ArticleAge and ageing2023
Comparison of sex differences in cognitive function in older adults between high- and middle-income countries and the role of education: a population-based multicohort study.
Article in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 27 citations in OpenAlex.
- Changing Patterns of Recent Substance Use in Emerging Adulthood and Their Associations With Cognitive Functions and Mental Health.Biological psychiatry global open science · 2026Article
- Association between becoming a carer in later life and changes in the trajectory of cognitive function: results from the English longitudinal study of ageing.Age and ageing · 2026Article
- Cross-Sectional Associations of Body Mass Index With Disability Across High- and Middle-Income Countries in 2002-2006 and 2015-2018.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Review
- Cognitive impairment among widowed older adults in India: a decomposition analysis of gender gap.BMC psychology · 2026Article
- Novel anthropometric indices and cognitive function among iranian older adults: Bushehr Elderly Health (BEH) program.PloS one · 2026Article
- Burden of dementia attributable to smoking among adults aged ≥40 years: A secondary dataset analysis of Global Burden of Disease 1990-2021 with projections to 2035.Tobacco induced diseases · 2026Article
- Article
- Hearing Status, Social Engagement, and Longitudinal Changes in Cognition: Results From the Mexican Health and Aging Study.Journal of aging research · 2026Article
- Dose-response and cumulative effects of educational attainment and occupational complexity on mid to late life cognitive performance in Brazil and Mexico.Alzheimer's & dementia. Behavior & socioeconomics of aging · 2025Article
- Own and parental schooling, gender, and cognitive performance based on the Harmonized Cognitive Assessment Protocol (HCAP) among older Chilean adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- Sex differences in the prevalence and determinants of death anxiety among community-dwelling older adults in China: a cross-sectional study.BMC geriatrics · 2025Article
- Alzheimer disease seen through the lens of sex and gender.Nature reviews. Neurology · 2025Review
- Closing the gap in dementia research by community-based cohort studies in the Chinese population.The Lancet regional health. Western Pacific · 2025Review
- Sex-specific associations between estimated glucose disposal rate and cognitive decline in middle-aged and older adults in China: a longitudinal cohort study.Frontiers in aging neuroscience · 2025Article
- Racial Differences in Older Adult's Mental Health and Cognitive Symptomatology: Identifying Subgroups Using Multiple-Group Latent Class Analysis.Journal of aging and health · 2024Article
- Educational Attainment and Later-Life Cognitive Function in High- and Middle-Income Countries: Evidence From the Harmonized Cognitive Assessment Protocol.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Cognitive function characteristics and influencing factors in patients with depressive disorders: a 5-year follow-up report based on the epidemiological survey of mental disorders in Shandong Province, China.Frontiers in psychiatry · 2024Article
- Life Course Socioeconomic Position and Cognitive Aging Trajectories: A Cross-National Cohort Study in China and England.Innovation in aging · 2023Article
- Social support and cognitive function in Chinese older adults who experienced depressive symptoms: is there an age difference?Frontiers in aging neuroscience · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe extent to which education explains variations in sex differences in cognitive function between countries at different levels of economic development is unknown. We examined the role of education in sex differences in four cognitive domains in high- and middle-income countries.
methodsAnalyses were based on 70,846 participants, aged 60 years and older, in cohort studies from a high-income (United States) and four middle-income countries (Mexico, Brazil, China, and India). We used weighted linear models to allow nationally-representative comparisons of sex differences in orientation, memory, attention, and fluency using the United States as the reference, before and after adjustment for education, and after stratification by education.
resultsFemales had lower levels of education than males in all countries, particularly in India. Before adjustment for education, sex differences in orientation and attention in all middle-income countries, memory in Brazil, China, and India, and fluency in India were less favourable to females than in the United States (P < 0.010). For example, females outperformed males in memory in the United States (mean difference [male-female scores] = -0.26 standard deviations [95% CI -0.30, -0.22]) but not in China (0.15 [0.09, 0.21]) or India (0.16 [0.13, 0.19]). Adjustment for education attenuated these sex differences. In analyses stratified by education, there were minimal sex differences in the high education group in all countries.
conclusionEducation contributes to larger female disadvantages in cognitive function at older ages in middle-income countries compared with the United States. Gender equity in education is an important target to reduce sex disparities in cognitive function globally.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.