Family-work history and inequalities in old-age cognition in China

Wu, J. & Marois, G. ORCID: https://orcid.org/0000-0002-2701-6286 (2025). Family-work history and inequalities in old-age cognition in China. Social Science & Medicine 381 e118318. 10.1016/j.socscimed.2025.118318.

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Abstract

Prior work showed that an individual's history of partnership, fertility, or employment was separately linked to old-age cognition, but little is known about how family-work history influences later-life cognition, especially in low- and middle-income countries. Our sample comprised respondents aged 50 and above in 2014 interviewed in regular (2011, 2013, 2015, 2018, and 2020) and life-history (2014) waves of the China Health and Retirement Longitudinal Study (CHARLS, n = 8,535). After conducting sequence analysis and identifying six statistically justifiable and context-attuned family-work trajectories, we investigated how Chinese older adults' family-work history (age 18–50) related to their cognition measured by immediate word recall (0–10) and mental status scores (0–11) cross-sectionally (pairwise comparison) and longitudinally (linear mixed-effects models). We found that older adults in the "early marriage, ≥2 children, agriculturally employed" trajectory had lowest baseline immediate recall and mental status scores compared with whom slower declines in immediate recall rather than mental status were found for those in "late marriage, ≥2 children, agriculturally employed (b = 0.02, 95 % confidence interval (CI): 0.00, 0.03)", "married, ≥2 children, not in labour force (mainly early retirees, b = 0.04, 95 % CI: 0.01, 0.06)", and "married, ≥2 children, non-agriculturally employed in public sector (b = 0.04, 95 % CI: 0.03, 0.06)" trajectories. Our findings imply that inequalities in China's pre-1964 birth cohorts' cognition were affected by marriage timing and, to a greater extent, driven by midlife employment sectors which determined substantial inequalities in access to social welfare.

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