Abstract
While internal migration is widely occurring in countries across the world and older people are more likely to be left behind by family members who out-migrated to other locations, little attention has been paid to the cognitive health of those people who have been left behind (PLB). Understanding how these demographic patterns relate to older persons’ cognitive health may inform efforts to reduce the disease burden due to cognitive decline. Data came from the China Health and Nutrition Survey in 1997, 2000 and 2004. Participants aged 55 to 93 who participated in a cognitive function screening test (score range: 0–31) in two or more waves and provided information on family members’ migration (n = 1,267) were included in the analysis. A mixed linear model was used to investigate the association between being left behind by any members who had not resided in the household for at least 6 months at baseline and cognitive function. Approximately 10% of the participants had been left behind by family members who migrated out of their communities. A significant interaction was observed in relation to cognitive function between being left behind and the number of years from the first test. Specifically, there was a less steep decline in cognitive function of PLB compared to people not left behind. This longitudinal study showed that PLB tended to have a higher cognitive function compared to those not left behind due to their relatively stable transition in cognitive function during the study period.
Highlights
There was no substantial difference between people who have been left behind (PLB) and people not left behind in relation to sex, education, household income, living arrangement, cognitive function and instrumental activities of daily living (IADL)
The interaction term between being left behind and the number of years from study entry was statistically significant. These overall trends did not change after adjusting for across-time variability in IADL difficulty and self-rated health scores while the interaction term became non-significant (p = 0.117) (Model 2); Fig 1 illustrates that the cognitive function score of PLB was much more stable across time compared to that of individuals not left behind which meant that by the end of the study period, cognitive function was higher in PLB
We found that over the 7-year follow-up period the cognitive function of participants with family members who out-migrated for at least 6 months at baseline remained relatively stable, whereas the cognitive function of individuals who did not have out-migrating family members declined over time
Summary
We thank the National Institute for Nutrition and Health, China Center for Disease Control and Prevention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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