Wang Hao, Chen Dan, Hu Daling, Tian Fangyuan, Dai Meifen, Zhang Shuangyan, Jin Liyu
Department of Nursing, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Department of Nursing, Changshu No.5 People's Hospital, Suzhou, China.
Front Public Health. 2024 Nov 15;12:1460941. doi: 10.3389/fpubh.2024.1460941. eCollection 2024.
Hearing and functional mobility impairments are recognized as risk factors for cognitive decline in older adults, yet the causal relationship underlying these associations is not well-understood. This study aims to explore whether engagement in social activities mediates the link between hearing or functional mobility impairment and cognitive decline.
This cross-sectional study was carried out in two cities in Jiangsu Province, Eastern China. Participants self-reported hearing impairment and social activity engagement, whereas functional mobility impairment was assessed using the Timed Up and Go Test (TUGT). Cognitive function was evaluated through the Modified Mini-Mental State Examination (MMSE). Logistic regression analysis explored factors influencing cognitive function, and mediation analysis was conducted to examine the relationship between hearing or functional mobility impairment and cognitive decline.
The study included 10,217 adults aged 60 and above. Among them, 19.35% reported hearing impairment, while 40.86% failed the Timed Up and Go Test (TUGT). The Modified Mini-Mental State Examination (MMSE) indicated a 30.40% prevalence of cognitive decline. Logistic regression analysis identified significant associations of cognitive function with factors such as gender, age, education level, residency, living arrangement, hyperlipidemia, cerebrovascular disease, alcohol consumption, smoking, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), social activity, hearing, and functional mobility ( < 0.01). Mediation analysis, after adjusting for confounders, showed that social activity engagement partially mediated the impact of functional mobility impairment on cognitive decline (indirect effect: -0.0947, 95% Bootstrapped CI: -0.1228, -0.0695; proportion of total effect: 11.635%, < 0.01). However, no mediation effect was observed in the relationship between self-reported hearing impairment and cognitive decline.
This study revealed that social activity engagement plays a mediating role in the relationship between functional mobility and cognitive function, but it does not significantly influence the relationship between self-reported hearing impairment and cognitive decline. These findings suggest that social activity engagement could be a crucial factor in preventing cognitive deterioration among older adults with functional mobility impairments.
听力和功能活动能力受损被认为是老年人认知衰退的风险因素，然而这些关联背后的因果关系尚未得到充分理解。本研究旨在探讨参与社交活动是否介导了听力或功能活动能力受损与认知衰退之间的联系。
这项横断面研究在中国东部江苏省的两个城市进行。参与者自我报告听力受损和社交活动参与情况，而功能活动能力受损则通过计时起立行走测试（TUGT）进行评估。认知功能通过改良简易精神状态检查表（MMSE）进行评估。逻辑回归分析探讨影响认知功能的因素，并进行中介分析以检验听力或功能活动能力受损与认知衰退之间的关系。
该研究纳入了10217名60岁及以上的成年人。其中，19.35%的人报告有听力受损，而40.86%的人计时起立行走测试（TUGT）未通过。改良简易精神状态检查表（MMSE）显示认知衰退的患病率为30.40%。逻辑回归分析确定认知功能与性别、年龄、教育水平、居住情况、生活安排、高脂血症、脑血管疾病、饮酒、吸烟、日常生活活动（ADL）、工具性日常生活活动（IADL）、社交活动、听力和功能活动能力等因素存在显著关联（<0.01）。在调整混杂因素后进行的中介分析表明，社交活动参与部分介导了功能活动能力受损对认知衰退的影响（间接效应：-0.0947，95%自抽样置信区间：-0.1228，-0.0695；占总效应的比例：11.635%，<0.01）。然而，在自我报告的听力受损与认知衰退之间的关系中未观察到中介效应。
本研究表明，社交活动参与在功能活动能力与认知功能之间的关系中起中介作用，但对自我报告的听力受损与认知衰退之间的关系没有显著影响。这些发现表明，社交活动参与可能是预防功能活动能力受损老年人认知恶化的关键因素。
