INTRODUCTION:
In India, where substantial educational disparities persist at older ages, it is essential to examine how education influences cognitive health to promote healthy aging. Therefore, we aimed (i) to assess the association between education and cognitive health in older adults aged 45 and above in India, and (ii) to identify factors that contribute to the cognitive health gap between educationally advantaged and disadvantaged groups.

METHODS:
Data for 57,794 older adults were obtained from the Longitudinal Ageing Study in India (2017-18). We estimated average cognitive health scores (mean-CHS) by education level across demographic, socioeconomic, and health variables, and conducted analyses using multiple-linear regression and Oaxaca-Blinder decomposition techniques.

RESULTS:
Findings showed that among those aged 45 and above, 50.7% had no schooling, 17.7% had 1-5years, 21.1% had 6-10years, and 10.5% had more than 10 years of schooling. The mean-CHS ranged from 20.5 for individuals with no schooling to 31.6 for those with more than 10years of schooling. The fully adjusted regression indicated that the β-coefficient was 3.71 (p<0.001) for individuals with 1-5 years of schooling, 6.38 (p<0.001) for 6-10 years, and 8.21 (p<0.001) for more than 10years, compared to those with no schooling, highlighting an educational gradient in cognitive health among older adults in India. The Oaxaca-Blinder decomposition identified sex, residence, body mass index, age, and caste group differences as key contributors to the gap in mean-CHS between educationally advantaged and disadvantaged groups.

CONCLUSIONS:
Educational gradients were found in cognitive health, indicating the need for targeted initiatives to promote lifelong learning among older adults in India to enhance the cognitive health of a rapidly aging population.