Page 96 - IJPS-11-4

International Journal of
Population Studies Health disparities and older adults well-being in China

dementia prevalence. One key driver behind these of socioeconomic variables on the mental health of older
variations is differences in educational attainment. Well- adults.
educated older generations in high-income countries
tend to exhibit better cognitive functioning. Furthermore,
most empirical studies indicate that MMSE scores tend to
decline with age; women typically score lower than men,
and individuals with compromised physical or mental
health are more susceptible to dementia (Van Gelder
et al., 2004; Marin et al., 2011; Brown et al., 2012; Groot
et al., 2016). Therefore, we introduced IADLs and CESD
scores as explanatory variables in an alternative model
(Model 6) to investigate the influence of physical and
mental health on cognitive health among the older adults.

In summary, given the abstract nature of health,
our study employed a comprehensive and objective
assessment. To accommodate different dependent variable
types (binary, discrete), we integrated ADLs, IADLs, CESD
scores, and MMSE scores to holistically reflect the health Figure 6. Age gradient of the instrumental activities of daily living index by sex
status of older adults participants. The distribution of these
indexes is presented in Figure 5-8.

2.3. Methodology and study strategy
There are many evaluation criteria for health of older people,
and some studies use the older people’s self-rated health
(SRH) as a variable of physical health. However, we believe
that SRH of the older people is a subjective perception
and instead use ADLs and IADLs as variables of physical
health. In models 1 and 2, we used the results of ADLs
and IADLs as the dependent variables and applied logit
regression analysis, controlling for personal characteristics.
For mental health analysis, we used the CESD score as
the dependent variable in both models 3 and 4. Although
model 3 does not consider the impact of physical health
on mental health, we included IADLs as an explanatory Figure 7. Age gradient of those suffering from depression (Center for
variable in model 4 to address this shortcoming. In models Epidemiological Studies Depression Scale-10 score ≥10) by sex
3 and 4, we used multiple regression to analyze the effect

Figure 8. Age gradient of those suffering from dementia (Mini-Mental
Figure 5. Age gradient of the activities of daily living index by sex State Examination score ≤23) by sex

Volume 11 Issue 4 (2025) 90 https://doi.org/10.36922/ijps.2035