, Volume 45, Issue 4, pp 907–926 | Cite as

Gender, resources across the life course, and cognitive functioning in Egypt

  • Kathryn M. Yount


In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning.


Cognitive Functioning Cognitive Resource United Nations Development Programme Ordinary Little Square Regression Schooling Attainment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Albert, M.S. 1995. “How Does Education Affect Cognitive Function?” Annals of Epidemiology 5:76–8.CrossRefGoogle Scholar
  2. Alderman, H., J.R. Behrman, D.R. Ross, and R. Sabot. 1996. “Decomposing the Gender Gap in Cognitive Skills in a Poor Rural Economy.” Journal of Human Resources 31:229–54.CrossRefGoogle Scholar
  3. Bornstein, A.R., C.I. Copenhaver, and J.A. Mortimer. 2006. “Early-Life Risk Factors for Alzheimer Disease.” Alzheimer Disease and Associated Disorders 20(1):63–72.CrossRefGoogle Scholar
  4. Breteler, M.M., J. J. Claus, D.E. Grobbee, and A. Hofman. 1994. “Cardiovascular Disease and Distribution of Cognitive Function in Elderly People: The Rotterdam Study.” British Medical Journal 308:1604–608.Google Scholar
  5. Cagney, K.A. and D.S. Lauderdale. 2002. “Education, Wealth, and Cognitive Function in Later Life.” Journals of Gerontology: Psychological Sciences 57B(2):163–72.Google Scholar
  6. Cerhan, J.R., A.R. Folsom, J.A. Mortimer, E. Shahar, D.S. Knopman, P.G. McGovern, M.A. Hays, L.D. Crum, and G. Heiss. 1998. “Correlates of Cognitive Function in Middle-Aged Adults. Atherosclerosis Risk in Communities (ARIC) Study Investigators.” Gerontology 44:95–105.CrossRefGoogle Scholar
  7. Cook, J.R. and L.A. Stefanski. 1994. “Simulation Extrapolation Estimation in Parametric Measurement Error Models.” Journal of the American Statistical Association 89:1314–28.CrossRefGoogle Scholar
  8. Elhan, A.H., S. Kutlay, A.A. Kucukdeveci, C. Cotuk, G. Ozturk, L. Tesio, and A. Tennant. 2005. “Psychometric Properties of the Mini-Mental State Examination in Patients With Acquired Brain Injury in Turkey.” Journal of Rehabilitative Medicine 37:306–11.CrossRefGoogle Scholar
  9. El-Zanaty, F., E.M. Hussein, G.A. Shawky, A.A. Way, and S. Kishor. 1996. Egypt Demographic and Health Survey 1995. Calverton, MD: National Population Council [Egypt], Macro International, Inc.Google Scholar
  10. Escobar J., A. Burnam, M. Karno, A. Forsythe, J. Landsverk, and J.M. Golding. 1986. “Use of the Mini-Mental State Examination (MMSE) in a Community Population of Mixed Ethnicity.” Journal of Nervous and Mental Disorders 174:607–13.CrossRefGoogle Scholar
  11. Everson-Rose, S.A., C.F. Mendes de Leon, J.L. Bienias, R.S. Wilson, and D.A. Evans. 2003. “Early Life Conditions and Cognitive Functioning in Later Life.” American Journal of Epidemiology 158:1083–89.CrossRefGoogle Scholar
  12. Farrag, A.K., E.M. Khedr, H. Abdel-Aleem, and T.A. Rageh. 2002. “Effect of Surgical Menopause on Cognitive Functions.” Dementia and Geriatric Cognitive Disorder 13:193–98.CrossRefGoogle Scholar
  13. Galal, O.M. 2002. “The Nutrition Transition in Egypt: Obesity, Undernutrition and the Food Consumption Context.” Public Health Nutrition 5(1A):141–48.CrossRefGoogle Scholar
  14. Herman, W.H., M.A. Ali, R.E. Aubert, M.M. Engelgau, S.J. Kenny, E.W. Gunter, A.M. Malarcher, R.J. Brechner, S.F. Wetterhall, F. DeStefano, T.J. Thompson, P.J. Smith, A. Badran, E.S. Sous, M. Habib, M. Hegazy, S. abd el Shakour, A.S. Ibrahim, and A. el Moneim el Behairy. 1995. “Diabetes Mellitus in Egypt: Risk Factors and Prevalence.” Diabetes Medicine 12:1126–31.CrossRefGoogle Scholar
  15. Hill, K. and D. Upchurch. 1995. “Gender Differences in Child Health: Evidence From the Demographic and Health Survey.” Population and Development Review 21:127–51.CrossRefGoogle Scholar
  16. Hoodfar, H. 1997. Between Marriage and the Market: Intimate Politics and Survival in Cairo. Berkeley: University of California Press.Google Scholar
  17. Hsu, H.C. 2005. “Gender Disparity of Successful Aging in Taiwan.” Women and Health 42(1): 1–21.CrossRefGoogle Scholar
  18. Huber, P.J. 1967. “The Behavior of Maximum Likelihood Estimates Under Nonstandard Conditions.” Pp. 221–23 in Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability, Vol. 1. Berkeley, CA: University of California Press.Google Scholar
