Cognitive health is an important dimension of well-being in older ages, but few studies have investigated
cognitive health in sub-Saharan Africa’s (SSA) growing population of mature adults (= persons age 45+). We
use data from the Malawi Longitudinal Study of Families and Health (MLSFH) to document the age and
gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the
understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age-pattern of
decline in cognitive health for both men and women is similar to that observed in the U.S. We also find that
women have substantially worse cognitive health than men, and experience a steeper decline of cognitive
ability with age. Strong social ties and exposure to socially complex environments are associated with higher
cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and
economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in
this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with
increased levels of depression and anxiety, and are associated with worse physical health measured through
both self-reports and physical performance.