Geographic Heterogeneity in the Association Between Schooling and Cognitive Change Among Older Adults in India

Higher years of schooling are linked to steeper cognitive decline among older adults in India overall, but the schooling–cognition change association varies significantly across 18 states and union territories.

• Why it matters: A national average may hide geographic heterogeneity in how education relates to cognitive aging, limiting accurate interpretation for older adults across India.
• What they did: Using Longitudinal Aging Study in India data (wave 1: 2017–2019; wave 2: 2022–2024), 2,510 adults aged 60+ were modeled with schooling-by-geography interactions in change-score and baseline-conditioned analyses.
• The result: The interaction was significant (change score: F = 2.97, P < .001; analysis of covariance: F = 4.11, P < .001), with state-specific estimates ranging from -0.056 SD/year in Odisha to +0.021 SD in Kerala.