Multivariate decomposition of gender differentials in cognitive impairment among older adults in India based on Longitudinal Ageing Study in India, 2017-2018.

ABSTRACT:

Background

Increasing life expectancy and declining fertility rates have increased the ageing population around the world. The literature lacks a consensus regarding the risk of cognitive impairments by gender.

Objective

Our study aims to examine the differences in cognition impairments between male and female older adults in India.

Methodology

We utilized data from the first wave of the Longitudinal Ageing Study in India (LASI) (2017-18), analyzing 31,464 older adults aged 60 years and above (15,098 males and 16,366 females). Cognitive impairment is measured using the Harmonized Cognitive Assessment Protocol (HCAP) which includes five broad domains (memory, orientation, arithmetic function, executive function, and object naming). A multivariate decomposition analysis was performed using STATA 17 software to identify covariates'contributions, which explain the group differences to average predictions.

Findings

The prevalence of cognitive impairment was significantly higher among females (19.8%) than males (6.4%) (p < 0.001). Gender disparities were more pronounced among the oldest-old (41.5% vs. 15.9%), widowed individuals (24.6% vs. 9.8%), those with no education (25.1% vs. 11.8%), and individuals living alone (23.4% vs. 5.0%). Decomposition analysis revealed that 62% of the gender gap in cognitive impairment was attributable to differences in compositional factors, primarily education (42%), marital status (6%), working status (6%), difficulty in instrumental activities of daily living (3%), and physical activity (2%). The remaining 38% of the disparity was due to differences in how these factors impacted men and women.

Conclusion

The findings indicate that cognitive impairments are more pronounced among women. Gender-responsive interventions improving education access among the female gender would bring relevant and desired results.

SUBMITTER: Sharma M 

PROVIDER: S-EPMC12004875 | biostudies-literature | 2025 Apr

REPOSITORIES: biostudies-literature