Externalities of polluting cooking fuels, gender, and adult cognitive health in low- and middle-income countries.

Scientific understanding of the relationship between environmental hazards and cognitive health at older ages in low- and middle-income countries (LMICs) is poor. Using data from the Longitudinal Aging Study of India and the World Health Organization's Survey on Global AGEing and adult health for 4 LMICs, we examine the association of direct and local exposure to polluting cooking fuels with cognitive health at older ages. We document the negative influence of both: Cognitive health is poorer among members of households that use polluting fuels and among residents of neighborhoods where the use of polluting fuels is more common. These associations cannot be explained by accounting for individual or local differences in socioeconomic status. Consistent with direct impacts of polluting fuels, we find that women in households where the use of polluting fuels is common have the lowest predicted cognitive scores. Our findings reveal the substantial direct influence and negative externalities of polluting fuel use in LMICs and help understand why overall cognitive health may be poor in these settings. Moving away from polluting fuels toward clean fuels may reduce individual risk and community-level exposure to air pollution, contributing to better cognitive health in older ages. This article is part of a Special Collection on Cross-National Gerontology.