The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital (JHK, TSS, WBG,EMSK, JL, BY), Shatin, The New Territories, Hong Kong.
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital (TCYK), Shatin, The New Territories, Hong Kong.
Am J Geriatr Psychiatry. 2021 Nov;29(11):1140-1151. doi: 10.1016/j.jagp.2021.01.014. Epub 2021 Jan 23.
Subjective social status (SSS), one's self-perceived social position, encompasses not only concrete socio-economic (SES) factors (e.g., income) but also intangible aspects of status (e.g., social capital). In recent years, there has been increasing research interest in SSS as a predictor of a vast array of health outcomes but very few studies examining effects on cognitive functioning. This study's main objective was to examine the association between SSS and long-term cognitive decline in older Chinese adults.
A 4-year longitudinal study.
Hong Kong, China.
Chinese adults (aged ≥65) (n = 3,153).
This study analyzed baseline SSS-Hong Kong (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one's own social network) as predictors of long-term cognitive decline. Multiple-linear-regression was performed on 4-year follow-up Mini-Mental-Status-Examination (MMSE) cognitive function score (score range: 0-30) after adjusting for baseline MMSE scores, traditional SES indicators (e.g., education), demographic variables (e.g., sex), clinical conditions (e.g., stroke history, depression), and lifestyle variables (e.g., physical activity levels).
Lower SSS-Community but not SSS-Hong Kong was associated with greater cognitive decline (unstandardized coefficient (95% CI) = 0.13 (0.07, 0.19) standardized β-coefficient = 0.08, after adjusting for objective SES measures and other background and clinical factors. The standardized β-coefficients for the SSS-Community variable were similar in magnitude to those for depression and diabetes.
Cognitive decline is influenced by self-perceived rank in proximal reference groups rather than socioeconomic comparison with society at-large. SSS-Community is a useful, single-item supplementary instrument to improve prediction of cognitive decline in elderly Chinese.
主观社会地位（SSS）是一个人对自己社会地位的感知，它不仅包含具体的社会经济地位（SES）因素（如收入），还包含地位的无形方面（如社会资本）。近年来，SSS 作为众多健康结果的预测因素引起了越来越多的研究兴趣，但很少有研究探讨其对认知功能的影响。本研究的主要目的是研究 SSS 与中国老年成年人长期认知衰退之间的关系。
一项为期 4 年的纵向研究。
中国香港。
中国成年人（年龄≥65 岁）（n=3153）。
本研究分析了基线 SSS-香港（在香港的自我感知社会地位）和 SSS-社区（在自己社交网络中的自我感知地位）作为长期认知衰退的预测因素。在调整基线 MMSE 评分、传统 SES 指标（如教育程度）、人口统计学变量（如性别）、临床状况（如中风史、抑郁）和生活方式变量（如体力活动水平）后，采用多元线性回归分析了 4 年随访的 Mini-Mental-State-Examination（MMSE）认知功能评分（评分范围：0-30）。
较低的 SSS-社区，但不是 SSS-香港，与更大的认知衰退相关（未标准化系数（95%置信区间）=0.13（0.07，0.19）标准化β系数=0.08，在调整客观 SES 测量和其他背景和临床因素后）。SSS-社区变量的标准化β系数与抑郁和糖尿病的相似。
认知衰退受近端参照群体中自我感知等级的影响，而不是与整个社会的社会经济比较。SSS-社区是一种有用的、单项补充工具，可以提高对中国老年人群认知衰退的预测。
