Impact of the South African Child Support Grant on memory decline and dementia probability in rural and low-income mothers, 2014-2021.

Autor: Beidelman ET; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA. Electronic address: ebeidelm@iu.edu., Chakraborty R; School of Nursing, George Washington University, Washington D.C., USA., Jock J; Auburn University, Department of Political Science, Auburn, AL, USA., Whiteson Kabudula C; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Phillips ML; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA., Kahn K; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden., Eyal K; Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa., Bassil DT; Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA., Berkman L; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA., Kobayashi LC; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA., Rosenberg M; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2024 Oct; Vol. 358, pp. 117217. Date of Electronic Publication: 2024 Aug 17.
DOI: 10.1016/j.socscimed.2024.117217
Abstrakt: Introduction: Aging populations across sub-Saharan Africa are rapidly expanding, leading to an increase in the burden of Alzheimer's disease and related dementias (ADRD). Cash transfer interventions are one plausible mechanism to combat ADRD at a population-level in low-income settings. We exploited exogenous variation in eligibility for South Africa's Child Support Grant (CSG) to estimate the longitudinal association between potential CSG benefit and cognitive trajectories in rural mothers with <10 children (n = 1090).
Methods: South Africa's CSG delivers monthly cash payments to primary caregivers, predominantly mothers, to offset the costs associated with child rearing. This study implemented a quasi-experimental design using data (2014-2022) from a rural, low-income cohort in the Agincourt research area, South Africa. We fit linear mixed effects models and generalized linear models to estimate the association of potential CSG benefit per eligible child with memory decline and dementia probability, respectively. We stratified all models by the mother's total number of children (1-4 and 5-9) and examined effect modification by household wealth and the mother's education level.
Results: Having above median CSG per eligible child was associated with higher baseline memory scores (β = 0.12 SD units, 95% CI = 0.02, 0.22) but steeper memory decline (β = -0.02 SD units, 95% CI = -0.04, -0.00) compared to below median CSG. Within stratified analyses, this effect was primarily observed among mothers with 5-9 children. No associations were observed between potential CSG per eligible child and dementia probability.
Conclusions: Our findings support the use of large-scale cash transfers as a promising intervention to promote healthy cognitive aging in mid-life women within rural, low-income settings. However, we found evidence that the CSG in its current structure may not be sufficient support for women to sustain measurable cognitive benefits over the long-term.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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