Lifestyle and Socioeconomic predictors of Cognitive Functioning of Older Indians: A Lifecourse Approach

Background: India is experiencing a rapidly growing aging population.The higher longevity is accompanied by greater decline in cognitive health among older Indians.The primary objective of this study is to examine impacts of socioeconomic and lifestyle factors across lifespan on cognitive functioning among older Indians. Methods: The cross-section data from the Study on Global Ageing and Adult Health (SAGE) Wave-1 (2007-2010) data from India were used to examine cognitive functions of older Indians. The SAGE is a nationally representative sample of individuals age 50 or older (N=7150). Cognitive performance was measured by (1) episodic memory (combined scores of immediate and delayed word recalls); and (2) global cognitive functioning (digit counting and verbal fluency score). A list of potential risk factors of cognitive performance included in the multivariate OLS regressions were education, health and lifestyle, social engagement, father's education, and geographic residency. Appropriate clustering technique was used to account for the correlation among responses within the same household. Results: No formal education, socially disadvantageous group, geographic residence, lower percapita income, smoking, father's with no formal education, and under- nutrition were correlated with lower cognitive performance across domains. Female performed poor on global cognitive functioning. Social engagement, vigorous exercise, and fruit /vegetable consumption were associated with higher cognitive scores. Conclusion: Education is the strongest contributor to all domains of cognitive functioning. Gender disparity is pronounced in northern India. Improving lifestyle, lowering female discrimination, particularly in northern states may improve cognitive health among older Indians. Transgenerational effect on poor cognitive performance was observed.