Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China.
Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China; NHC Key Lab of Health Economics and Policy Research (Shandong University) (CZ), Jinan, China; Institute of Health and Elderly Care, Shandong University (CZ), Jinan, China.
Am J Geriatr Psychiatry. 2023 Sep;31(9):726-736. doi: 10.1016/j.jagp.2023.04.002. Epub 2023 Apr 13.
This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults.
This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults.
The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific.
This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
本研究旨在检验社会隔离在身体活动与认知功能之间的中介作用，以及在中国老年人中，这种中介效应是否存在性别差异。
这是一项前瞻性队列研究。我们从中国健康与退休纵向研究的 2011 年（时间 1，T1）、2015 年（时间 2，T2）和 2018 年（时间 3，T3）三个波次中获取数据，共纳入 3395 名 60 岁及以上的参与者。认知功能采用电话访谈认知状态测试、单词回忆和图形绘制进行评估，这些方法在先前的研究中被广泛应用。我们使用交叉滞后模型来检验假设，即社会隔离在身体活动与认知功能之间的关系中起中介作用。
T1 身体活动受限对 T3 认知功能的总效应（β=-0.055，bootstrap p<0.001）为显著负相关。社会隔离在男性和女性中均起中介作用（男性：β=-0.008，bootstrap p=0.012；女性：β=-0.006，bootstrap p=0.023），表明社会隔离在身体活动与认知功能之间的中介作用不具有性别特异性。
本研究证实，社会隔离在中国男性和女性老年人的身体活动与认知功能之间存在关联，这表明逆转社会隔离可能是预防认知能力下降和促进成功老龄化的优先干预目标，特别是对于身体活动受限的老年人。
