Sujarwoto Sujarwoto, Yumarni Tri, Holipah Holipah, Maharani Asri
Department of Public Administration, University of Brawijaya, Malang, Indonesia.
Department of Public Health, University of Brawijaya, Malang, Indonesia.
Front Public Health. 2025 May 27;13:1563543. doi: 10.3389/fpubh.2025.1563543. eCollection 2025.
Cognitive decline, including cognitive impairment non-dementia (CIND) and dementia, is a growing public health concern, particularly in ageing populations within developing countries. Socioeconomic status (SES) is increasingly recognized as a key determinant of cognitive ageing, yet evidence from low- and middle-income contexts remains limited. This study investigates the relationship between SES and later-life cognitive outcomes in Indonesia.
We analysed longitudinal data from Waves 4 and 5 of the Indonesia Family Life Survey (IFLS), involving 3,087 participants aged 50 years and older at baseline (Wave 4). Cognitive outcomes, including CIND and dementia, were assessed seven years later using an adapted version of the Telephone Interview for Cognitive Status (TICS). Multilevel ordinal regression was employed to evaluate the association between SES indicators at baseline-such as education, income, residential location, and participation in community-based older adults health posts ()-and subsequent cognitive outcomes.
At follow-up, 38% of the sample exhibited CIND, and 19% were classified as having dementia. Higher levels of formal education, greater income, urban residence, and engagement in activities were significantly associated with reduced risk of both CIND and dementia.
Findings suggest that SES disparities contribute to cognitive decline in later life. Interventions aimed at improving educational attainment, economic conditions, and community health access among older adults may serve as critical strategies to mitigate the future burden of dementia. Reducing social inequalities in health should therefore be prioritized in dementia prevention policies within low-resource settings.
认知能力下降，包括轻度认知障碍（CIND）和痴呆症，日益成为公共卫生关注的焦点，特别是在发展中国家的老年人群体中。社会经济地位（SES）越来越被认为是认知老化的关键决定因素，但来自低收入和中等收入背景的证据仍然有限。本研究调查了印度尼西亚SES与晚年认知结果之间的关系。
我们分析了印度尼西亚家庭生活调查（IFLS）第4波和第5波的纵向数据，基线（第4波）时有3087名50岁及以上的参与者。七年后，使用认知状态电话访谈（TICS）的改编版本评估包括CIND和痴呆症在内的认知结果。采用多水平有序回归来评估基线时的SES指标，如教育程度、收入、居住地点以及参与社区老年人卫生站活动与随后的认知结果之间的关联。
在随访中，38%的样本表现出CIND，19%被归类为患有痴呆症。较高的正规教育水平、较高的收入、城市居住以及参与活动与CIND和痴呆症风险降低显著相关。
研究结果表明，SES差异导致晚年认知能力下降。旨在提高老年人教育程度、经济状况和社区卫生服务可及性的干预措施可能是减轻未来痴呆症负担的关键策略。因此，在资源匮乏地区的痴呆症预防政策中，应优先减少健康方面的社会不平等。
