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Childhood Deprivation and Later-life Cognitive Health in a South African Cohort Study of Aging

Year: 2017

Type: article

Abstract: Although the populations of low-to-middle income countries are rapidly aging, very little research has evaluated the drivers of cognitive aging in these settings. We aimed to investigate the relationship between father’s occupation during childhood (a marker of childhood socioeconomic deprivation) and later-life cognitive function, and whether educational attainment may explain this relationship among older, rural South Africans. Data were from baseline assessments in “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in Rural South Africa” (HAALSI), a population-based cohort in Agincourt, South Africa. The cohort included 5059 men and women aged ≥40 years in 2015. A formal mediation analysis was conducted using linear models adjusted for age cohort, sex, country of birth, and self-rated childhood health. Nearly half of the sample had no education (45%) or were illiterate (40%). The total effect of father’s occupation during childhood on z-standardized latent cognitive function score was 0.134 (95% CI: 0.074–0.187 for skilled vs. unskilled labor) and the controlled direct effect not explained by education was 0.104 (95% CI: 0.048–0.157). The indirect effect mediated by education was 0.030 (95% CI: 0.010–0.054), representing 22% of the total effect. These results indicate that older South African adults whose father worked in unskilled labor had, on average, worse cognitive outcomes than those with a father in skilled work, partly because they received very little, if any formal education. In this post-Apartheid context of aging in rural South Africa, socioeconomic inequalities in cognitive outcomes appear consistent with patterns observed in high-income countries.

Source: Innovation in Aging

DOI: 10.1093/geroni/igx004.1522