Effect of a cash transfer intervention on memory decline and dementia probability in older adults in rural South Africa

• 成果类型: Article
• 署名作者: Rosenberg, Molly; Beidelman, Erika T.; Chen, Xiwei; Kabudula, Chodziwadziwa Whiteson; Pettifor, Audrey; Bassil, Darina T.; Berkman, Lisa; Kahn, Kathleen; Tollman, Stephen; Kobayashi, Lindsay C.
• 署名单位: Indiana University System; Indiana University Bloomington; South African Medical Research Council; University of Witwatersrand; Indiana University System; Indiana University Bloomington; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine; Harvard University; Harvard T.H. Chan School of Public Health; Umea University; University of Michigan System; University of Michigan
• 刊物名称: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
• ISSN/ISSBN: 0027-14145
• DOI: 10.1073/pnas.2321078121
• 发表日期: 2024-10-01
• 关键词: cognitive function; HEALTH

摘要

Evidence on cash transfers as a population- level intervention to support healthy cognitive aging in low- income settings is sparse. We assessed the effect of a cash transfer intervention on cognitive aging outcomes in older South African adults. We leveraged the overlap in the sampling frames of a Phase 3 randomized cash transfer trial [HIV Prevention Trial Network (HPTN) 068, 2011-2015] and an aging cohort [Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community (HAALSI), 2014- 2022] in rural Mpumalanga Province, South Africa. In 2011/12, young women and their primary caregivers were randomly assigned 1:1 to receive a monthly cash transfer or control. In 2014/2015, 862 adults aged 40+ y living in trial households were enrolled in the HAALSI cohort, with cognitive data collected in three waves over 7 y. We estimated the impact of the intervention on rate of memory decline and dementia probability scores. Memory decline in the cash transfer arm was 0.03 SD units (95% CI: 0.002, 0.05) slower per year than in the control arm. Dementia probability scores were three percentage points lower in the cash transfer arm than the control arm (beta = -0.03; 95% CI: -0.05, -0.001). Effects were consistent across subgroups. A modestly sized household cash transfer delivered over a short period in mid- to later- life led to a meaningful slowing of memory decline and reduction in dementia probability 7 y later. Cash transfer programs could help stem the tide of new dementia cases in economically vulnerable populations in the coming decades.