Focus on housing issues: Associations between housing quality and cognitive impairment among older adults in China and India

BackgroundHousing is a key social determinant of health, yet its association with cognitive impairment, a precursor to dementia and Alzheimer's disease, remains understudied in rapidly aging populations.ObjectiveTo investigate the association between housing quality and cognitive impairment among community-dwelling older adults in China and India.MethodsThis study examined the association between housing quality and cognitive impairment in community-dwelling older adults using nationally representative data from the China Health and Retirement Longitudinal Study (n = 5136) and the Longitudinal Ageing Study in India (n = 29,124). Housing quality was assessed using five indicators (temporary housing materials, sanitation, tap water access, solid fuel use for cooking, and electricity) and categorized as good (0-1 scores), moderate (2-3 scores), or poor (4-5 scores). Cognitive function was assessed using validated instruments adapted for each dataset, with cognitive impairment defined as performance at least one standard deviation below age-specific norms.ResultsThe median age was 67 years in India and 66 years in China, with 51.41% and 44.31% female participants, respectively. A significant dose-response relationship was observed between housing quality and cognitive impairment in both countries. Compared with good housing quality, moderate housing quality was associated with 1.54 (95% CI: 1.41-1.68) and 1.41 (95% CI: 1.16-1.72) times higher odds of cognitive impairment in India and China, respectively, while poor housing quality was associated with 1.94 (95% CI: 1.75-2.16) and 1.97 (95% CI: 1.56-2.50) times higher odds, respectively, after adjustment for confounders.ConclusionsHousing quality is a potentially modifiable environmental determinant of cognitive impairment in aging populations.