Numeracy, literacy, and formal education as mechanisms of inequities in late‐life cognitive performance between Indigenous‐speaking and non–Indigenous‐speaking older Mexican adults

INTRODUCTION: Indigenous adults face educational inequities, but it is unclear how education, literacy, and numeracy contribute to disparities in late-life cognition. METHODS: This study included 1958 adults ages 55+ (mean 68.1 [8.9 SD] years) from the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog; 2016). Linear regression models estimated associations between speaking an Indigenous language (vs. not) and cognitive factor scores, adjusting for sociodemographic covariates. Mediation analyses decomposed associations into direct and indirect effects via education, literacy, and numeracy. RESULTS: Eleven percent of participants spoke an Indigenous language, which was associated with lower memory (β [95% confidence interval [CI] = -0.31 [-0.40, -0.21]), language (-0.65 [-0.75, -0.55]), executive function (-0.60 [-0.73, -0.47]), and orientation (-0.31 [-0.44, -0.18]) scores. Education explained 31%-61% of the association, literacy 11%-26%, and numeracy 2%-9%. DISUSSION: High-quality education may help reduce cognitive disparities in Mexico. Future research should address data limitations by collecting measures of Indigeneity beyond language use (e.g., self-identification, colorism).