Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India.
BMJ Open. 2022 Oct 6;12(10):e063336. doi: 10.1136/bmjopen-2022-063336.
The present study aimed to examine the confounding effects of depressive symptoms and the role of gender in the association between social engagement and cognitive functioning among older Indian adults.
Large-scale cross-sectional survey data were analysed.
Data from the Longitudinal Aging Study in India (2017-2019) were used in the analysis. The sample included 23 584 individuals aged 60 years and above (11 403 men and 12 181 women).
The outcome variable was cognitive functioning, which was based on various measures including immediate and delayed word recall, orientation, executive functioning, arithmetic ability and object naming. Social engagement measure consists of marital status, living arrangement, availability of confidant, and participation in indoor games, and social and cultural functions. The Center for Epidemiological Studies-Depression Scale was used to assess depressive symptoms.
Significant gender differences in mean cognition scores (men: 25.8, women: 21.1; on a scale of 0-43) were observed. Two-way stratification between social engagement and depressive symptoms was significantly associated with cognitive functioning after controlling for selected explanatory factors. Older men with a low level of social engagements had significantly poor cognitive functioning (β=-1.12; 95% CI: -1.53 to -0.72) compared with men with a high level of social engagements. On the other hand, women with a higher level of social engagement performed poorly on cognitive tests (β=-1.54; 95% CI: -2.11 to -0.98) compared with men with higher social engagements. Three-way stratification between social engagement, gender and depressive symptoms suggests that social engagement's buffering effects are lower in women than in men. The Karlson-Holm-Breen method identified a significant confounding effect of depressive symptoms on the relationship between social engagement and cognitive functioning.
The positive association of social engagement with cognitive functioning was significantly confounded by depressive symptoms, suggesting the need for maintaining social relations that help improve mental health and cognitive functioning among older adults.
本研究旨在探讨抑郁症状的混杂作用以及性别在社交参与度与老年印度成年人认知功能之间关系中的作用。
对大规模横断面调查数据进行了分析。
分析中使用了印度纵向老龄化研究（2017-2019 年）的数据。样本包括 23584 名 60 岁及以上的个体（男性 11403 人，女性 12181 人）。
认知功能，基于各种指标，包括即时和延迟单词回忆、定向、执行功能、算术能力和物体命名。社交参与度的测量包括婚姻状况、居住安排、可信赖的人的可用性以及参与室内游戏和社交文化活动。采用流行病学研究中心抑郁量表评估抑郁症状。
观察到平均认知评分存在显著的性别差异（男性：25.8，女性：21.1；0-43 分制）。在控制了选定的解释因素后，社会参与度和抑郁症状的双向分层与认知功能显著相关。与高社交参与度的男性相比，低社交参与度的老年男性认知功能明显较差（β=-1.12；95%CI：-1.53 至-0.72）。另一方面，与高社交参与度的男性相比，社交参与度较高的女性在认知测试中的表现较差（β=-1.54；95%CI：-2.11 至-0.98）。社会参与度、性别和抑郁症状之间的三向分层表明，社交参与度的缓冲作用在女性中低于男性。卡尔森-霍尔姆-布林方法确定了抑郁症状对社交参与度与认知功能之间关系的显著混杂作用。
社交参与度与认知功能的正相关关系受到抑郁症状的显著混杂，这表明需要保持有助于改善老年人大脑健康和认知功能的社交关系。
