Educational Differences in Cognitive Life Expectancy Among Older Adults in Brazil.

OBJECTIVES: To investigate the differences in life expectancy with and without cognitive impairment (CI) by educational levels and sex in Brazil.

DESIGN: Longitudinal observational study.

SETTING: The sample was drawn from three waves (2000, 2006, and 2010) of the Health, Well-Being, and Aging Study (Saúde, bem-estar e envelhecimento; SABE) collected in São Paulo, Brazil.

PARTICIPANTS: Adults aged 60 years and older (N = 2116).

MEASUREMENTS: Educational levels were estimated in the baseline wave (2000), cognition was assessed in all waves, and mortality data were obtained through the state and municipal mortality system in Brazil. Interpolation of Markov chain methods was used to estimate life expectancy with and without CI by education and sex.

RESULTS: Life expectancy without CI at the age of 60 years was 13.0 years among men with no education and 17.6 years among their counterparts with 8 years of schooling. On the other hand, life expectancy with CI was higher among men with no education than those with more education (3.2 and 0.6 years, respectively). Among 60-year-old women without education, life expectancy without CI reached 16.2 years, but it was considerably higher among more educated women (22.7 years). Life expectancy with CI reached 4.5 years among women aged 60 years with no education, vs 1.0 year among women with 8 years of schooling.

CONCLUSIONS: Adults older than 60 years with no education live shorter lives and with longer periods of CI than those with education. Women in São Paulo live longer lives than men, but they live with CI for a greater number of years.