Cheng Wenwen, Zhu Ning-Li, Li Jia-Xue, Jing-Jing Sun, Li Xiao-Yu, Zhang Si-Yu, Wang Dong-Guang, Liu Xiao-Hui, Zhu Liang
School of Preventive Medicine, The Fourth Military Medical University, Xi'an, Shaanxi, China.
The Shaanxi Provincial Key Laboratory of Environmental Health Hazard Assessment and Protection, Xi'an, China.
BMJ Open. 2025 Jun 13;15(6):e094063. doi: 10.1136/bmjopen-2024-094063.
This study investigated the effects of work cessation on cognitive function among older adults in rural China. Given that cognitive disorders affect 6.04% of individuals aged 60 and above-with higher prevalence in rural areas-understanding this relationship is critical.
A cross-sectional study was employed, using data from the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS). Regression analysis assessed the impact of work cessation on cognitive function and the moderating effects of social activities, health behaviours and internet use.
Data were collected from 150 districts, 450 villages, and urban community units in China.
The study included 6,318 participants, with 4,045 currently employed and 2,273 no longer working.
Cognitive function was evaluated using measures of mathematical computation, temporal and image cognition, and situational memory was tested through 20 memory-related questions. Explanatory variables included work cessation status, while moderating variables encompassed social activities, health behaviours (smoking and alcohol consumption) and internet use.
Work cessation has a negative impact on cognitive function, particularly situational memory and overall cognitive ability. Stopping work was associated with a decrease in cognitive functioning by 0.796 SD (p<0.01), a reduction in situational memory capacity by 1.083 SD (p<0.01) and a decline in total cognitive ability by 1.879 SD (p<0.01). However, more social activities, better health behaviours (eg, quitting smoking) and internet use can alleviate the impact. Seniors with high social activity levels showed an increase in cognitive functioning by 0.375 SD (p<0.01), while those who drank less alcohol had a 0.598 SD improvement in cognitive functioning (p<0.01). Internet use improved cognitive function by 1.265 SD (p<0.01).
Work cessation significantly reduced cognitive function in rural Chinese older adults. Leisure activities can mitigate this decline, but they often lack quality and diversity. Health behaviour improvements show heterogeneity, and internet use mitigates cognitive decline despite urban-rural digital gaps. To protect rural older adults' cognitive function, policies promoting flexible employment, enhanced recreational infrastructure, health outreach and bridging digital divides are proposed.
本研究调查了中国农村老年人停止工作对认知功能的影响。鉴于认知障碍影响6.04%的60岁及以上人群，且在农村地区患病率更高，了解这种关系至关重要。
采用横断面研究，使用中国健康与养老追踪调查（CHARLS）2020年的数据。回归分析评估了停止工作对认知功能的影响以及社会活动、健康行为和互联网使用的调节作用。
数据收集自中国的150个县、450个村庄和城市社区单位。
该研究纳入了6318名参与者，其中4045人目前仍在工作，2273人已不再工作。
使用数学计算、时间和图像认知测量来评估认知功能，并通过20个与记忆相关的问题测试情景记忆。解释变量包括停止工作状态，调节变量包括社会活动、健康行为（吸烟和饮酒）和互联网使用。
停止工作对认知功能有负面影响，尤其是情景记忆和整体认知能力。停止工作与认知功能下降0.796标准差（p<0.01）、情景记忆能力下降1.083标准差（p<0.01）以及总认知能力下降1.879标准差（p<0.01）相关。然而，更多的社会活动、更好的健康行为（如戒烟）和互联网使用可以减轻这种影响。社会活动水平高的老年人认知功能提高了0.375标准差（p<0.01），而饮酒较少的老年人认知功能提高了0.598标准差（p<0.01）。互联网使用使认知功能提高了1.265标准差（p<0.01）。
停止工作显著降低了中国农村老年人的认知功能。休闲活动可以减轻这种下降，但往往缺乏质量和多样性。健康行为改善存在异质性，尽管存在城乡数字鸿沟，但互联网使用可减轻认知衰退。为保护农村老年人的认知功能，建议出台促进灵活就业、加强娱乐基础设施建设、开展健康宣传和弥合数字鸿沟的政策。
