School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Health Sciences, MPH and Public Health Education Programs, California State University, Northridge, California, USA.
J Glob Health. 2024 Sep 20;14:04193. doi: 10.7189/jogh.14.04193.
Prior studies exploring the impact of widowhood on cognitive impairment in later life have been focussed on the USA and Europe. We aimed to explore the mediating role of social engagement, health behaviours, and subjective well-being in the association between widowhood and cognitive impairment in the Chinese population.
We conducted a study on 7796 older individuals enrolled in the 2018 wave of the Chinese Longitudinal Health Longevity Study. We used logistic regression models to analyse the impact of widowhood on cognitive health among older adults and performed mediation analysis to determine possible mediating factors in this relationship.
Widows and widowers had a higher risk of having cognitive impairment than married older adults (95% confidence interval (CI) = 1.312, 2.279). The results from structural equation modelling (SEM) provided a good fit to the observed data (χ = 24.909; P = 0.00) and indicated that the effect of widowhood on cognitive impairment was partially mediated by social engagement, lifestyle behaviours, and subjective well-being (β = 0.075; P < 0.01).
Our findings contribute to existing research on the mechanisms underlying the association between widowhood and cognitive impairment among older individuals, suggesting a need for policies targeted at the specific needs of this vulnerable population, such as the maintenance of social interactions, adoption of a healthy lifestyle, improvement of subjective well-being, and provision of necessary support systems.
先前探索鳏寡对晚年认知障碍影响的研究集中于美国和欧洲。我们旨在探索社会参与、健康行为和主观幸福感在丧偶与中国人群认知障碍之间关联中的中介作用。
我们对参加 2018 年中国健康长寿追踪调查的 7796 名老年人进行了一项研究。我们使用逻辑回归模型分析丧偶对老年人认知健康的影响，并进行中介分析以确定该关系中的可能中介因素。
与已婚老年人相比，鳏夫和寡妇认知障碍的风险更高（95%置信区间（CI）=1.312，2.279）。结构方程模型（SEM）的结果与观察数据拟合良好（χ=24.909；P=0.00），表明丧偶对认知障碍的影响部分通过社会参与、生活方式行为和主观幸福感来介导（β=0.075；P<0.01）。
我们的研究结果为现有关于丧偶与老年人认知障碍之间关联的机制研究做出了贡献，表明需要制定针对这一脆弱人群特定需求的政策，例如维持社会互动、采用健康的生活方式、改善主观幸福感和提供必要的支持系统。
