The effect of socioeconomic position across the life course on cognitive function among older adults in China

Cognitive impairment is one of the major health challenges in China. This study aimed to investigate how three mechanisms the cumulative model, sensitive period model, and social mobility model - articulate the impact of socioeconomic position (SEP) across the life course on late-life cognitive function in a Chinese context. The analysis utilized data from older adults across six waves of CLHLS (2002–2018), involving 12,049 individuals with a total of 33,716 observations. Acknowledging the changes in SEP across the life course, the study constructed eight distinct SEP trajectories across the lifespan. Multiple multilevel regressions were used to test the three conceptual models. Three hypotheses - the cumulative model, sensitive period model, and social mobility model - were tested and supported. These hypotheses related to the gradual accumulation of SEP disadvantage, lower SEP during adulthood, and downward inter-generational and intra-generational mobility, all being linked with poorer cognitive performance (lower cognitive function scores and a higher risk of cognitive impairment) among older adults in China. Policies aiming to reduce social inequality should engage multiple sectors, focusing on promoting equal opportunities across all stages of life.