DIRECT AND INDIRECT EFFECTS OF SOCIAL ENGAGEMENT ON COGNITIVE IMPAIRMENT AMONG CHINESE OLDER ADULTS

Abstract

Objective: To decompose the total effect of social engagement on cognitive impairment through psychological well-being and to explore gender differences. Methods: A total of 6,998 older adults aged 65 and over were obtained from the latest two waves of Chinese Longitudinal Healthy Longevity Survey. Social engagement was constructed by marital status, living situation, availability of help, availability of confidant, and social participation. Cognitive impairment was defined as £18 of the Mini-Mental State Examination. Psychological well-being was measured by seven items concerning mood-related and personality-related concepts of affect. The total effect was decomposed into direct and indirect effect by using logistic regression based on the Karlson, Holm, and Breen (KHB) method. Results: The prevalence of follow-up cognitive impairment among the whole population was 15.69%, with 10.19% and 20.93% among male and female sub-sample respectively. The majority of old men scored 4 in social engagement while a majority of old women score 3. Old men had a better average score of psychological well-being than old women (19.52 vs. 18.44). The mediating effect was 15.38%, with 13.07% and 21.43% in the whole sample, male and female sub-sample respectively. However, the mediation was only significant in male sub-sample. Conclusions: Social engagement was associated with an increased risk of cognitive impairment in old men. Moreover, part of the effect was significantly mediated by psychological well-being among male older adults. It helps us to pour more attention to old men when interventions are proposed to improve their cognitive function and quality of life.