs.16732.

Sex Differences in Cognitive Health Among Older Adults in India

Marco Angrisani  1   2 , Urvashi Jain  1 , Jinkook Lee  1   2   3
Affiliations

Sex Differences in Cognitive Health Among Older Adults in India

Marco Angrisani et al. J Am Geriatr Soc. 2020 Aug.

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.

Keywords: India; cognition; sex.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Cognition summary Z-scores by education. The source was individual-level data from the Longitudinal Aging Study in India–Diagnostic Assessment of Dementia 2017 to 2019.
See this image and copyright information in PMC

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