Social Science & Medicine

Cognitive ageing: sex and life course social class differences in England

Cohort study in peoplePopulations
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Abstract

Whilst cognitive decline is often assumed to be an inevitable part of old age, plenty of studies document its heterogeneity, with many older people showing high functioning and resilience to decline. Lower socioeconomic status is a known risk factor for cognitive decline. This study links the theoretical ideas of cognitive reserve to psychosocial theory and intersectionality to propose that combinations of demographic factors better define lived experiences of social position than individual categories for understanding patterns of cognitive function over time. We use 10 waves from the English Longitudinal Study of Ageing (ELSA), spanning 2002-2023, and operationalise cognitive ageing with repeated measures of episodic memory. We examine the intersectional effects of sex, birth cohort, own social class, and parents' social class using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) modelling. The results show women have better episodic memory scores than men, there is a gradient by social class, and parental social class exerts an influence on cognition over and above own class. The 'intersections' with the lowest cognition scores include those multiply disadvantaged, such as working-class women from lower-class backgrounds, and the downwardly mobile. Examination of pairs of interactions show that social class exerts stronger interactive effects than sex or cohort (having controlled for age). However, the variance components analysis from the model shows little evidence of significant intersectionality, and thus suggests that the effects of sex, birth cohort, own social class, and parents' social class are additive rather than multiplicative.

The paper

University of Oxford; Centre de Recherche en Économie et Statistique

Social Science & Medicine, 14 Nov 2025

doi.org/10.1016/j.socscimed.2025.118787PubMed 41242162