Li Yanyan, Yang Jieru, Li Xiang, Jin Yaru, Zhou Wendie, Yu Jiaqi, Chen Hejing, Wang Xue, Wang Cuili
Department of Basic Nursing, School of Nursing, Peking University, Beijing, China.
College of Medicine and Nursing, Dezhou University, Dezhou, People's Republic of China.
Psychogeriatrics. 2025 Jul;25(4):e70056. doi: 10.1111/psyg.70056.
Self-rated health is predictive of frailty, cognitive impairment, suggesting it may also predict cognitive frailty, although the mechanism involving leisure activities has not been empirically examined. To identify the association between self-rated health and cognitive frailty, and leisure activities as a mediator and its interaction with self-rated health on cognitive frailty.
A total of 3434 participants aged 60 or older were recruited in 2011 and followed up in 2015 from the . Cognitive frailty was assessed through the coexistence of frailty (Fried) and mild cognitive impairment (cognitive tests), excluding concurrent dementia.
Self-rated poor health increased the risk of cognitive frailty (OR = 2.02 [95% CI: 1.58, 2.60]). Leisure activities nonparticipation (estimate = 0.081 [95% CI: 0.01, 0.18]) mediated the association between self-rated health and cognitive frailty. Older adults with both self-rated poor health and leisure activities nonparticipation (OR = 2.97 [95% CI: 2.12, 4.16]) had a higher risk of cognitive frailty than those with self-rated poor health (OR = 1.67 [95% CI: 1.12, 2.47]) or leisure activities nonparticipation (OR = 1.30 [95% CI: 0.94, 1.80]) alone. The relative excess risk of interaction, the attributable proportion due to interaction, were 1.00 (95% CI: 0.14, 1.86) and 0.34 (95% CI: 0.09, 0.59), respectively.
Self-rated health predicted cognitive frailty, mediated by leisure activities, and has additive interactions with leisure activities, suggesting it as a screening tool to identify older adults at high risk of cognitive frailty and emphasising early interventions that particularly motivate their intention to participate in leisure activities.
自我评估健康状况可预测衰弱、认知障碍，这表明它可能也能预测认知衰弱，尽管涉及休闲活动的机制尚未经过实证检验。本研究旨在确定自我评估健康状况与认知衰弱之间的关联，以及休闲活动作为中介变量及其与自我评估健康状况对认知衰弱的交互作用。
2011年共招募了3434名60岁及以上的参与者，并于2015年对其进行随访。认知衰弱通过衰弱（Fried标准）和轻度认知障碍（认知测试）并存来评估，排除同时存在的痴呆症。
自我评估健康状况较差会增加认知衰弱的风险（OR = 2.02 [95% CI：1.58, 2.60]）。不参与休闲活动（估计值 = 0.081 [95% CI：0.01, 0.18]）介导了自我评估健康状况与认知衰弱之间的关联。自我评估健康状况较差且不参与休闲活动的老年人（OR = 2.97 [95% CI：2.12, 4.16]）比仅自我评估健康状况较差（OR = 1.67 [95% CI：1.12, 2.47]）或仅不参与休闲活动（OR = 1.30 [95% CI：0.94, 1.80]）的老年人患认知衰弱的风险更高。交互作用的相对超额风险、交互作用归因比例分别为1.00（95% CI：0.14, 1.86）和0.34（95% CI：0.09, 0.59）。
自我评估健康状况可预测认知衰弱，休闲活动起中介作用，且与休闲活动存在相加交互作用，这表明自我评估健康状况可作为一种筛查工具，用于识别认知衰弱高危老年人，并强调早期干预，特别是激发他们参与休闲活动的意愿。
