Intersectional Social Inequalities and Cognitive Functioning among Community-Dwelling Older Adults in England: A Decomposition Analysis of the Mediating Role of Loneliness
Abstract
Normative cognitive decline is an emerging public health issue for older adult populations. It is necessary that we take an intersectional approach to examining heterogeneity in cognitive health outcomes. Using complex longitudinal survey data from the English Longitudinal Study of Ageing (ELSA), multiple linear regression models were used to examine the relationship between intersectional group membership based on age, education, and sex, and change in cognitive functioning domains (memory function, and executive function) over an 8-year period. Three-way decomposition analysis was also used to examine the mediating effect of loneliness on the association between intersectional group membership and the change in cognition domains. Intersectional group membership was found to be significantly associated with changes in memory function and executive function over time. However, loneliness was not observed to have a significant mediating effect on the relationship between intersectional group membership and the change in cognition outcomes.