Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Xi Chen

Second Advisor

Becca Levy


Decision-making among the older population is of importance as older persons make critically consequential decisions on daily errands, household financials, and care-seeking that affect the remainder of their lives. Despite the increasing prevalence rate of cognitive impairment in developing countries, many questions surrounding the impact of cognitive impairment on decision-making among older persons remain unexplored. Therefore, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study helps bridge the gap in the existing literature by examining the effect of cognitive decline on decision-making among the older population in China. We first investigate the association between an individual's cognitive ability and decision-making status on daily errands. The study results suggest that differences in the level of cognitive ability have a significant impact on individual’s ability to make decisions on daily errands. Effects of cognitive decline on decision-making among older persons are more sizable among those who are currently single, went to school, have fewer children, and are experiencing poor health. In addition, we examine the relationship between individual's cognitive ability and financial decision-making within the household. We find that cognitive decline plays a major role in determining the responsibility of making personal and household financial decisions. More salient effects are found among elders who are single, went to school, have fewer children and siblings, and are in poor health status. Next, we study the association between changes in cognitive ability and preventive care-seeking patterns. Due to limited waves of data available, we do not observe any significant effects of cognitive decline on the use patterns of preventive care. In conclusion, our findings suggest that cognitive decline is associated with poor decisions made among those aged 65 or above, indicating the practical significance of cognition health among older Chinese adults.


This is an Open Access Thesis.

Open Access

This Article is Open Access