Gender differentials in cognitive impairment and decline of the oldest old in China.

OBJECTIVE Research in China has shown that women are significantly disadvantaged in cognitive functioning in old age. This article adds to this line of inquiry by examining gender differentials in the odds of having cognitive impairment at baseline and during follow-up among the Chinese oldest old, as well as the potential pathways linking gender and the likelihood of having cognitive impairment. METHODS Using two waves (1998 and 2000) of the Chinese Longitudinal Healthy Longevity Survey, the researcher estimated logistic and multinomial regression models of cognitive impairment for a nationwide sample of people aged 80-105 years old (N = 8,291). RESULTS Among the Chinese oldest old, women were at higher risk than men for having cognitive impairment both at baseline and during 2-year follow-up, controlling for age, activities of daily living disability, and rural residence. Women's disadvantages in socioeconomic status, social network, and participation in leisure activities partially accounted for the gender differentials in cognitive impairment. DISCUSSION The findings suggest that oldest old Chinese women are a vulnerable group at higher risk for cognitive impairment than oldest old men. Closing gender disparities in formal education will significantly reduce the gender gap in cognitive impairment in old age.