Supplemental Materials: Duration of poverty and subsequent cognitive function and decline among older adults in China, 2005-2018

Objective To investigate the relationship between late-life duration of
poverty exposure and cognitive function and decline among older adults in
China. Methods Data were from 3,209 participants aged ≥64 in the Chinese
Longitudinal Healthy Longevity Survey (CLHLS). Duration of poverty,
defined according to urban and rural regional standards from the China
Statistical Yearbook, was assessed from 2005-2011 (never in
poverty; 1/3 of the period in poverty; ≥2/3 of the
period in poverty). Cognitive function was measured by the Chinese Mini
Mental State Exam (CMMSE) from 2011 to 2018. We used attrition-weighted,
multivariable mixed-effects Tobit regression to examine the association of
duration of poverty with cognitive performance and rate of decline.
Results A total of 1,162 individuals (36.21%) were never in poverty over
the period from 2005 to 2011, 1,172 (36.52%) were in poverty 1/3 of the
period, and 875 (27.27%) were in poverty ≥2/3 of the period. A longer
poverty duration was associated with lower subsequent CMMSE scores with a
dose-response relationship (1/3 vs. never in poverty: β = -0.98; 95% CI:
-1.61 to -0.35; ≥2/3 vs. never in poverty: β = -1.55; 95% CI: -2.29 to
-0.81). However, a longer duration of poverty was associated with a slower
rate of CMMSE score decline over time. Conclusion These findings provide
valuable evidence on the role of cumulative late-life poverty in relation
to cognitive health among older adults in a rapidly urbanizing and aging
middle-income country. Our findings may support a compensation hypothesis
for cognitive reserve in this setting.