A – 81 The Role of Education in Cognitive Aging and Functional Independence Among Chinese Adults and Older Adults

Abstract Objective While education influences cognitive functioning in adults, less is known about its connection to functional independence and cognitive change. This study examines whether instrumental activities of daily living (IADL) difficulties indicate cognitive decline and whether this association varies by education level. Method The sample included 25,586 adults (51.8% female; mean age: 59.61) from the China Health and Retirement Longitudinal Study (CHARLS); 86% having primary, 11% secondary, and 3% tertiary education. Cognitive function was assessed through immediate/delayed recall, orientation, and serial sevens. IADL scores measured functional ability. Linear mixed-effects models examined how education moderates the IADL-cognitive change over seven years. Results Lower education was linked to lower baseline cognitive scores. Orientation declined across groups, with a slower decline in the secondary group with more IADL difficulty. Recall decline was the steepest among the primary group with greater IADL difficulty. Serial seven performance declined across groups, with IADL difficulty linked to worse performance; decline was slower in primary and secondary groups, and faster in the tertiary group. Conclusion Across education levels, IADL difficulties were linked to worse cognitive outcomes across education, but the relationship varied. Those with primary education showed the steepest cognitive decline, with IADL difficulty worsening recall and orientation. In the secondary education group, decline was less severe, and IADLs effects weakened over time. The tertiary education group showed minimal decline, but functional difficulty had the strongest negative impact. These findings suggest education moderates the link between functional independence and cognitive aging, with IADL difficulties being a stable marker of decline among less-educated adults.