Gender-Based Pathways to Cognitive Aging in the Mexican-Origin Population in the U.S.: The Significance of Work and Family.

Objectives This study uses the life course perspective to explore the role of key mid-life factors (occupation and number of children) for gender- and nativity-based pathways to cognitive aging for older Mexican Americans. Methods Using the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE, 1993/1994-2016, n=2,779), this study presents (a) cognitive impairment trajectories over 20 years of data and (b) multinomial logistic regression analyses of trajectory group membership by lifetime occupation and number of children, controlling for educational attainment. Results For older Mexican American men, lifetime employment in agricultural occupations is associated with elevated risk for late life cognitive impairment. Delayed risk for impairment is observed for U.S.-born men who were employed in factory work (e.g., production and repair) and in Mexican-born men who were employed in occupations with skilled or supervisory requirements. For all women, labor force participation, especially in skilled occupations, is related to a delayed risk of cognitive impairment. Number of children is unrelated to impairment for men; however, women with five or more children (compared to women with two to four children) are at risk for consistent and rapid cognitive impairment in late life. Discussion Late life cognitive health disparities that disproportionately impact the Mexican American population can be addressed by improving access to educational and occupational opportunities in early and mid-life. This study points to key areas of intervention within work and the home for the Mexican-origin population.