Cognition and SES Relationships Among the Mid-Aged and Elderly: A Comparison of China and Indonesia
In this paper, we use a measure of fluid intelligence, an adaptive number series test, to measure that part of cognition for respondents in two developing countries: China and Indonesia, both with very low educated elderly populations. This test was specially adapted by us and our collaborators from measures used in the United States to better fit such populations. We also use a measure of episodic memory and one measuring mental state intactness and examine their distributions and then the socio-economic gradients associated with each, concentrating on gender differences and how those change as SES and variables measuring community development are added.
We find large variation in our cognition measures in both countries, even among those 60 and over with no schooling. We explore the bivariate socio-economic gradients for these measures, separately for different age groups: 45-59 and 60 and above. We find strong gender, education and rural-urban gradients. Of these, the education gradient is the strongest, followed by the rural-urban gradient. China has a stronger rural-urban gradient than Indonesia, which is associated with the hukou residential permit system in China.
We find a significant, negative multivariate differential for women, that is significantly larger in China than Indonesia. The gender differential in both countries is smaller for the mid-aged, 45-59, for whom the gender schooling differentials are smaller. The gender differential declines substantially, and the China-Indonesia differential disappears once we control for SES characteristics. Adding community measures related to mean schooling and asset levels does not affect the gender differential.
Schooling levels are monotonically and significantly related to higher levels of cognition for all three of the variables we use. The magnitudes of the schooling coefficients are relatively large. Higher log of household per capita expenditure (pce) is positively associated with cognition, more so in China. Other SES characteristics such as height, are also positively related to the cognition measures, again more strongly so in China. Rural respondents have substantially lower levels of cognition measures, with a significantly stronger gradient in China. Mean community level schooling and log pce are also positively related to cognition outcomes, especially for elderly women.
The prior work of Dr. John McArdle is greatly appreciated. The development of the revised adaptive number series test for use in Indonesia and other low income countries originated from long discussions between Strauss, John McArdle, Robert Willis and Rebeca Wong, with the support of the Division of Behavioral and Social Research, National Institute on Aging. Richard Woodcock was also heavily consulted. Support from small grants from the USC/UCLA Center on Biodemography and Population Health (from P30-AG017256) and from the University of Michigan (from P01-AG026571) helped to fund the pretest field work in Indonesia and Mexico for the adaptive number series test used in this paper. Grant support from the National Institute on Aging, R01-AG026676, and the National Institute of Child Health and Human Development, R01-HD050764 for IFLS and from the National Institute on Aging, R01-AG037031, the National Natural Science Foundation of China, 71450001,71273237, 7130002, 71603013, and the China Medical Board, 16-249, for CHARLS is greatly appreciated. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
The fund from Zhejiang Social Science Foundation in China (13JDLB02YB) is acknowledged as well.