Laboratory

Population Health

At a Glance Projects Publications Team

Project

Cognitive Functioning in Middle- and High-Income Countries

Mikko Myrskylä, Jo Mhairi Hale (MPIDR / University of St Andrews, United Kingdom), Shubhankar Sharma, Daniel Schneider, Jutta Gampe; in Collaboration with Neil Kishor Mehta (University of Michigan, Ann Arbor, USA)

Detailed Description

As people age, they often experience reductions in the levels of cognitive functioning. These declines can affect the quality of life and influence the nature of interpersonal relationships. Reductions in cognition can also limit an individual’s independence when it becomes more difficult to perform common activities, such as filling out paperwork or performing everyday calculations. Patterns of cognitive decline likely vary by individual characteristics, such as gender, educational attainment, and race/ethnicity. Variations in public health conditions, educational systems, and welfare and support systems for the elderly mean that these patterns are likely to differ across countries and over time.

In low- and middle-income countries, older adults tend to live with their adult children and thus enjoy extended familial support. But they must also contend with low levels of institutional support and weak economic conditions, which means that the average individual has a lower education, worse health, and has generally experienced tougher socioeconomic conditions over the life course. These experiences may in turn affect the type and the rate of decline in cognitive function that this older individual experiences. In high-income countries, by contrast, a higher percentage of older adults live in institutions such as nursing homes or senior residences, which provide around-the-clock medical attention and allow for some social contact with other seniors. To disentangle these complicated pathways, we apply innovative methodological techniques and exploit data from multiple countries as well as datasets, including the Mexican Health and Aging Study and the US Health and Retirement Study.

Our results have shown a clear association between early-life exposures and later-life health and cognitive functioning and that these associations may be changing across cohorts. Furthermore, there were mediating and moderating mid- to later-life social factors that are modifiable, such as educational attainment, labor-force participation, and health behaviors. Our policy-relevant findings include that educational attainment appeared to be more protective for Blacks and Latinx than for whites, postponing retirement buffers against cognitive decline, and that, contrary to other research literature, trends in dementia were increasing, not declining.

Additional key findings are that all Hispanic subgroups in the United States, with the exception of Cubans, had significantly lower scores for all cognitive domains compared to non-Hispanic whites (NHWs). Among Hispanics, Puerto Ricans had the lowest scores of cognitive functioning in the United States. Our analyses based on the Mexican Health and Aging Study have also revealed important gender differences in cognitive functioning and variations over time between 2001 and 2012. Total cognitive scores and educational attainment were higher for men than they were for women across the whole period. But the gender gap in the overall cognition score was smaller in 2012 compared to 2001.

We also investigated whether fertility history is associated with cognitive functioning among older adults in Mexico. We have found that those who have two or three children had the highest levels of cognitive functioning and that this held true for men and women. These patterns likely stemmed from a mix of selection processes, and they illustrate the benefits of social support from children and family more generally.

Publications

Gerstorf, D.; Ram, N.; Drewelies, J.; Düzel, S.; Eibich, P.; Steinhagen-Thiessen, E.; Liebig, S.; Goebel, J.; Demuth, I.; Villringer, A.; Wagner , G. G.; Lindenberger, U.; Ghisletta, P.:
Psychological Science 34:1, 22–34. (2023)
Sharma, S.; Hale, J. M.; Myrskylä, M.; Kulu, H.:
Population Studies, 1–11. (2023)    
Sharma, S.; Hale, J. M.; Myrskylä, M.; Kulu, H.:
Demography 60:5, 1441–1468. (2023)    
Hale, J. M.; Schneider, D. C.; Mehta, N. K.; Myrskylä, M.:
MPIDR Working Paper WP-2022-029. (2022)    
Sharma, S.; Hale, J. M.; Myrskylä, M.; Kulu, H.:
MPIDR Working Paper WP-2022-001. (2022)    
Wahl, H.-W.; Drewelies, J.; Düzel, S.; Lachman, M. E.; Smith, J.; Eibich, P.; Steinhagen-Thiessen, E.; Demuth, I.; Lindenberger, U.; Wagner , G. G.; Ram, N.; Gerstorf, D.:
Psychology and Aging 37:3, 413–429. (2022)
Hale, J. M.; Schneider, D. C.; Gampe, J.; Mehta, N. K.; Myrskylä, M.:
Epidemiology 32:5, 717–720. (2021)
Sáenz, J. L.; Díaz-Venegas, C.; Crimmins, E. M.:
Journals of Gerontology, Series B: Psychological Sciences and Social Sciences 76:4, e140–e152. (2021)
Hale, J. M.; Schneider, D. C.; Gampe, J.; Mehta, N. K.; Myrskylä, M.:
Epidemiology 31:5, 745–754. (2020)    
Hale, J. M.; Schneider, D. C.; Mehta, N. K.; Myrskylä, M.:
SSM-Population Health 11:100577, 1–9. (2020)    
Díaz-Venegas, C.; Downer, B.; Langa, K. M.; Wong, R.:
In: Contextualizing health and aging in the Americas: effects of space, time and place, 85–107. Cham: Springer. (2019)    
Díaz-Venegas, C.; Semper-Ternent, R.; Michaels-Obregón, A.; Wong, R.:
Aging and Mental Health 23:11, 1586–1594. (2019)    
Gerstorf, D.; Drewelies, J.; Düzel, S.; Smith, J.; Wahl, H.-W.; Schilling, O. K.; Kunzmann, U.; Siebert, J. S.; Katzorreck, M.; Eibich, P.; Demuth, I.; Steinhagen-Thiessen, E.; Wagner , G. G.; Lindenberger, U.; Heckhausen, J.; Ram, N.:
Psychology and Aging 34:8, 1090–1108. (2019)
Díaz-Venegas, C.; Schneider, D. C.; Myrskylä, M.; Mehta, N. K.:
PLOS One 12:12, e0190488–e0190488. (2017)    
The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.