Wang Suyan, Chen Xiyu, Wang Haoyu, Tang Qiwei, Cheng Cheng, Wu Yao, Hu Jinrui, Duan Yishan, Xian Xiaobing, Chen Bojiang
Frontiers Science Center for Disease-related Molecular Network, West China Hospital, and Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610041, Sichuan, China.
Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Sci Rep. 2025 Jul 1;15(1):21210. doi: 10.1038/s41598-025-03491-w.
Cognitive impairment (CI) has emerged as a critical global public health concern, particularly among older adults. Community-based services (CBSs) and psychological resilience (PR) are potential protective factors, yet their interrelationships remain underexplored. This study examines how CBSs influence CI among older adults and whether PR mediates this association. Based on data from 7,565 individuals aged ≥ 65 in the China Longitudinal Health Longevity Survey (CLHLS), the structural equation modeling was used to test direct and indirect pathways between CBSs, PR, and CI, adjusting for eighteen basic demographic covariates. Mediation effects were validated via the Bootstrap 2000 method. The findings highlight that CBSs are positively associated with both lower CI (β = 0.049, P < 0.001) and higher PR (β = 0.071, P < 0.001), while PR associates with CI risk positively (β = 0.260, P < 0.001). PR mediated 26.87% of the total CBSs-CI association (indirect effect = 0.018, 95%CI: 0.012-0.026). Specific CBSs, including doctors or sending medicine to home (χ = 7.05, P = 0.008) and health care education (χ = 7.89, P = 0.005), showed a strong protective effect against CI. These results underscore the importance of enhancing CBSs and fostering PR to mitigate CI and promote healthy aging. A collaborative effort between communities and society is essential to empower older adults, strengthen their PR and facilitate active aging.
认知障碍（CI）已成为一个关键的全球公共卫生问题，在老年人中尤为突出。基于社区的服务（CBSs）和心理韧性（PR）是潜在的保护因素，但其相互关系仍未得到充分探索。本研究考察了CBSs如何影响老年人的CI，以及PR是否介导了这种关联。基于中国老年健康影响因素跟踪调查（CLHLS）中7565名年龄≥65岁个体的数据，采用结构方程模型来检验CBSs、PR和CI之间的直接和间接路径，并对18个基本人口统计学协变量进行了调整。通过Bootstrap 2000方法验证中介效应。研究结果表明，CBSs与较低的CI（β = 0.049，P < 0.001）和较高的PR（β = 0.071，P < 0.001）均呈正相关，而PR与CI风险呈正相关（β = 0.260，P < 0.001）。PR介导了CBSs与CI总关联的26.87%（间接效应 = 0.018，95%CI：0.012 - 0.026）。特定的CBSs，包括医生上门或送药（χ = 7.05，P = 0.008）和健康教育（χ = 7.89，P = 0.005），对CI显示出强大的保护作用。这些结果强调了加强CBSs和培养PR以减轻CI和促进健康老龄化的重要性。社区和社会之间的合作努力对于增强老年人的能力、加强他们的PR以及促进积极老龄化至关重要。
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