Rural/urban dwelling across the life-course and late-life cognitive ability in Mexico

How does urbanization affect the cognitive function among older adults: A geospatial analysis in China

There has been a plethora of studies on urbanization and older adults, and more recent ones on how older adults adapt to this process with their cognitive competence. Yet it has been unclear about the relationship between them, like how the level and rate of urbanization affect the cognitive function among older adults. This study sourced, formed, and analyzed a set of geospatial big datasets from different sources, such as the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data, and the NPP/VIIRS nighttime light (NTL) data. Results showed a generally negative linear association between the rate of urbanization and cognitive performance among older adults in China. The "U" shaped non-linear relationship between urbanization level and cognitive function, as well as the tipping point, were identified. At the same time, it should be noted that mediators such as education, physical activity, social activity, and community elderly service might be able to mitigate these negative associations. Furthermore, older adults living in eastern regions or urban areas appeared to have better cognitive function than those living in mid-western regions or rural areas in China. The findings also pointed to the importance of focusing on older adults with poor cognitive health status in rapidly urbanizing areas.

Rural and urban differences in lifetime occupation and its influence on mortality among Mexican adults

OBJECTIVE

To determine how primary lifetime occupation type is associated with mortality, and how the relationship varies by rural and urban dwelling.

MATERIALS AND METHODS

Data come from 2001-2018 Mexican Health and Aging Study (adults aged 50+, n=11 094). We created five occupation categories. Cox proportional hazard models predicted mortality using baseline covariates.

RESULTS

In both rural and urban settings, participants with manual jobs, such as agriculture and production/industrial jobs, had an increased risk of mortality compared to those with administrative/professional jobs. In urban settings, participants in the domestic/service and no main job categories had higher risk of mortality than those in the administrative/professional category. For men these differences remained, but not for women.

CONCLUSION

In a context of rural and urban demographic shifts, it is crucial to consider the implications that occupation as a socioeconomic factor can have on health and to identify the most vulnerable groups.

Mental health and cognitive function among medical students after the COVID-19 pandemic in China

Background

Chinese people experienced a nationwide coronavirus disease 2019 (COVID-19) pandemic after the adjustment of epidemic response policies from December 2022 to January 2023. This study aims to explore the prevalence of mental and cognitive symptoms and their associated factors among medical students after the COVID-19 pandemic.

Methods

A cross-sectional study was conducted between February 27th and March 8th, 2023. The symptoms of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), and cognitive function among medical students were examined using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Athens Insomnia Scale (AIS), the Impact of Event Scale-6 (IES-6), and the Perceived Deficits Questionnaire-Depression-5 (PDQ-D-5). Data on demographic information was also collected. Statistical analyses were conducted to describe the prevalence and explore the associated factors of mental and cognitive symptoms.

Results

Among 947 participants, the proportion of students experiencing anxiety, depression, insomnia, and PTSD symptoms was 37.8, 39.3, 28.3, and 29.5%, respectively. The self-reported COVID-19 infection rate was 72.2%. Higher grades, childhood, and current rural residence were identified as potential risk factors for mental and cognitive symptoms. Gender, age, average monthly household income, and COVID-19 diagnosis were not associated with mental and cognitive symptoms among medical students.

Conclusion

Our findings revealed a high prevalence of mental and cognitive symptoms among Chinese medical students after the COVID-19 pandemic. Special attention should be paid to the mental health of higher-grade students and those residing in rural areas.

Life course rural/urban place of residence, depressive symptoms and cognitive impairment among older adults: findings from the Longitudinal Aging Study in India

BACKGROUND

Given the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms and cognitive impairment, among older adults in India. The study also examined the relationship between older individuals' life-course rural/urban place of residence and late-life mental and cognitive health.

METHODS

Utilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults.

RESULTS

Childhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05-1.80] but not men. Childhood [aOR: 1.88, CI: 1.16-3.04], adulthood [aOR: 2.00, CI: 1.26-3.16] and current rural residence [aOR: 1.93, CI: 1.27-2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 1.71, CI: 1.29-2.27] was associated with cognitive impairment in women. There was no significant association between life-course place of residence and depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -0.14, CI: -0.21- -0.07] compared to those with rural-rural-rural place of residence. There were significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants, showing an urban advantage in cognitive function among older adults.

CONCLUSIONS

This study showed significant associations between life-course residence and depressive symptoms among permanent rural/urban residents. The study also showed significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants. Considering the rural disadvantage in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. The findings also urge social scientists and gerontologists in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study

Background

Modifiable risks for dementia are more prevalent in rural populations, yet there is a dearth of research examining life course rural residence on late-life cognitive decline.

Methods

The association of rural residence and socioeconomic status (SES) in childhood and adulthood with late-life cognitive domains (verbal episodic memory, executive function, and semantic memory) and cognitive decline in the Kaiser Healthy Aging and Diverse Life Experiences cohort was estimated using marginal structural models with stabilized inverse probability weights.

Results

After adjusting for time-varying SES, the estimated marginal effect of rural residence in childhood was harmful for both executive function (β = -0.19, 95% confidence interval [CI] = -0.32, -0.06) and verbal episodic memory (β = -0.22, 95% CI = -0.35, -0.08). Effects of adult rural residence were imprecisely estimated with beneficial point estimates for both executive function (β = 0.19; 95% CI = -0.07, 0.44) and verbal episodic memory (β = 0.24, 95% CI = -0.07, 0.55).

Conclusions

Childhood rurality is associated with poorer late-life cognition independent of SES.

Food Insecurity across the Life-Course and Cognitive Function among Older Mexican Adults

BACKGROUND

Food insecurity remains a global public health problem. Experiencing food insecurity is related to poorer cognitive function among older adults. However, few studies have examined how food insecurity, experienced over the life-course, relates to cognitive function among older adults in Mexico.

METHODS

Data came from the 2015 Mexican Health and Aging Study (n = 11,507 adults aged 50 and over). Early- and late-life food insecurity were ascertained by self-report. We evaluated how both measures of food insecurity related to the performance of multiple cognitive tasks (Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency), while controlling for key health and sociodemographic confounders using linear regression.

RESULTS

In descriptive analyses, respondents who experienced food insecurity in either early or late life performed significantly worse on all cognitive tasks when compared to the food secure. In models adjusted for health and sociodemographic confounders, early-life food insecurity predicted worse Verbal Learning performance and late-life food insecurity was associated with poorer Visual Scanning performance.

CONCLUSIONS

Food insecurity was related to poorer cognitive function in a nationally representative sample of older adults in Mexico. However, results suggested that the significance of effects depended on cognitive task and when in the life-course food insecurity was experienced.