Aging
Inter-relations of Education, Social Participation, and Cognitive Function. A Longitudinal Analysis of Taiwanese Middle-Aged and Older Adults Yu-Tien Hsu* Yu-Tien Hsu Ichiro Kawachi Jarvis T. Chen
Social participation is associated with maintenance of cognitive function in older persons and could be a potential mediator of the association between educational attainment and late-life cognitive function. Moreover, social participation could interact with educational attainment on cognitive function. However, few studies have formally tested these relationships within a causal mediation framework.
We used data from the Taiwan Longitudinal Study in Aging, a nationally representative sample. The sample comprised participants aged 50 or above and recruited in 1989 (n = 4,400), stratified by age group (aged 50-64 years versus 65 or above). We used sequence analysis and optimal matching technique to define clustered patterns of social participation and work history in 1996, 1999, 2003, 2007, and 2011. We then used four-way decomposition to identify the effects of educational attainment, social participation pattern, and their interaction on the cognitive function in 2015, measured bythe Short Portable Mental Status Questionnaire.
We found a strong association between education and late-life cognitive function for both subgroups. As we decomposed the underlying pathway, the mediating pathway through social participation only accounted for 5% or less of the total effect for both subgroups, none of them were statistically significant. Notably, comparing college or above group to no formal education group in the younger subgroup, the reference interaction effect was a statistically significant component of the total effect (-0.58, 95% C.I. = -1.13, -0.11). Furthermore, under a hypothetical intervention scenario among younger participants, there could be 25% (95% C.I. = 0.01, 0.49) and 37% (95% C.I. = 0.12, 0.71) reductions in educational disparity in late-life cognitive function if we could set the participants without formal education to have a same level of social participation as those with middle/high school or college education.
Our results indicate that testing interventions encouraging more active patterns of social participation or stable involvement in employment could be valuable to mitigate educational disparities in late-life cognitive function. Moreover, people with higher level of educational attainment may benefit more from social participation than those without.