Luo Jingjing, Zhou Chengchao
Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, People's Republic of China.
Eur J Psychotraumatol. 2025 Dec;16(1):2543630. doi: 10.1080/20008066.2025.2543630. Epub 2025 Sep 2.
Little is known regarding the association between adverse experiences and cognitive frailty, and the role of social support in this relationship. This study aimed to investigate the association between adverse experiences and cognitive frailty, as well as determine how social support affects this relationship among rural older adults in China. Data were obtained from two waves of follow-up surveys (2020 and 2022) conducted by the Shandong Rural Elderly Health Cohort (SREHC), including 2,572 participants aged 60 years or above. The primary outcome was cognitive frailty, defined as the co-existence of physical frailty (≥3 Fried criteria) and cognitive impairment (educationally adjusted Mini-Mental Status Examination). Self-reported adverse experiences were categorised as no adversity, only childhood adversity (≥1 of 12 events before age 17), only current adversity (≥1 of 7 events past year), and dual adversity (experiencing both childhood and current adversity). The Generalized Estimating Equation (GEE) analyses and the margins plot were performed to estimate our hypothetical models. In fully adjusted models, older adults with dual adversity were significantly associated with a higher risk of cognitive frailty (OR = 1.64, 95% CI: 1.02-2.63), not significant in only childhood or only current adversity. Social support alleviated the risk of cognitive frailty among rural older adults with only childhood adversity (OR = 0.41, 95% CI: 0.21-0.79) or dual adversity (OR = 0.26, 95% CI: 0.09-0.72), but not among those with only current adversity. Our results underscore the relationship between dual adversity and cognitive frailty, not significant in only childhood or only current adversity, with social support serving as a pivotal moderating factor. Governmental authorities should elevate their awareness of adverse experiences, and enhancing social support is crucial to preventing cognitive frailty and promoting healthy aging.
关于不良经历与认知衰弱之间的关联以及社会支持在这种关系中所起的作用，目前所知甚少。本研究旨在调查不良经历与认知衰弱之间的关联，并确定社会支持如何影响中国农村老年人的这种关系。数据来自山东农村老年健康队列（SREHC）进行的两轮随访调查（2020年和2022年），包括2572名60岁及以上的参与者。主要结局是认知衰弱，定义为身体衰弱（≥3项弗里德标准）和认知障碍（经教育调整的简易精神状态检查表）并存。自我报告的不良经历分为无逆境、仅有童年逆境（17岁之前12项事件中≥1项）、仅有当前逆境（过去一年7项事件中≥1项）以及双重逆境（经历童年和当前逆境）。采用广义估计方程（GEE）分析和边际图来估计我们的假设模型。在完全调整模型中，有双重逆境的老年人与认知衰弱风险较高显著相关（OR = 1.64，95% CI：1.02 - 2.63），在仅有童年逆境或仅有当前逆境时不显著。社会支持减轻了仅有童年逆境（OR = 0.41，95% CI：0.21 - 0.79）或双重逆境（OR = 0.26，95% CI：0.09 - 0.72）的农村老年人的认知衰弱风险，但对仅有当前逆境的老年人没有作用。我们的结果强调了双重逆境与认知衰弱之间的关系，在仅有童年逆境或仅有当前逆境时不显著，社会支持是一个关键的调节因素。政府当局应提高对不良经历的认识，加强社会支持对于预防认知衰弱和促进健康老龄化至关重要。
