Comparison of Executive Functioning between Ageing Urban and Rural Participants in India: A Cross‐sectional Analysis

Abstract

AbstractBackgroundOlder adults living in urban areas differ from their rural counterparts in many ways, including the cognitive performance. Executive functioning is one of the few cognitive domains that is implicated to be affected in early stages of dementia. However, there are very few studies that have explored differences in cognitive functioning across rural and urban contexts in India. Our objective was to evaluate differences in executive functioning across urban and rural participants.MethodOur study sample includes ageing individuals (≥ 45 years): 1089 from the urban Tata Longitudinal Study on Ageing (TLSA) cohort and 4913 from the rural Srinivaspura Ageing, Neuro Senescence and COGnition (SANSCOG) study cohort. The TLSA and SANSCOG are parallel, harmonised, community‐based cohort studies in urban and rural India exploring the risk and protective factors associated with cognitive changes due to normal ageing, dementia and other related disorders. The difference in executive functioning measured by Categorical fluency, Letter fluency, Visuospatial span and Stroop tests were compared across both cohorts.ResultUrban participants were older, had more years of education had less Geriatric Depression Score (GDS) as shown in Table 1. They did not differ in gender and proportion of cognitive impairment. Multiple Linear Regression analysis was performed to examine the effects of each executive functioning tests between both the cohorts (urban participants were coded as reference category) while age, years of education and GDS were adjusted.Urban participants performed better than Rural participants on Categorical fluency (β = ‐2.379, p < 0.001), Letter fluency (β = ‐4.343, < 0.001), Visuospatial span (β = ‐0.279, < 0.001) and Stroop (β = 0.934, < 0.001). Similar results were obtained after gender stratification as shown in Table 2.ConclusionUrban participants performed better than their rural counterparts in all tests examining executive functioning. Poorer cognitive functioning in the rural ageing cohort could be due to a number of reasons including limited or less cognitively demanding occupations. There is a need for more such longitudinal studies in India that explore community environment on cognitive function across different cohorts.