Although prior studies have explored cognition by caste, education, or gender separately, their combined effects on older adults remain unexamined. This study examines cognitive disparities among older adults in India using an intersectional approach across caste, education, and gender. Using data from 31,549 individuals aged 60+ from the 2017–18 Longitudinal Ageing Study in India, we find that disadvantaged groups—especially scheduled caste (SC) and scheduled tribe (ST) individuals—consistently show poorer cognitive outcomes, regardless of literacy or gender. Gender further amplifies inequalities within caste and education. These findings underscore intersectionality as a key framework for identifying the most vulnerable older adults with low cognitive functioning.
AlleyDSuthersKCrimminsE (2007) Education and cognitive decline in older Americans: results from the AHEAD sample. Research on Aging29(1): 73–94.
2.
AngrisaniMJainULeeJ (2020) Sex differences in cognitive health among older adults in India. Journal of the American Geriatrics Society68(Suppl. 3): S20–S28.
3.
ArdilaAOstrosky-SolisFRosselliM, et al. (2000) Age-related cognitive decline during normal aging: the complex effect of education. Archives of Clinical Neuropsychology15(6): 495–513.
4.
AyyarVKhandareL (2012) Mapping color and caste discrimination in Indian society. In: R.Hall (ed.) The Melanin Millennium: Skin Color as 21st Century International Discourse. Dordrecht: Springer, pp.71–95.
5.
BailwalNPaulS (2021) Caste discrimination in provision of public schools in rural India. Journal of Development Studies57(11): 1830–1851.
6.
BrewsterPWHMelroseRJMarquineMJ, et al. (2014) Life experience and demographic influences on cognitive function in older adults. Neuropsychology28(6): 846–858.
7.
Castora-BinkleyMPerontoCLEdwardsJD, et al. (2015) A longitudinal analysis of the influence of race on cognitive performance. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences70(4): 512–518.
8.
ChandraVGanguliMRatcliffG, et al. (1998) Practical issues in cognitive screening of elderly illiterate populations in developing countries. the Indo-US cross-national dementia epidemiology study. Aging Clinical and Experimental Research10(5): 349–357.
9.
CloustonSAPSmithDMMukherjeeS, et al. (2020) Education and cognitive decline: an integrative analysis of global longitudinal studies of cognitive aging. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences75(7): E151–E160.
10.
CoffeyDSpearsDHathiP (2020) Assessing high-profile public messaging for sanitation behaviour change: evidence from a mobile phone survey in India. Waterlines (London, England)39(4): 240–252.
11.
DrézeJSenA (1996) Gender inequality and women’s agency. In: DrézeJSenA (eds) India Economic Development and Social Opportunity. Oxford: Oxford University Press, pp.140–178.
12.
EarlyDRWidamanKFHarveyD, et al. (2013) Demographic predictors of cognitive change in ethnically diverse older persons. Psychology and Aging28(3): 633.
13.
FletcherJToppingMZhengF, et al. (2021) The effects of education on cognition in older age: evidence from genotyped Siblings. Social Science & Medicine280: 114044. https://doi.org/10.1016/J.SOCSCIMED.2021.114044
14.
GanguliMChandraVGilbyJE, et al. (1996) Cognitive test performance in a community-based nondemented elderly sample in rural India: the Indo-U.S. Cross-national dementia epidemiology study. International Psychogeriatrics8(4): 507–524.
15.
GlymourMMManlyJJ (2008) Lifecourse social conditions and racial and ethnic patterns of cognitive aging. Neuropsychology Review18(3): 223–254.
16.
HaradaCNNatelson LoveMCTriebelKL (2013) Normal cognitive aging. Clinics in Geriatric Medicine29(4): 737–752.
17.
HathiidPCoffeyDThoratA, et al. (2021) When women eat last: discrimination at home and women’s mental health. PLoS One16(3): e0247065.
KarlamanglaASMiller-MartinezDAneshenselCS, et al. (2009) Trajectories of cognitive function in late life in the United States: demographic and socioeconomic predictors. American Journal of Epidemiology170(3): 331–342.
20.
KarpAKåreholtIQiuC, et al. (2004) Relation of education and occupation-based socioeconomic status to incident Alzheimer’s disease. American Journal of Epidemiology159(2): 175–183.
21.
LancetT (2014) The health of India: a future that must be devoid of caste. Lancet384: 1901.
22.
LeeJShihRFeeneyK, et al. (2014) Gender disparity in late-life cognitive functioning in India: findings from the longitudinal aging study in India. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences69(4): 603.
23.
LeeJShihRAFeeneyKC, et al. (2011) Cognitive Health of Older Indians: Individual and Geographic Determinants of Female Disadvantage. Santa Monica, CA: RAND Corporation.
24.
LeeYBackJHKimJ, et al. (2010) Multiple socioeconomic risks and cognitive impairment in older adults. Dementia and Geriatric Cognitive Disorders29(6): 523–529.
25.
MaselMCPeekMK (2009) Ethnic differences in cognitive function over time. Annals of Epidemiology19(11): 778–783.
26.
MehrotraSKapoorS (2009) Gender discrimination in Asia. Global Social Policy9: 197–205.
27.
MidyaDKIslamMM (2024) Gender discrimination in education among the Muslims: a case study in an Indian village for identifying the key factors. Journal of Asian and African Studies59(1): 274–291.
28.
MosseD (2018) Caste and development: contemporary perspectives on a structure of discrimination and advantage. World Development110: 422–436.
29.
MuhammadTSrivastavaSSekherTV (2022) Assessing socioeconomic inequalities in cognitive impairment among older adults: a study based on a cross-sectional survey in India. BMC Geriatrics22(1): 1–13.
30.
RoccaWAPetersenRCKnopmanDS, et al. (2011) Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimer’s and Dementia7(1): 80–93.
31.
ScarmeasNAlbertSMManlyJJ, et al. (2006) Education and rates of cognitive decline in incident Alzheimer’s disease. Journal of Neurology, Neurosurgery and Psychiatry77(3): 308–316.
32.
SharmaMPradhanMR (2023) Socioeconomic inequality in cognitive impairment among India’s older adults and its determinants: a decomposition analysis. BMC Geriatrics23(1): 1–10.
33.
SinghPKJasilionisDOksuzyanA (2018) Gender difference in cognitive health among older Indian adults: a cross-sectional multilevel analysis. SSM—Population Health5: 180.
34.
SloanFAWangJ (2005) Disparities among older adults in measures of cognitive function by race or ethnicity. The Journals of Gerontology: Series B60(5): P242–P250.
SternY (2006) Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders20(2): 112–117.
37.
ThoratSMadheswaranS (2018) Graded caste inequality and poverty: evidence on role of economic discrimination. Journal of Social Inclusion Studies4(1): 3–29.
WilsonRSLiYAggarwalNT, et al. (2004) Education and the course of cognitive decline in Alzheimer disease. Neurology63(7): 1198–1202.
41.
ZimmermannL (2012) Reconsidering gender bias in intrahousehold allocation in India. Journal of Development Studies48(1): 151–163.
42.
ZsembikBAPeekMK (2001) Race differences in cognitive functioning among older adults. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences56(5): S266–S274.
