Dose–response and cumulative effects of educational attainment and occupational complexity on mid to late life cognitive performance in Brazil and Mexico

INTRODUCTION While education and occupational complexity have been individually associated with lower odds of cognitive impairment, less is known about the effect of both together on cognition, particularly in Latin America. METHODS The sample included older adults from Brazil ( n = 9914) and Mexico ( n = 16,172). Linear regression was used to investigate the association of education and occupation with cognitive impairment. RESULTS Brazilian participants had a mean age of 64.0 ± 9.6 years, 50% were women, and 6% were cognitively impaired. Mexican participants had a mean age of 62.8 ± 10.3 years, 56% were women, and 7% were cognitively impaired. Across cohorts, participants with increasing levels of education and occupational complexity had lower odds of cognitive impairment compared to participants with low education who had never worked. This dose–response effect was absent in Brazilian paritcipants with high education who had never worked. Age, income, and private healthcare modified the associations. DISCUSSION Our results highlight the cumulative benefits of education and occupation on cognition.