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社会参与对中国老年人心理健康的影响:基于心理脆弱指数的分析

The impact of social participation on mental health among the older adult in China: an analysis based on the mental frailty index.

作者信息

Jing Maiyu, Wang Qianqian, Jia Yuheng, Yu Xiaoyong, Tian Kan

机构信息

School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China.

School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Front Public Health. 2025 Apr 24;13:1557513. doi: 10.3389/fpubh.2025.1557513. eCollection 2025.

Abstract

OBJECTIVES

Social participation and the psychological well-being of the older adult are correlated. A substantial body of research has delineated the relationship between social participation and the mental health of older adults, while the indicators for assessing the mental health of the older adult are not sufficiently systematic or comprehensive. This study aims to further explore the relationship between social participation and the mental health of older adults from the perspective of mental frailty, providing a reference for the improvement of health among the older adult population.

METHODS

We selected 9,208 older adults aged 60 years and older from the China Health and Retirement Longitudinal Study (CHARLS) 2013-2018 database. The mental frailty index was constructed, which integrates both depression and cognitive status to assess the mental health status of the older adult. By using a fixed-effects model, we analyzed the impact of social participation on the mental health of the older adult and compared gender, residence and marriage difference. Meanwhile, the instrumental variables method was used to conduct endogeneity tests.

RESULTS

Overall, 65.8% of the respondents had low social participation. Social participation had a significant enhancement effect on mental health in the older adult ( = -0.013,  < 0.001). In specific types of social participation, cultural and sports activities ( = -0.006,  < 0.001), communication and educational activities ( = -0.002,  < 0.05), and skill-enhancing ( = -0.006,  < 0.001) activities were negatively correlated with the index of mental frailty of the older adult, whereas volunteering activities ( = 0.002,  < 0.05) was positively correlated with the index of mental frailty of the older adult.

CONCLUSION

Social participation has a positive effect on the mental health of the older adult in China, and the effect varies for the older adult with different characteristics, which suggests that social participation may be a protective factor for the mental health of the older adult population. Targeting differentiated population characteristics, individualized policies should be developed for different groups of older persons.

摘要

目的

老年人的社会参与度与心理健康状况相关。大量研究已阐明社会参与度与老年人心理健康之间的关系,然而评估老年人心理健康的指标尚不够系统或全面。本研究旨在从心理脆弱性的角度进一步探究社会参与度与老年人心理健康之间的关系,为改善老年人群体的健康状况提供参考。

方法

我们从中国健康与养老追踪调查(CHARLS)2013 - 2018年数据库中选取了9208名60岁及以上的老年人。构建心理脆弱指数,该指数综合了抑郁和认知状况以评估老年人的心理健康状况。通过使用固定效应模型,我们分析了社会参与度对老年人心理健康的影响,并比较了性别、居住地区和婚姻状况的差异。同时,使用工具变量法进行内生性检验。

结果

总体而言,65.8%的受访者社会参与度较低。社会参与度对老年人的心理健康有显著的增强作用(β = -0.013,p < 0.001)。在特定类型的社会参与中,文化和体育活动(β = -0.006,p < 0.001)、交流和教育活动(β = -0.002,p < 0.05)以及技能提升活动(β = -0.006,p < 0.001)与老年人的心理脆弱指数呈负相关,而志愿活动(β = 0.002,p < 0.05)与老年人的心理脆弱指数呈正相关。

结论

社会参与对中国老年人的心理健康有积极影响,且对不同特征的老年人影响各异,这表明社会参与可能是老年人群体心理健康的一个保护因素。应针对不同老年人群体的特征制定个性化政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056a/12058493/a3453f7a51b6/fpubh-13-1557513-g001.jpg

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