Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Many health challenges have emerged due to rapid population aging, including declined cognitive ability among older adults. WHAT IS ADDED BY THIS REPORT? Childhood circumstances have significant and lasting impacts on cognition in old age. This study compared cognition data from China with both the United States (U.S.) and the European Union (EU) during 2008-2018, finding that childhood circumstances could respectively explain 65.4% [95% confidence interval (CI): 59.4%, 71.4%] (China vs. the U.S.) and 38.2% (95% CI: 35.1%, 41.2%) (China vs. the EU) of the overall differences in cognition among older adults. Family socioeconomic status explained the largest share of differences among all considered childhood circumstances. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? Large disparities in cognition should be addressed by mitigating childhood disadvantages.