Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Prev Med. 2022 Nov;164:107230. doi: 10.1016/j.ypmed.2022.107230. Epub 2022 Aug 31.
Social participation may theoretically decrease risk for mild cognitive impairment (MCI). However, to date, no study has specifically investigated the association between social participation and MCI in LMICs, while the mediating role of loneliness is unknown. Thus, we investigated this association in a sample of adults aged ≥50 years from six low- and middle-income countries (LMICs; China, Ghana, India, Mexico, Russia, South Africa) using nationally representative datasets. We analyzed cross-sectional, community-based data from the Study on Global Ageing and Adult Health. A social participation score (range 0-10 with higher scores corresponding to greater levels of social participation) was created based on nine questions about involvement in community activities in the last 12 months. The National Institute on Ageing-Alzheimer's Association criteria were used to define MCI. Multivariable logistic regression and mediation analysis was performed. The analytical sample consisted of 32,715 individuals aged ≥50 years with preserved functional abilities [mean (SD) age 62.1 (15.6) years; 51.7% females]. In the overall sample, after adjustment for potential confounders, a one-unit increase in the social participation score was associated with a 13% decrease in odds for MCI (OR = 0.87; 95%CI = 0.82-0.93). Loneliness only explained 3.0% of the association. Greater levels of social participation were associated with a reduced odds for MCI, and this was not largely explained by loneliness. It may be prudent to implement interventions in LMICs to increase levels of social participation to aid in the prevention of MCI and ultimately dementia.
社会参与理论上可以降低轻度认知障碍（MCI）的风险。然而，迄今为止，尚无研究专门探讨中低收入国家（LMICs）中社会参与与 MCI 之间的关系，而孤独感的中介作用尚不清楚。因此，我们使用来自六个中低收入国家（中国、加纳、印度、墨西哥、俄罗斯和南非）的全国代表性数据集，在年龄≥50 岁的成年人样本中调查了这种关联。我们分析了全球老龄化和成人健康研究的横断面、社区为基础的数据。根据过去 12 个月中参与社区活动的九个问题，创建了一个社会参与评分（范围为 0-10，得分越高表示社会参与程度越高）。使用国家老龄化研究所-阿尔茨海默病协会的标准来定义 MCI。进行了多变量逻辑回归和中介分析。分析样本包括 32715 名功能正常的≥50 岁的个体[平均（SD）年龄 62.1（15.6）岁；51.7%为女性]。在整个样本中，在调整潜在混杂因素后，社会参与评分增加一个单位，MCI 的几率降低 13%（OR=0.87；95%CI=0.82-0.93）。孤独感仅解释了 3.0%的关联。更高水平的社会参与与 MCI 的几率降低相关，而这主要不是由孤独感引起的。在 LMICs 中实施增加社会参与水平的干预措施，以帮助预防 MCI 并最终预防痴呆症，可能是谨慎的做法。
