Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan.
The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
BMC Geriatr. 2021 Jan 10;21(1):38. doi: 10.1186/s12877-020-01990-1.
It is well known that females generally live longer than males, but women tend to suffer from more illnesses and limitations than men do, also for dementia. However, limited empirical evidence is available why this 'male-female health-survival paradox' is observed. This study aimed to investigate factors which account for gender differences in health, particularly cognitive functioning and decline among older adults.
Data were retrieved from the National Survey of the Japanese Elderly, which is a longitudinal survey of a nationwide representative sample of Japanese adults aged 60 or over. Gender differences in cognitive functioning and decline in three-year follow-ups were decomposed using Blinder-Oaxaca decomposition analysis, regarding demographic, socioeconomic, and health-related factors into the 'explained' component, by differences in individual attributes listed above, and the 'unexplained' component.
Empirical analyses showed that women's lower cognitive functioning was partly explained by the endowment effect. Moreover, a shorter duration of formal education and a larger proportion with their longest occupation being domestic worker accounted for steeper cognitive decline and more prevalent mild cognitive impairment in women than in men.
This empirical study suggested that gender differences in cognitive functioning and decline account for different individual attributes of social determinants among men and women. Particularly, men seem to be more engaged in activities which accumulate intellectual experiences through education and occupation, as suggested by the cognitive reserve hypothesis.
众所周知,女性的寿命通常比男性长,但女性比男性更容易患病,活动能力受限,老年痴呆症也是如此。然而,为什么会出现这种“男性-女性健康-生存悖论”,目前仅有有限的实证证据。本研究旨在调查导致健康方面性别差异的因素,特别是老年人群认知功能和衰退的性别差异。
本研究的数据来自日本老年人全国调查,这是一项针对 60 岁及以上日本成年人的全国代表性样本的纵向调查。使用 Blinder-Oaxaca 分解分析,根据人口统计学、社会经济和与健康相关的因素,将认知功能和三年随访期间的下降差异分解为“可解释”部分,即上述个体属性的差异,以及“不可解释”部分。
实证分析表明,女性较低的认知功能部分可以通过禀赋效应来解释。此外,受教育时间较短,以及从事家务劳动的比例较高,这些因素导致女性的认知衰退速度较快,轻度认知障碍的患病率也高于男性。
本实证研究表明,认知功能和下降方面的性别差异可以解释男女社会决定因素的不同个体属性。特别是,正如认知储备假说所表明的那样,男性似乎更多地参与通过教育和职业积累智力经验的活动。