社会参与和心理弹性与中国老年人不良认知结局的关系：一项全国纵向研究。

Association of social participation and psychological resilience with adverse cognitive outcomes among older Chinese adults: A national longitudinal study.

机构信息

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

J Affect Disord. 2023 Apr 14;327:54-63. doi: 10.1016/j.jad.2023.01.112. Epub 2023 Feb 2.

DOI:10.1016/j.jad.2023.01.112

PMID:36739004

Abstract

BACKGROUND

Limited epidemiological evidence exists regarding the association of social participation and psychological resilience with cognitive health. This study aimed to comprehensively investigate the effects of social participation and psychological resilience on adverse cognitive outcomes among older adults in China.

METHODS

We used two waves (2011 and 2014) of data from the Chinese Longitudinal Survey of Health and Longevity (CLHLS), and 9765 respondents were eligible for the subsequent screening for the present prospective analysis. The Cox proportional hazards model was utilized to examine the association of social participation and psychological resilience with cognitive impairment, cognitive decline and greater cognitive decline. The restricted cubic spline plots were applied to clarify the dose-response relationships between them.

RESULTS

Compared to those with low social participation, participants with high social participation had a lower hazard ratio (HR) of 0.72 (95 % confidence interval [CI]: 0.59-0.89) for cognitive impairment, 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.78 (95 % CI: 0.67-0.90) for greater cognitive decline. Participants with high psychological resilience had an HR of 0.77 (95 % CI: 0.63-0.95) for cognitive impairment 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.85 (95 % CI: 0.73-0.98) for greater cognitive decline compared with those with low psychological resilience. Similar effects were observed for social participation score and psychological resilience score. The dose-response analysis also showed that the risk of adverse cognitive outcomes decreased gradually with increasing social participation scores and psychological resilience scores. Additionally, the multiplicative interaction between social participation and psychological resilience was not significant.

LIMITATION

All information was collected by self-report, which may lead to biases in the process of information collection.

CONCLUSION

In this study, social participation and psychological resilience were independently associated with a lower risk of adverse cognitive outcomes, and therefore both need to be considered as broader measures to preserve cognitive health among older Chinese adults.

摘要

背景

关于社会参与和心理弹性与认知健康之间的关联，现有的流行病学证据有限。本研究旨在全面调查社会参与和心理弹性对中国老年人不良认知结局的影响。

方法

我们使用中国健康长寿追踪调查（CLHLS）的两个时间点（2011 年和 2014 年）的数据，对 9765 名符合后续筛选条件的受访者进行了前瞻性分析。我们采用 Cox 比例风险模型来检验社会参与和心理弹性与认知障碍、认知衰退和认知衰退程度较大之间的关联。限制性三次样条图用于阐明它们之间的剂量-反应关系。

结果

与社会参与程度较低的参与者相比，社会参与程度较高的参与者认知障碍的风险比（HR）为 0.72（95%置信区间[CI]：0.59-0.89），认知衰退的 HR 为 0.85（95%CI：0.76-0.94），认知衰退程度较大的 HR 为 0.78（95%CI：0.67-0.90）。心理弹性较高的参与者认知障碍的 HR 为 0.77（95%CI：0.63-0.95），认知衰退的 HR 为 0.85（95%CI：0.76-0.94），认知衰退程度较大的 HR 为 0.85（95%CI：0.73-0.98），与心理弹性较低的参与者相比。社会参与评分和心理弹性评分也观察到类似的效果。剂量-反应分析还表明，随着社会参与评分和心理弹性评分的增加，不良认知结局的风险逐渐降低。此外，社会参与和心理弹性之间的乘法交互作用不显著。