Social exclusion and cognitive impairment - A triple jeopardy for Chinese rural elderly women

This study investigates how social exclusion, defined as a multidimensional concept encompassing financial deprivation, social isolation, and a lack of basic social rights, is associated with cognitive impairment of elderly Chinese. Using three waves of the Chinese Longitudinal Healthy Longevity Survey (N = 10,923), we find that rural elderly women are the most vulnerable to social exclusion (17.28%) and cognitive impairment (18.52%) among the Chinese elderly. After addressing the methodological challenges of endogeneity and sample attrition due to mortality, and holding an array of demographic, lifestyle, and health variables constant, we find that social exclusion is significantly associated with higher risks of cognitive impairment. Rural elderly women suffering from severe or extreme social exclusion are 23 times more likely to be cognitively impaired as compared to their urban male counterparts who are not socially excluded. Lack of participation in social activity is the most common risk factor associated with cognitive impairment across groups, after controlling for relevant covariates.