Ni Ping, Chen Hongxiu, Hu Xiuying
Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, PR China.
Aging Clin Exp Res. 2024 Dec 27;37(1):7. doi: 10.1007/s40520-024-02897-2.
Cognitive decline is a significant public health problem worldwide, but little is known about social engagement's impact on cognitive changes over time. This study aimed to explore the relationship between social engagement decline and cognitive function change in Chinese adults, and to analyze the effect of changes in depressive symptoms on this relationship.
Participants were selected from the China Health and Retirement Longitudinal Study. Multiple linear regression was conducted to determine the association between social engagement decline and cognitive function changes, and a three-step method was used to test the mediating role of changes in depressive symptoms.
During the four-year follow-up, participants' overall cognitive function decreased by an average of 0.41 points (3.0%). The decline in social engagement was significantly associated with subsequent poorer global cognitive function (Model 1: β = - 0.060, P =.005; Model 2: β = - 0.056, P =.009), and changes in depressive symptoms partially mediated this effect, accounting for 15.3% of the total effect in Model 1 and 13.8% in Model 2. Model 1 adjusted for sociodemographic characteristics, and Model 2 adjusted for health-related factors based on Model 1.
When developing programs for cognitive improvement in middle-aged and older adults, measures to enhance social engagement should be considered. This may not only reduce depressive symptoms but also help to minimize cognitive decline.
认知能力下降是全球一个重大的公共卫生问题，但对于社会参与度随时间推移对认知变化的影响却知之甚少。本研究旨在探讨中国成年人社会参与度下降与认知功能变化之间的关系，并分析抑郁症状变化对这种关系的影响。
参与者选自中国健康与养老追踪调查。采用多元线性回归来确定社会参与度下降与认知功能变化之间的关联，并采用三步法来检验抑郁症状变化的中介作用。
在四年的随访期间，参与者的整体认知功能平均下降了0.41分（3.0%）。社会参与度的下降与随后较差的整体认知功能显著相关（模型1：β = -0.060，P = 0.005；模型2：β = -0.056，P = 0.009），抑郁症状的变化部分介导了这种效应，在模型1中占总效应的15.3%，在模型2中占13.8%。模型1对社会人口学特征进行了调整，模型2在模型1的基础上对健康相关因素进行了调整。
在制定改善中老年人认知能力的方案时，应考虑采取措施提高社会参与度。这不仅可能减轻抑郁症状，还有助于最大限度地减少认知能力下降。
