Place of Residence and Cognitive Function in Older Adults in China: The Mediating Role of Social Participation.

Le Yang,Jingmin Cheng,Hongman Wang

doi:10.3390/ijerph19010013

Abstract

Background: Cognitive impairment is a severe health problem faced by older adults and their families, as well as the countries in which they live. Differences in place of residence may contribute to differences in the cognitive function of older adults, and the mediating effect of social participation has rarely been studied in China. Methods: A total of 10,014 older adult participants were included, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Place of residence was described as either a city, town, or rural area. The frequency of participation in organized social activities and visits and interactions with friends was used to assess both formal and informal social participation. The Chinese version of a Mini-Mental State Examination (MMSE) was used as a measure of cognitive function. The mediation analysis was conducted using Hayes’ process version 3.4 on SPSS (IBM, Armonk, NY, USA). Results: Place of residence had a negative effect on cognitive function in older adults. The mediating functions of both informal (a1b1 = 0.199) and formal (a2b2 = −0.056) social participation indicate a suppression effect on the part of informal social participation and a partial mediation effect on the part of formal social participation in terms of the association between place of residence and cognitive function in older adults. Promoting both informal and formal social participation seems to be an important strategy for preventing a decline in the cognitive function of older adults, especially for those living in rural areas.

Highlights

Cognitive function is an important determinant of independence, daily living ability, and quality of life in older adults [1–3]
This paper explored the mediating role of social participation in the association between place of residence and cognitive function in older adults, adjusting for age, gender, education, marital status and household income
Using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cross-sectional survey, social participation was found to play a mediating role in the association between place of residence and cognitive function in older adults, which indicates that differences in place of residence are associated with differences in social participation, and in turn have different influences on cognitive function in older adults

Summary

Introduction

Cognitive function is an important determinant of independence, daily living ability, and quality of life in older adults [1–3]. Older adults tend to experience degenerative changes in their cognitive function in areas such as memory, attention, and executive functioning [4,5]. Recent research has shown that in China there are 15.07 million adults aged 60 years or older with dementia, and an additional 38.77 million older adults with mild cognitive impairment (MCI) [6]. Cognitive impairment will put great stress on the country, community, family and older adults themselves. The issue of how to prevent cognitive decline and maintain cognitive function among older adults as well as how to provide social care for those with cognitive impairment has been the focus of researchers and experts on ageing, and a staple of the Healthy China

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