Zhou Sumei, Deng Tianfang, Shao Shirong, Zeng Zhi
Department of Neurosurgery, Deyang People's Hospital, Deyang, Sichuan, China.
Department of Gastroenterology, Deyang People's Hospital, Deyang, Sichuan, China.
Front Aging Neurosci. 2025 Mar 27;17:1549615. doi: 10.3389/fnagi.2025.1549615. eCollection 2025.
With global and Chinese populations aging rapidly, maintaining cognitive function among middle-aged and elderly individuals has become a critical health priority. Understanding the factors influencing cognitive health is crucial for developing effective health policies and interventions.
This study investigates the impact of social participation on cognitive function among middle-aged and elderly individuals, examining the mediating effects of depression and grandchild care. Given the potential variation in these effects across different demographic and socioeconomic groups, this study also explores subgroup differences to provide targeted policy recommendations.
Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were used to analyze the relationship between social participation and cognitive function. Ordinary Least Squares (OLS) and stepwise regression models were employed, with robustness checks conducted using 2SLS regression.
The study included 17,962 participants aged 45 and above. Baseline regression results indicate that social participation significantly enhances cognitive function (β = 0.417, = 0.001) after adjusting for confounding factors. Subgroup analysis revealed that the cognitive benefits of social participation were more pronounced among individuals residing in the western region, those aged 60 and above, high-income groups, and rural populations. Mediation analysis showed that depression played a more substantial mediating role (β = -0.109, = 0.001), while grandchild care exhibited a statistically significant but relatively small mediation effect (β = 0.004, = 0.001).
Social participation not only directly improves cognitive function but also indirectly enhances it by reducing depression and increasing grandchild caregiving engagement among middle-aged and elderly individuals. However, while the mediating effect of grandchild care is statistically significant, its effect size remains relatively small, suggesting that its overall contribution to cognitive function should be interpreted with caution. In contrast, depression demonstrates a more substantial mediating effect, highlighting the critical role of mental health in cognitive aging. Given these findings, policy should prioritize interventions that mitigate depression as a primary pathway for enhancing cognitive function in aging populations. Expanding social participation opportunities should be a key strategy, particularly in the central and eastern regions, among individuals under 60 years old, those with lower income levels, and urban residents, to ensure equitable access to cognitive health benefits. Additionally, while grandchild caregiving may serve as a meaningful form of social engagement, its effects on cognitive function appear to be complex and context-dependent. Future research should explore the long-term impact of caregiving intensity and emotional burden on cognitive health to better inform aging policies and intergenerational support programs.
随着全球和中国人口迅速老龄化，维持中老年人群的认知功能已成为一项关键的健康优先事项。了解影响认知健康的因素对于制定有效的健康政策和干预措施至关重要。
本研究调查社会参与对中老年人群认知功能的影响，考察抑郁和照顾孙辈的中介作用。鉴于这些影响在不同人口统计学和社会经济群体中可能存在差异，本研究还探讨亚组差异，以提供有针对性的政策建议。
使用2020年中国健康与养老追踪调查（CHARLS）的数据来分析社会参与与认知功能之间的关系。采用普通最小二乘法（OLS）和逐步回归模型，并使用两阶段最小二乘法（2SLS）回归进行稳健性检验。
该研究纳入了17962名年龄在45岁及以上的参与者。基线回归结果表明，在调整混杂因素后，社会参与显著增强认知功能（β = 0.417，P = 0.001）。亚组分析显示，社会参与对认知的益处在西部地区居民、60岁及以上人群、高收入群体和农村人口中更为明显。中介分析表明，抑郁发挥了更大的中介作用（β = -0.109，P = 0.001），而照顾孙辈表现出具有统计学意义但相对较小的中介效应（β = 0.004，P = 0.001）。
社会参与不仅直接改善认知功能，还通过减少中老年人群的抑郁和增加照顾孙辈的参与度间接增强认知功能。然而，虽然照顾孙辈的中介效应具有统计学意义，但其效应大小仍然相对较小，这表明应谨慎解释其对认知功能的总体贡献。相比之下，抑郁表现出更大的中介效应，凸显了心理健康在认知老化中的关键作用。鉴于这些发现，政策应优先考虑将减轻抑郁作为增强老年人群认知功能的主要途径的干预措施。扩大社会参与机会应是一项关键策略，特别是在中部和东部地区，针对60岁以下、收入水平较低的人群以及城市居民，以确保公平获得认知健康益处。此外，虽然照顾孙辈可能是一种有意义的社会参与形式，但其对认知功能的影响似乎复杂且依赖于具体情境。未来的研究应探索照顾强度和情感负担对认知健康的长期影响，以便更好地为老龄化政策和代际支持项目提供信息。
