Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China.
Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China.
Soc Sci Med. 2021 Nov;289:114423. doi: 10.1016/j.socscimed.2021.114423. Epub 2021 Sep 23.
Social relationships consist of distinct dimensions. The literature on the effect of specific social relationship subdomains on cognitive function is limited. This large-scale, prospective cohort study examined the associations of social relationships with cognitive decline and further explored which subdomains of social relationships were predictive of cognitive decline among elderly Chinese individuals.
A total of 3314 older Chinese adults aged 65-110 years from the 2011-2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. Cognitive decline was defined based on the Chinese version of the Mini-Mental State Examination (MMSE). Social relationships were divided into three subdomains: social activities, social networks, and social support. Linear and binary logistic regression analyses were conducted to assess the effect of social relationships and the social relationship subdomains on cognitive decline after adjusting for age, sex, education, residence, exercise, drinking, smoking, activities of daily living, chronic diseases, depression, and baseline cognitive function.
Seven hundred and sixty-eight participants (23.17%) developed greater cognitive decline during the 3-year follow-up. The social relationships score was negatively associated with cognitive decline. Binary adjusted odds ratios showed that after potential covariates were controlled, social relationships, activities, and networks significantly reduced the risk of cognitive decline. When all social relationships variables were entered simultaneously with all covariates, the effect of social activities and networks on the risk of greater cognitive decline remained significant. However, we did not observe a significant association between social support and the risk of greater cognitive decline.
Our findings suggest that social relationships and the subdomains of social activities and networks, but not social support, have a protective effect against greater cognitive decline in older adults. This implies that structural dimensions of social relationships might be more important than functional dimensions in preserving cognitive health among elderly Chinese individuals.
社会关系由不同的维度组成。关于特定社会关系亚领域对认知功能影响的文献有限。这项大规模的前瞻性队列研究调查了社会关系与认知能力下降的关联,并进一步探讨了社会关系的哪些亚领域对中国老年人的认知能力下降具有预测性。
共纳入 3314 名来自 2011-2012 年中国长寿纵向研究(CLHLS)的 65-110 岁的中国老年人。认知能力下降定义为基于中国版简易精神状态检查(MMSE)的认知能力下降。社会关系分为三个亚领域:社会活动、社会网络和社会支持。线性和二元逻辑回归分析用于评估社会关系和社会关系亚领域对认知能力下降的影响,调整了年龄、性别、教育、居住、运动、饮酒、吸烟、日常生活活动、慢性疾病、抑郁和基线认知功能。
768 名参与者(23.17%)在 3 年随访期间认知能力下降更大。社会关系评分与认知能力下降呈负相关。二元调整后比值比显示,在控制潜在协变量后,社会关系、活动和网络显著降低了认知能力下降的风险。当所有社会关系变量与所有协变量同时进入时,社会活动和网络对认知能力下降风险的影响仍然显著。然而,我们没有观察到社会支持与认知能力下降风险之间的显著关联。
我们的研究结果表明,社会关系以及社会活动和网络的亚领域对老年人的认知能力下降具有保护作用,但社会支持没有。这表明在保护中国老年人群体的认知健康方面,社会关系的结构维度可能比功能维度更为重要。