Community Development and Late-Life Cognitive Functioning Decline in Taiwan: The Role of National Health Insurance

Chi Chiao, National Yang Ming University

Using an 18-year national cohort sample from the Taiwan Longitudinal Study on Aging (TLSA) (n = 2,944), the present study examines whether National Health Insurance (NHI) is one plausible mechanism explaining the disparities in cognitive functioning between communities among older adults. While somewhat complex and explained in detail herein, preliminary analyses from mixed-effects models found a significant increase in cognitive functioning among older Taiwanese adults after the establishment of NHI (ß=0.30, p<0.001). Further, the pre-NHI uninsured had a significantly lower level of cognitive functioning than the pre-NHI insured government employees (ß=-0.13, p<0.1), even after controlling for community development and effects of aging and practice, although the difference in cognitive functioning was not significantly reduced by NHI over time. In addition to the effect of community development, preliminary results suggest the contributing influence of NHI to late-life cognitive functioning, independent of aging and practice effects.