Own and Parental Schooling, Gender, and Cognitive Performance based on the Harmonized Cognitive Assessment Protocol (HCAP) among Older Chilean Adults.

Objectives: This study aimed to investigate associations of own and parental schooling with cognitive performance measured using the Harmonized Cognitive Assessment Protocol (HCAP) in Chile, a context distinct from previous studies using the HCAP.

Methods: Using Chile-Cog HCAP data linked to the Chilean Social Protection Longitudinal Survey, we used multivariate-adjusted regressions for individuals aged ≥60 to estimate associations between own and parental schooling and global HCAP and domain-specific scores, and examined gender differences (n = 1,791).

Results: Own schooling, with basic covariates, is associated with 40% of the variance in global HCAP scores. Less-than-primary vs. lower-secondary schooling is associated with lower global HCAP scores and with lower orientation, memory, executive function, language, and visuospatial domain scores. Post-secondary versus lower-secondary schooling is associated with higher global and domain-specific scores: orientation, memory, executive function, language, and visuospatial. Including parental schooling yields lower estimates for own schooling, and maternal completion of primary schooling or above is associated with higher global scores than less-than-primary schooling. Being female is not significantly associated with global HCAP scores, but it was positively associated with memory scores and negatively with the visuospatial scores. Interaction between own schooling and being female suggests significantly higher scores for primary schooling for female than male for the orientation and memory domains.

Discussion: These results reinforce the findings of earlier studies regarding the strong association of schooling with better cognition in a South American country that transitioned from a developing to a high-income country during respondents' lifetimes.