  19. Ibrahim, M.M., L.J. Appel, H.H. Rizk, S. Helmy, J. Mosley, Z. Ashour, W. El-Aroussy, E. Roccella, and P. Whelton. 2001. “Cardiovascular Risk Factors in Normotensive and Hypertensive Egyptians.” Journal of Hypertension 19:1933–40.CrossRefGoogle Scholar
  20. Jann, B. 2005. Standard Errors for the Blinder-Oaxaca Decomposition. Available online at http:// Scholar
  21. Kabir, Z.N. and A. Herlitz. 2000. “The Bangla Adaptation of Mini-Mental State Examination (BAMSE): An Instrument to Assess Cognitive Function in Illiterate and Literate Individuals.” International Journal of Geriatric Psychiatry 15:441–50.CrossRefGoogle Scholar
  22. Kannel, W.B. 2002. “The Framingham Study: Historical Insight on the Impact of Cardiovascular Risk Factors in Men Versus Women.” Journal of Gender Specific Medicine 5(2)27–37.Google Scholar
  23. King, E.M. and A.D. Mason. 2001. Engendering Development—Through Gender Equality in Rights, Resources, and Voice. New York: Oxford University Press, and Washington, DC: The World Bank.Google Scholar
  24. Kuusisto, J., K. Koivisto, L. Mykkanen, E.L. Helkala, M. Vanhanen, T. Hanninen, K. Pyorala, P. Riekkinen, and M. Laakso. 1993. “Essential Hypertension and Cognitive Function: The Role of Hyperinsulinemia.” Hypertension 22:771–79.Google Scholar
  25. Lebrun, C.E., Y.T. van der Schouw, F.H. de Jong, H.A. Pols, D.E. Grobbee, and S.W. Lamberts. 2005. “Endogenous Oestrogens Are Related to Cognition in Healthy Elderly Women.” Clinical Endocrinology (Oxford) 63(1):50–55.CrossRefGoogle Scholar
  26. Lloyd, C.B., ed., and National Research Council/Institute of Medicine (NRC/IOM) panel on Transitions to Adulthood in Developing Countries. 2005. Growing Up Global: The Changing Transitions to Adulthood in Developing Countries. Washington, DC: National Academies Press.Google Scholar
  27. Luo, Y. and L.J. Waite. 2005. “The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-being in Later Life.” Journal of Gerontology B: Psychological Sciences and Social Sciences 60:S93-S101.Google Scholar
  28. Manly, J.J., N. Schupf, M.-X. Tang, and Y. Stern. 2005. “Cognitive Decline and Literacy Among Ethnically Diverse Elders.” Journal of Geriatric Psychiatry 18:213–17.CrossRefGoogle Scholar
  29. Neumark, D. 1988. “Employers’ Discriminatory Behavior and the Estimation of Wage Discrimination.” Journal of Human Resources 23:279–95.CrossRefGoogle Scholar
  30. Oaxaca, R.L. and M.R. Ransom. 1994. “On Discrimination and the Decomposition of Wage Differentials.” Journal of Econometrics 61:5–21.CrossRefGoogle Scholar
  31. Palloni, A. n.d. Protocol of the Multicenter Study: Health, Well-being, and Aging in Latin American and the Caribbean. Washington, DC: Pan American Health Organization.Google Scholar
  32. Park, R.M., P.A. Schulte, J.D. Bowman, J.T. Walker, S.C. Bondy, M.G. Yost, J.A. Touchstone, and M. Dosemeci. 2005. “Potential Occupational Risks for Neurodegenerative Diseases.” American Journal of Industrial Medicine 48:63–77.CrossRefGoogle Scholar
  33. Perls, T.T., J.N. Morris, W.L. Ooi, and L.A. Lipsitz. 1993. “The Relationship Between Age, Gender, and Cognitive Performance in the Very Old: The Effect of Selective Survival.” Journal of the American Geriatric Society 41:1193–201.Google Scholar
  34. Rennemark, M. and B. Hagberg. 1999. “Gender Specific Associations Between Social Network and Health Behavior in Old Age.” Aging and Mental Health 3:320–27.CrossRefGoogle Scholar
  35. Reynolds, C.A., A. Fiske, L. Fratiglioni, N.L. Pedersen, and M. Gatz. 2006. “Heritability of an Age-Dependent Categorical Phenotype: Cognitive Dysfunction.” Twin Research and Human Genetics 9(1):17–23.CrossRefGoogle Scholar
  36. Richards, M. and I.J. Deary. 2005. “A Life Course Approach to Cognitive Reserve: A Model for Cognitive Aging and Development.” Annals of Neurology 58:617–22.CrossRefGoogle Scholar
  37. Richards, M., M.J. Jarvis, N. Thompson, and M.E.J. Wadsworth. 2003. “Cigarette Smoking and Cognitive Decline in Midlife: Evidence From a Prospective Birth Cohort Study.” American Journal of Public Health 93:994–98.CrossRefGoogle Scholar
