Singh Prashant Kumar, Jasilionis Domantas, Oksuzyan Anna
Department of Policy Studies, TERI School of Advanced Studies, 10 Institutional Area, Vasant Kunj, New Delhi 110070, India.
Max Planck Institute for Demographic Research, Konrad-Zuse Str. 1, 18057 Rostock, Germany.
SSM Popul Health. 2018 Jun 28;5:180-187. doi: 10.1016/j.ssmph.2018.06.008. eCollection 2018 Aug.
This study assesses the gender gap in cognitive health among older adults in India and examines the extent to which individual, household and state level characteristics contribute to the male-female difference in cognitive health. The study is based on 6548 women and men who participated in the WHO Study on Global AGEing and Adult Health conducted in six states in India during 2007-08. Multilevel ordinary least square regression was used to examine the gender difference in cognitive health, adjusting for individual, household, health behavior and state-level variables. A composite cognitive score (CCS) was calculated by combining scores of five individual cognitive tests. Results suggest that CCS is worse among women than among men after adjusting for individual and state level factors. The largest reduction in the gender gap in CCS was observed when adjusting for education, followed by other individual factors such as marital status, individual height, caste, religion, tobacco consumption and chronic health status. Although state level urbanization and female workforce participation rate were significantly associated with CCS, these characteristics did not contribute to the reduction of gender difference in CCS. This study extends the current knowledge of women's disadvantage in cognitive health, demonstrating that individual level characteristics remain key determinants of gender difference in cognition among older adults in India. Importantly, this relationship holds in the context of very large cross-state variations in cognitive health and its determinants.
本研究评估了印度老年人认知健康方面的性别差异,并考察了个人、家庭和州层面的特征在多大程度上导致了认知健康方面的男女差异。该研究基于2007 - 2008年期间在印度六个邦参与世界卫生组织全球老龄化与成人健康研究的6548名男性和女性。采用多层普通最小二乘法回归来检验认知健康方面的性别差异,并对个人、家庭、健康行为和州层面的变量进行了调整。通过综合五项个体认知测试的分数计算出一个综合认知分数(CCS)。结果表明,在对个人和州层面因素进行调整后,女性的CCS比男性更差。在调整教育因素时,观察到CCS性别差距的最大幅度缩小,其次是婚姻状况、个人身高、种姓、宗教、烟草消费和慢性健康状况等其他个人因素。虽然州层面的城市化和女性劳动力参与率与CCS显著相关,但这些特征并未导致CCS性别差异的缩小。本研究扩展了目前关于女性在认知健康方面劣势的认识,表明个人层面的特征仍然是印度老年人认知方面性别差异的关键决定因素。重要的是,这种关系在认知健康及其决定因素存在非常大的跨邦差异的背景下依然成立。