Life course social mobility and cognitive function among middle-aged and older adults in India: Exploring heterogeneity by gender

This study investigates the link between life course social mobility and cognitive function among middle-aged and older adults in India, specifically emphasizing whether upward and downward mobility exerts symmetric associations and potential gender heterogeneity within these associations. Leveraging data from the Longitudinal Aging Study in India 2017-2018, encompassing 64,710 individuals aged 45 years or above, we classified social mobility as 'consistently high,' 'upward mobility,' 'downward mobility,' and 'consistently low,' based on socioeconomic position during childhood and late adulthood. Multivariable regression and gender-interaction analyses were employed to assess associations. Overall, 35.69% maintained a consistently high socioeconomic position, whereas 22.87% remained consistently low; 20.05% experienced upward mobility, and 21.39% faced downward mobility. Compared to consistently high socioeconomic position, consistently low socioeconomic position was associated with lower cognitive function (b = -1.47; 95% CI = -1.59, -1.34), followed by downward mobility (b = -0.84; 95% CI = -0.95, -0.72) and upward mobility (b = -0.72; 95% CI = -0.84, -0.61). Notably, the interaction model revealed significant differences by gender, especially between opposite social mobility groups. Among men, upward and downward mobility displayed asymmetric associations, with upward mobility being associated with a higher cognitive function than downward mobility (b = 0.31; 95% CI = 0.13, 0.50), whereas such differences were not observed for women (b = -0.01; 95% CI = -0.20, 0.17). These findings highlight the critical influence of life course social mobility on cognitive health, with implications for interventions tailored to the unique trajectories of social mobility by gender in India.