Meagan T Farrell1, Lindsay C Kobayashi2, Livia Montana1, Ryan G Wagner3, Nele Demeyere4, Lisa Berkman1,5. 1. Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts. 2. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. 3. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 4. Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, UK. 5. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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.
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.
Authors: Laura B Zahodne; M Maria Glymour; Catharine Sparks; Daniel Bontempo; Roger A Dixon; Stuart W S MacDonald; Jennifer J Manly Journal: J Int Neuropsychol Soc Date: 2011-09-19 Impact factor: 2.892
Authors: Lindsay C Kobayashi; M Maria Glymour; Kathleen Kahn; Collin F Payne; Ryan G Wagner; Livia Montana; Farrah J Mateen; Stephen M Tollman; Lisa F Berkman Journal: Soc Sci Med Date: 2017-08-14 Impact factor: 4.634
Authors: Francesco Panza; Vincenza Frisardi; Cristiano Capurso; Alessia D'Introno; Anna M Colacicco; Bruno P Imbimbo; Andrea Santamato; Gianluigi Vendemiale; Davide Seripa; Alberto Pilotto; Antonio Capurso; Vincenzo Solfrizzi Journal: Am J Geriatr Psychiatry Date: 2010-02 Impact factor: 4.105
Authors: Marina A Njelekela; Rose Mpembeni; Alfa Muhihi; Nuru L Mligiliche; Donna Spiegelman; Ellen Hertzmark; Enju Liu; Julia L Finkelstein; Wafaie W Fawzi; Walter C Willett; Jacob Mtabaji Journal: BMC Cardiovasc Disord Date: 2009-07-17 Impact factor: 2.298
Authors: Cassandra C Soo; Meagan T Farrell; Stephen Tollman; Lisa Berkman; Almut Nebel; Michèle Ramsay Journal: Front Genet Date: 2021-10-14 Impact factor: 4.772
Authors: Stephen B Asiimwe; Meagan Farrell; Lindsay C Kobayashi; Jen Manne-Goehler; Kathleen Kahn; Stephen M Tollman; Chodziwadziwa Whiteson Kabudula; F Xavier Gómez-Olivé; Ryan G Wagner; Livia Montana; Lisa F Berkman; M Maria Glymour; Till Bärnighausen Journal: Sci Rep Date: 2020-10-06 Impact factor: 4.379