  38. Richards, M. and A. Sacker. 2003. “Lifetime Antecedents of Cognitive Reserve.” Journal of Clinical and Experimental Neuropsychology 25:614–24.CrossRefGoogle Scholar
  39. Rosenzweig, M. and T.P. Schultz. 1982. “Market Opportunities, Genetic Endowments, and Intrafamily Resource Distribution: Child Survival in Rural India.” American Economic Review 72:803–15.Google Scholar
  40. Scarmeas, N. and Y. Stern. 2003. “Cognitive Reserve and Lifestyle.” Journal of Clinical and Experimental Neuropsychology 25:625–33.CrossRefGoogle Scholar
  41. Schaie, K.W. 1994. “The Course of Adult Intellectual Development.” American Psychologist 49:304–13.CrossRefGoogle Scholar
  42. Stern, Y., G.E. Alexander, I. Prohovnik, and R. Mayeux, 1992. “Inverse Relationship Between Education and Parietotemporal Perfusion Deficit in Alzheimer’s Disease.” Annals of Neurology 32:371–75.CrossRefGoogle Scholar
  43. Turrell, G., J.W. Lynch, G.A. Kaplan, S.A. Everson, E.L. Helkala, J. Kauhanen, and J.T. Salonen. 2002. “Socioeconomic Position Across the Life Course and Cognitive Function in Late Middle Age.” Journals of Gerontology 57B(1):S43-S51.Google Scholar
  44. United Nations, Population Division, Department of Economic and Social Affairs. 2007. World Population Prospects: The 2006 Revision. Available online at Scholar
  45. United Nations, Population Division, Department of Economic and Social Affairs. 2007. World Urbanization Prospects: The 2007 Revision. Available online at Scholar
  46. United Nations Development Programme [UNDP] and Institute for National Planning [INP]. 2003. Egypt Human Development Report 2002–2003. Cairo: UNDP and INP.Google Scholar
  47. United Nations Development Program [UNDP] Regional Bureau for Arab States. 2002. Arab Human Development Report: Creating Opportunities for Future Generations. New York: United Nations.Google Scholar
  48. White, H. 1980. “A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity.” Econometrica 48:817–30.CrossRefGoogle Scholar
  49. Wilson, R.S., P.A. Scherr, J.L. Bienias, C.F. Mendes de Leon, S.A. Everson-Rose, D.A. Bennett, and D.A. Evans. 2005. “Socioeconomic Characteristics in the Community in Childhood and Cognition in Old Age.” Experimental Aging Research 31:393–407.CrossRefGoogle Scholar
  50. World Bank Group. 2002. Genderstats: Database of Gender Statistics. Available online at http:// Scholar
  51. World Health Organization [WHO] 2007. Revised Global Burden of Disease (GBD) 2002 Estimates. Available online at Scholar
  52. Yount, K.M. 2001. “Excess Mortality of Girls in the Middle East in the 1970s and 1980s: Patterns, Correlates, and Gaps in Research.” Population Studies 55:291–308.CrossRefGoogle Scholar
  53. Yount, K.M. and E. Agree. 2005. “Differences in Disability Between Older Women and Men in Egypt and Tunisia.” Demography 42:169–87.CrossRefGoogle Scholar
  54. Yount, K.M. and Z. Khadr. 2006. “A Biosocial Model of Medication Use Among Older Adults in Ismailia, Egypt.” Journal of Biosocial Science 38:577–603.CrossRefGoogle Scholar
  55. Yount, K.M. and A. Sibai. Forthcoming. “The Demography of Aging in Arab Countries.” In International Handbook of the Demography of Aging, edited by P. Uhlenberg. Dordrecht, The Netherlands: Springer.Google Scholar
  56. Zhang, M.Y., R. Katzman, D. Salmon, H. Jin, G.J. Cai, Z.Y. Wang, G.Y. Qu, I. Grant, E. Yu, P. Levy, M.R. Klauber, and W.T. Liu. 1990. “The Prevalence of Dementia and Alzheimer’s Disease in Shanghai, China: Impact of Age, Gender, and Education.” Annals of Neurology 27:428–37.CrossRefGoogle Scholar
  57. Zhang, Z. 2006. “Gender Differentials in Cognitive Impairment and Decline of the Oldest Old in China.” Journals of Gerontology: Social Sciences 61B(2):S107–15.Google Scholar
  58. Zhou, D.F., C.S. Wu, H. Qi, J.H. Fan, X.D. Sun, P. Como, Y.L. Qiao, L. Zhang, and K. Kieburtz. 2006. “Prevalence of Dementia in Rural China: Impact of Age, Gender, and Education.” Acta Neurologica Scandinavica 114:273–80.CrossRefGoogle Scholar

Copyright information

© Population Association of America 2008

Authors and Affiliations

  • Kathryn M. Yount
    • 1
  1. 1.Hubert Department of Global Health and Department of SociologyEmory UniversityAtlanta

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