The role of education and income for cognitive functioning in old age: A cross-country comparison

Int J Geriatr Psychiatry. 2021 Dec;36(12):1908-1921. doi: 10.1002/gps.5613. Epub 2021 Aug 19.

ABSTRACT

OBJECTIVES: Previous studies have shown that higher education promotes cognitive health. This effect, however, is embedded in the living conditions of a particular country. Since it is not clear to what extent the country and its specific living standards are necessary preconditions for the observed effect, we investigated whether the impact of education and income on cognitive functioning differs between countries.

METHODS: Analyses were based on harmonized data from the World Health Organization's multi-country Study on global AGEing and adult health, the Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe of over 85,000 individuals aged 50 years and older. Analyses were conducted via multivariate regression analyses and structural equation modeling adjusted for age, gender, marital status, health status, and depression.

RESULTS: The effect of education was twice as large as the effect of income on cognitive functioning and indirectly moderated the effect of income on cognitive functioning. The effect sizes varied strongly between countries. The country's gross domestic product per capita seems to influence cognitive functioning.

CONCLUSIONS: Our findings indicate that education has a dominant effect on cognitive functioning in people aged 50 years and older, which might even offset the adverse implications of living with low income on cognitive health. Therefore, expanding efforts to achieve universal education are essential to mitigate health disparities due to low income and early life disadvantages, including chances for good cognitive functioning over the life-span.

PMID:34378818 | DOI:10.1002/gps.5613