Center of Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, 710119, China.
School of Economics and Management, Xidian University, No. 266 Xinglong Section of Xifeng Road, Chang'an District, Xi'an, 710126, China.
BMC Geriatr. 2024 Oct 12;24(1):825. doi: 10.1186/s12877-024-05386-3.
The increasing prevalence of cognitive impairment poses substantial risks to older adults, particularly those with chronic diseases. While existing studies have examined the connection between the empty nest phenomenon and cognitive function, few have attempted to consider endogeneity issues within this relationship, with limited attention given to older adults with chronic diseases. This study investigates the impact of empty nest status on cognitive function among rural Chinese older adults with chronic diseases and explores the possible mechanisms underlying this effect.
A cross-sectional study involved 365 older adults aged 60 or above with chronic diseases in rural areas of Shaanxi province, northwest China. Cognitive function was measured using the Mini-Mental State Examination. Multiple regression models and the instrumental variable (IV) method were employed to examine the association between empty nest and cognitive function.
Among the 365 older adults aged 60 or above with chronic diseases, 43% experienced cognitive impairment. Results from both multiple regression and IV analyses consistently demonstrate a significant association between empty nest status and higher cognitive function scores (β = 1.757, p = 0.007; β = 3.682, p = 0.034, respectively). Mechanism analysis further supports that the positive association may arise from empty nesters receiving more social support from children and friends, and perceiving loneliness experiences as inadequate. Heterogeneity analysis reveals that the association between empty nest status and cognitive function is more pronounced among male adults with chronic diseases.
This study challenges the notion that empty nest status is a risk factor for cognitive decline in older adults with chronic diseases in rural China. The positive impact is attributed to the robust social relationships of empty nesters, encompassing sustained support from their social network, and the absence of an increase in loneliness. Therefore, future interventions aimed at improving cognitive function in older adults may benefit from promoting the development of social relationships.
认知障碍的患病率不断上升，给老年人带来了巨大风险，尤其是患有慢性病的老年人。虽然现有研究已经探讨了空巢现象与认知功能之间的联系，但很少有研究试图考虑这种关系中的内生性问题，也很少关注患有慢性病的老年人。本研究调查了空巢状态对中国农村慢性病老年人大脑认知功能的影响，并探讨了这种影响的可能机制。
本横断面研究共纳入了 365 名来自中国西北陕西省农村地区的 60 岁及以上患有慢性病的老年人。采用简易精神状态检查量表评估认知功能。采用多元回归模型和工具变量法（IV）检验空巢与认知功能之间的关系。
在 365 名患有慢性病的 60 岁及以上老年人中，43%存在认知障碍。多元回归和 IV 分析的结果均表明，空巢状态与更高的认知功能评分显著相关（β=1.757，p=0.007；β=3.682，p=0.034）。机制分析进一步支持了这样一种观点，即空巢老人可能从子女和朋友那里获得了更多的社会支持，而且认为自己的孤独感并不强烈，这使得他们的认知功能得到了提升。异质性分析表明，空巢状态与认知功能之间的关联在患有慢性病的男性老年人中更为明显。
本研究挑战了空巢状态是中国农村慢性病老年人大脑认知功能衰退的风险因素这一观点。空巢老人的积极影响归因于他们强大的社会关系，包括持续得到社交网络的支持，以及孤独感的减轻。因此，未来旨在改善老年人认知功能的干预措施可能受益于促进社会关系的发展。
