Ko Soohyeon, Oh Hannah, Subramanian S V, Kim Rockli
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Cambridge, MA, USA; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
Soc Sci Med. 2025 Feb;366:117640. doi: 10.1016/j.socscimed.2024.117640. Epub 2024 Dec 17.
This study investigates the link between life course social mobility and cognitive function among middle-aged and older adults in India, specifically emphasizing whether upward and downward mobility exerts symmetric associations and potential gender heterogeneity within these associations. Leveraging data from the Longitudinal Aging Study in India 2017-2018, encompassing 64,710 individuals aged 45 years or above, we classified social mobility as 'consistently high,' 'upward mobility,' 'downward mobility,' and 'consistently low,' based on socioeconomic position during childhood and late adulthood. Multivariable regression and gender-interaction analyses were employed to assess associations. Overall, 35.69% maintained a consistently high socioeconomic position, whereas 22.87% remained consistently low; 20.05% experienced upward mobility, and 21.39% faced downward mobility. Compared to consistently high socioeconomic position, consistently low socioeconomic position was associated with lower cognitive function (b = -1.47; 95% CI = -1.59, -1.34), followed by downward mobility (b = -0.84; 95% CI = -0.95, -0.72) and upward mobility (b = -0.72; 95% CI = -0.84, -0.61). Notably, the interaction model revealed significant differences by gender, especially between opposite social mobility groups. Among men, upward and downward mobility displayed asymmetric associations, with upward mobility being associated with a higher cognitive function than downward mobility (b = 0.31; 95% CI = 0.13, 0.50), whereas such differences were not observed for women (b = -0.01; 95% CI = -0.20, 0.17). These findings highlight the critical influence of life course social mobility on cognitive health, with implications for interventions tailored to the unique trajectories of social mobility by gender in India.
本研究调查了印度中老年人的人生历程社会流动与认知功能之间的联系，特别强调向上和向下流动是否产生对称关联以及这些关联中潜在的性别异质性。利用2017 - 2018年印度纵向老龄化研究的数据，该研究涵盖了64710名45岁及以上的个体，我们根据童年和成年后期的社会经济地位将社会流动分为“始终处于高位”、“向上流动”、“向下流动”和“始终处于低位”。采用多变量回归和性别交互分析来评估关联。总体而言，35.69%的人始终保持较高的社会经济地位，而22.87%的人始终处于较低地位；20.05%的人经历了向上流动，21.39%的人面临向下流动。与始终处于较高社会经济地位相比，始终处于较低社会经济地位与较低的认知功能相关（b = -1.47；95%置信区间 = -1.59，-1.34），其次是向下流动（b = -0.84；95%置信区间 = -0.95，-0.72）和向上流动（b = -0.72；95%置信区间 = -0.84，-0.61）。值得注意的是，交互模型显示出性别差异显著，尤其是在相反的社会流动群体之间。在男性中，向上和向下流动表现出不对称关联，向上流动与比向下流动更高的认知功能相关（b = 0.31；95%置信区间 = 0.13，0.50），而女性未观察到此类差异（b = -0.01；95%置信区间 = -0.20，0.17）。这些发现凸显了人生历程社会流动对认知健康的关键影响，对根据印度不同性别的社会流动独特轨迹量身定制干预措施具有启示意义。
