Disparity in Educational Attainment Partially Explains Cognitive Gender Differences in Older Rural South Africans

Abstract Objectives Direction and magnitude of gender differences in late-life cognitive function are inextricably tied to sociocultural context. Our study evaluates education and literacy as primary drivers of gender equality in cognitive performance among middle-aged and older adults in rural Sout...

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Veröffentlicht in:The journals of gerontology. Series B, Psychological sciences and social sciences Psychological sciences and social sciences, 2020-08, Vol.75 (7), p.e161-e173
Hauptverfasser: Farrell, Meagan T, Kobayashi, Lindsay C, Montana, Livia, Wagner, Ryan G, Demeyere, Nele, Berkman, Lisa
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container_issue 7
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container_title The journals of gerontology. Series B, Psychological sciences and social sciences
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creator Farrell, Meagan T
Kobayashi, Lindsay C
Montana, Livia
Wagner, Ryan G
Demeyere, Nele
Berkman, Lisa
description Abstract Objectives Direction and magnitude of gender differences in late-life cognitive function are inextricably tied to sociocultural context. Our study evaluates education and literacy as primary drivers of gender equality in cognitive performance among middle-aged and older adults in rural South Africa. Method Data were collected on 1,938 participants aged 40–79 from Agincourt, South Africa. Cognitive function was measured via the Oxford Cognitive Screen-Plus, a tablet-based assessment with low literacy demands. Four cognitive domains were derived through confirmatory factor analysis: episodic memory, executive function, visual spatial, and language. Structural equation models tested domain-specific gender effects, incrementally controlling for demographic, education, health, and socioeconomic variables. Results In the model adjusting only for demographic factors, men outperformed women on executive function and visual-spatial domains. Adding education and literacy to the model revealed a robust female advantage in episodic memory, and reduced the magnitude of male advantage in executive function and visual and spatial by 47% and 42%, respectively. Health and socioeconomic factors did not alter patterns of gender associations in subsequent models. Discussion In this older South African cohort, gender inequality in cognitive performance was partially attributable to educational differences. Understanding biopsychosocial mechanisms that promote cognitive resilience in older women is critically important given the predominantly female composition of aging populations worldwide.
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Our study evaluates education and literacy as primary drivers of gender equality in cognitive performance among middle-aged and older adults in rural South Africa. Method Data were collected on 1,938 participants aged 40–79 from Agincourt, South Africa. Cognitive function was measured via the Oxford Cognitive Screen-Plus, a tablet-based assessment with low literacy demands. Four cognitive domains were derived through confirmatory factor analysis: episodic memory, executive function, visual spatial, and language. Structural equation models tested domain-specific gender effects, incrementally controlling for demographic, education, health, and socioeconomic variables. Results In the model adjusting only for demographic factors, men outperformed women on executive function and visual-spatial domains. Adding education and literacy to the model revealed a robust female advantage in episodic memory, and reduced the magnitude of male advantage in executive function and visual and spatial by 47% and 42%, respectively. Health and socioeconomic factors did not alter patterns of gender associations in subsequent models. Discussion In this older South African cohort, gender inequality in cognitive performance was partially attributable to educational differences. Understanding biopsychosocial mechanisms that promote cognitive resilience in older women is critically important given the predominantly female composition of aging populations worldwide.</description><identifier>ISSN: 1079-5014</identifier><identifier>EISSN: 1758-5368</identifier><identifier>DOI: 10.1093/geronb/gbaa035</identifier><identifier>PMID: 32211786</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cognition ; Educational Status ; Female ; Health Status Disparities ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Rural Population - statistics &amp; numerical data ; Sex Factors ; Socioeconomic Factors ; South Africa - epidemiology ; The Journal of Gerontology: Psychological Sciences</subject><ispartof>The journals of gerontology. Series B, Psychological sciences and social sciences, 2020-08, Vol.75 (7), p.e161-e173</ispartof><rights>The Author(s) 2020. 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source Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection
subjects Adult
Aged
Aged, 80 and over
Cognition
Educational Status
Female
Health Status Disparities
Humans
Male
Middle Aged
Neuropsychological Tests
Rural Population - statistics & numerical data
Sex Factors
Socioeconomic Factors
South Africa - epidemiology
The Journal of Gerontology: Psychological Sciences
title Disparity in Educational Attainment Partially Explains Cognitive Gender Differences in Older Rural South Africans
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