Zhang Hong-Guang, Fan Fang, Zhong Bao-Liang, Chiu Helen Fung-Kum
Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China.
Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China.
Gen Psychiatr. 2023 Jun 9;36(3):e101054. doi: 10.1136/gpsych-2023-101054. eCollection 2023.
Due to the inaccuracy of the traditional geographical distance-based definition of left-behind status, data on the negative effect of left-behind status on cognitive function among older adults are controversial.
This study examined the cross-sectional and longitudinal associations of left-behind status with cognitive function in older Chinese adults. The left-behind status definition was based on the frequency of face-to-face parent-child meetings.
Data from a nationally representative sample of 8 682 older adults (60+ years) in 2015 (5 658 left behind and 3 024 non-left behind), of which 6 933 completed the follow-up in 2018, were obtained from the China Health and Retirement Longitudinal Study. Left-behind older adults were broadly defined as those aged 60+ years who had living adult children and saw their children less than once per month. The cognitive function was assessed with a composite cognitive test with higher total scores indicating better cognitive function.
Left-behind older adults had significantly lower cognitive test scores than non-left-behind older adults in both 2015 (11.1 (6.0) vs 13.2 (5.9), t=15.863, p<0.001) and 2018 (10.0 (6.6) vs 12.4 (6.7), t=14.177, p<0.001). After adjusting for demographic factors, lifestyle factors, chronic medical conditions and the baseline cognitive test score (in the longitudinal analysis only), on average, the cognitive test score of left-behind older adults was 0.628 lower than their non-left-behind counterparts in 2015 (t=5.689, p<0.001). This difference in cognitive test scores attenuated to 0.322 but remained significant in 2018 (t=2.733, p=0.006).
Left-behind older Chinese adults have a higher risk of poor cognitive function and cognitive decline than their non-left-behind counterparts. Specific efforts targeting left-behind older adults, such as encouraging adult children to visit their parents more regularly, are warranted to maintain or delay the progression of cognitive decline.
由于传统的基于地理距离的留守儿童状态定义不准确，关于留守儿童状态对老年人认知功能负面影响的数据存在争议。
本研究探讨了中国老年人群中留守儿童状态与认知功能的横断面和纵向关联。留守儿童状态的定义基于面对面亲子会面的频率。
数据来自中国健康与养老追踪调查，该调查于2015年对8682名60岁及以上的老年人进行了全国代表性抽样（5658名留守儿童和3024名非留守儿童），其中6933人在2018年完成了随访。留守儿童大致定义为60岁及以上、有成年子女且每月与子女见面次数少于一次的老年人。认知功能通过综合认知测试进行评估，总分越高表明认知功能越好。
2015年（11.1（6.0）对13.2（5.9），t = 15.863，p < 0.001）和2018年（10.0（6.6）对12.4（6.7），t = 14.177，p < 0.001），留守儿童老年人的认知测试得分均显著低于非留守儿童老年人。在调整了人口统计学因素、生活方式因素、慢性疾病状况和基线认知测试得分（仅在纵向分析中）后，2015年，留守儿童老年人的认知测试得分平均比非留守儿童老年人低0.628（t =
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