社会支持与中国老年人认知障碍的发生率：来自中国健康与养老追踪调查研究的发现
Social Support and the Incidence of Cognitive Impairment Among Older Adults in China: Findings From the Chinese Longitudinal Healthy Longevity Survey Study.
作者信息
Yin Shufei, Yang Quan, Xiong Jinli, Li Tian, Zhu Xinyi
机构信息
Department of Psychology, Faculty of Education, Hubei University, Wuhan, China.
Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
出版信息
Front Psychiatry. 2020 Apr 7;11:254. doi: 10.3389/fpsyt.2020.00254. eCollection 2020.
OBJECTIVE
Social support shows a protective effect against cognitive impairment in older adults. However, the longitudinal relationship between the distinct sources of social support and the incidence of cognitive impairment remains unclear. This study aims to investigate the association between different sources of social support and the incidence of cognitive impairment among older adults in China.
METHOD
We used longitudinal data (2005-2014) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005-2014, mean follow-up years 5.32 ± 2.64). In total, 5897 participants (aged 81.7 ± 9.7 years, range 65-112 years, 49.0% male) were enrolled. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). Social support included support from family and friends (marital status; contacts with family and friends; children's visits; siblings' visits, sick care; money received from and money given to children) and the availability of support from social community (social service and social security). We calculated subdistribution hazard ratios (SHR) of cognitive impairment by establishing Cox regression models, adjusting for residence, gender, age, education, participation in physical exercise, activities of daily living, smoking, drinking, negative psychological well-being, baseline cognitive function, occupation, leisure activities, and diseases.
RESULTS
During a 9-year follow-up, 1047 participants developed cognitive impairment. Participants who were married had a 16.0% lower risk of developing cognitive impairment compared to the widowed older adults after controlling for all covariates, but the protective effect of being married was no longer significant ( = 0.067) when additional adjustment was made for all types of social support. Children's visits were significantly associated with the risk of cognitive impairment after controlling for all types of social support and covariate variables (SHR = 0.808, 95% confidence interval, 0.669-0.975, = 0.026).
CONCLUSION
Children's visits were consistently associated with a lower incidence of cognitive impairment in Chinese older adults.
目的
社会支持对老年人认知障碍具有保护作用。然而，社会支持的不同来源与认知障碍发生率之间的纵向关系仍不明确。本研究旨在探讨中国老年人不同社会支持来源与认知障碍发生率之间的关联。
方法
我们使用了中国健康与养老追踪调查（CLHLS，2005 - 2014年，平均随访年限5.32±2.64年）的纵向数据。总共纳入了5897名参与者（年龄81.7±9.7岁，范围65 - 112岁，男性占49.0%）。认知障碍通过简易精神状态检查表（MMSE）进行测量。社会支持包括来自家人和朋友的支持（婚姻状况；与家人和朋友的联系；子女探访；兄弟姐妹探访、生病护理；从子女处获得的金钱及给予子女的金钱）以及来自社会社区的支持可用性（社会服务和社会保障）。我们通过建立Cox回归模型计算认知障碍的亚分布风险比（SHR），并对居住地区、性别、年龄、教育程度、体育锻炼参与情况、日常生活活动能力、吸烟、饮酒、负面心理健康状况、基线认知功能、职业、休闲活动和疾病进行了调整。
结果
在9年的随访期间，1047名参与者出现了认知障碍。在控制了所有协变量后，已婚参与者发生认知障碍的风险比丧偶老年人低16.0%，但在对所有类型的社会支持进行额外调整后，婚姻的保护作用不再显著（P = 0.067）。在控制了所有类型的社会支持和协变量后，子女探访与认知障碍风险显著相关（SHR = 0.808，95%置信区间，0.669 - 0.975，P = 0.026）。
结论
在中国老年人中，子女探访一直与较低的认知障碍发生率相关。
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