Abstract
Background Cognitive impairment is associated with decreased life expectancy. Among socioeconomic factors, low education has been related to cognitive impairment and mortality. The objective of this study is to estimate cognitively healthy life expectancy (CHLE), life expectancy with cognitive impairment (CILE), and life expectancy with dementia (DLE), in Mexican adults aged 60 and older stratified by educational attainment. Methods Data came from Waves 1 (2001) to 5 (2018) of the Mexican Health and Aging Study. The final sample included all individuals aged 60 and older who were interviewed between 2001 and 2018 (n=15,284). Educational attainment was categorized as no formal education (n=3,642), incomplete elementary (n=5,073), complete elementary (n=3,078), middle school (n=1,102), medium-superior (high school, technical school, teaching school; n=1,438), and superior (professional or graduate degree; n=951). Participants were classified as cognitively healthy, cognitively impaired, and dementia. Life expectancy was estimated using a multistate life table analysis. Results Total life expectancy by educational attainment was 22.7 years (no formal education), 22.6 years (incomplete elementary), 22.9 (complete elementary), 23.6 (middle school), 24.7 years (medium-superior), and 24.4 years (superior). CHLE ranged from 17.6 years for individuals with no formal education to 23 years for individuals with a medium-superior level of education. CILE and DLE decreased with greater educational attainment. The largest changes in CILE were between individuals with no formal education (2.3 years), incomplete elementary (1.4 years), middle school (0.9 years), and medium-superior (0.5 years). Dementia life expectancy ranged from 2.8 years for individuals with formal education to 0.9 years for those with a superior level of education. Conclusion Older adults in Mexico with higher education live more years cognitively healthy and fewer years with cognitive impairment and dementia. Future research should assess the role of occupation and other factors related to educational attainment in late-life cognitive reserve.
