AI Insight
This study of 2,510 Indian adults aged 60 and older found that the relationship between educational attainment and cognitive decline varies substantially across different Indian states. While the national average showed higher education associated with steeper measured cognitive decline, state-specific effects ranged from negative 0.056 standard deviations per year of schooling in Odisha to positive 0.021 in Kerala. The direction of the overall association reversed from negative to positive when adjusting for baseline cognitive function, indicating that a single national estimate masks important geographic heterogeneity.
Why it matters
These findings suggest that policies and interventions aimed at preserving cognitive health in aging populations cannot assume uniform effects of education across India. The geographic variation indicates that regional factors—such as healthcare access, literacy quality, or socioeconomic conditions—may modify how education influences cognitive trajectories in older adults, requiring location-specific approaches to cognitive health promotion.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Higher educational attainment is associated with steeper measured cognitive decline among older adults in India, but whether this association is uniform across the country is unknown. Using the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (wave 1, 2017-2019; wave 2, 2022-2024), this study examined whether the association between years of schooling and cognitive change varied across 18 states and union territories among 2,510 adults aged 60 years or older who were assessed at both waves. Models adjusted for age, sex, household wealth, and rural or urban residence. Change-score models related inter-wave change to schooling, and analysis of covariance additionally conditioned on baseline cognition. The schooling-by-geography interaction was significant in both specifications (change score, F = 2.97, P < .001; analysis of covariance, F = 4.11, P < .001). State-specific change-score estimates ranged from -0.056 SD per year of schooling in Odisha to +0.021 SD in Kerala. The pooled association reversed sign with baseline adjustment, from -0.022 SD (95% CI: -0.027, -0.016) to +0.031 SD (95% CI: 0.024, 0.038). A single national coefficient conceals substantial geographic variation in how schooling relates to cognitive aging in India.