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Childhood deprivation and later-life cognitive function in a population-based study of older rural South Africans
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of t he Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
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2017 (Engelska)Ingår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 190, s. 20-28Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Rationale: Little research has evaluated the life course drivers of cognitive aging in South Africa.

Objectives: We investigated the relationships of self-rated childhood health and father's occupation during childhood with later-life cognitive function score and whether educational attainment mediated these relationships among older South Africans living in a former region of Apartheid-era racial segregation.

Methods: Data were from baseline assessments of "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community" (HAALSI), a population-based study of 5059 men and women aged >= 40 years in 2015 in rural Agincourt sub-district, South Africa. Childhood health, father's occupation during childhood, and years of education were self-reported in study interviews. Cognitive measures assessed time orientation, numeracy, and word recall, which were included in a z-standardized latent cognitive function score variable. Linear regression models adjusted for age, sex, and country of birth were used to estimate the total and direct effects of each childhood risk factor, and the indirect effects mediated by years of education.

Results: Poor childhood health predicted lower cognitive scores (total effect = -0.28; 95% CI = -035, -0.21, versus good); this effect was not mediated by educational attainment. Having a father in a professional job during childhood, while rare (3% of sample), predicted better cognitive scores (total effect = 0.25; 95% CI = 0.10, 0.40, versus unskilled manual labor, 29% of sample). Half of this effect was mediated by educational attainment. Education was linearly associated with later-life cognitive function score (0.09; 95% CI = 0.09, 0.10 per year achieved).

Conclusion: In this post-Apartheid, rural South African context, older adults with poor self-reported childhood health or whose father worked in unskilled manual labor had relatively poor cognitive outcomes. Educational attainment strongly predicted cognitive outcomes, and appeared to be, in part, a mechanism of social stratification in later-life cognitive health in this context.

Ort, förlag, år, upplaga, sidor
Pergamon-Elsevier Science Ltd , 2017. Vol. 190, s. 20-28
Nyckelord [en]
South Africa, rural, aging, cognitive aging, cognitive function, education, socioeconomic conditions, self-rated health
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-141488DOI: 10.1016/j.socscimed.2017.08.009ISI: 000413135900003PubMedID: 28837862OAI: oai:DiVA.org:umu-141488DiVA, id: diva2:1158775
Tillgänglig från: 2017-11-21 Skapad: 2017-11-21 Senast uppdaterad: 2018-06-09Bibliografiskt granskad

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Kobayashi, Lindsay C.Kahn, KathleenPayne, Collin F.Tollman, Stephen M.

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Kobayashi, Lindsay C.Kahn, KathleenPayne, Collin F.Tollman, Stephen M.
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Social Science and Medicine
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