Effect Of Social Support And Social Participation On The Risk Of Cognitive Impairment Among The Elderly In China

Objectives:According to the current situation of cognitive function among the elderly in China,the relevant factors affecting the cognitive impairment of the elderly were analyzed.From the perspective of social factors,explored the impact of social support and social participation on the risk of cognitive impairment among the elderly in China,and revealed the causal relationship.To analyze the impact of social support and social participation on the risk of cognitive impairment for the male and female.In addition,structural equation model was used to analyze the influence factors of cognitive function,deeply explored the influence of social support,social participation,life-diet,gender,partner,and educational background on cognitive function,and used social support and social participation as mediating variables to test the mediating effect.Effectively prevented and delayed the occurrence of cognitive impairment,improved and enhanced the cognitive function of the elderly in China,and provided a scientific evidence for comprehensively protecting the physical and mental health of the elderly.Methods:This paper used the Chinese Longitudinal Healthy Longevity Survey(CLHLS)data from 2005 to 2018.Firstly,used descriptive analysis methods to analyze the basic information,dietary characteristics and lifestyle characteristics of the research subjects.And used the multi-factor Cox regression model to analyze the impact of social support and social participation on the risk of cognitive impairment among the elderly in China.In addition,restricted cubic spline models were used to analyze the dose-response relationship between social support,social participation and the risk of cognitive impairment.Besides,the structural equation model was used to deeply explore the impact of social support,social participation,life-diet,gender,partner and educational background on cognitive function.Combined with Bootstrap statistical method,it was found that the mediating variables which were social support and social participation had a mediation effect in the influence of gender,parter and educational background on cognitive function.Results:(1)A total of 8016 subjects were included in this article.After an average of 10.53 years of follow-up times surveys,there were 2463 subjects had the outcome of cognitive impairment,with an incidence rate of 30.73%.And the male incidence rate of cognitive impairment was 23.30%,and the female incidence rate of cognitive impairment was 38.42%.(2)Multivariate Cox regression analysis showed that the risk of cognitive impairment in poor social support was 1.56 times(95%confidence interval:1.24-1.95)of the elderly compared to better social support.The risk of cognitive impairment in medium social support was 1.42 times(95%confidence interval:1.17-1.72)of the elderly compared to better social support.The social support score and the risk of cognitive impairment showed a non-linear dose response relationship(Poverall-trend<0.05,Pnon-linear<0.05).Although there was a downward trend of the risk of cognitive impairment with the increase of social support,there was no statistical significance between the better social support and the risk of cognitive impairment.(3)Multivariate Cox regression analysis showed that the risk of cognitive impairment in poor social participation was 2.75 times(95%confidence interval:2.09-3.61)of the elderly compared to better social participation.The risk of cognitive impairment in medium social participation was 1.92 times(95%confidence interval:1.47-2.52)of the elderly compared to better social participation.The social participation score and the risk of cognitive impairment showed a non-linear dose response relationship(Poverall-trend<0.05,Pnon-linear<0.05).There was a downward trend of the risk of cognitive impairment with the increase of social participation,and the better social participation was a protective factor for cognitive impairment.(4)Regression analysis showed that male,female have different risk of cognitive impairment under social support and social participation.The risk of male poor social support was 1.63 times(95%confidence interval:1.17-2.27)of the elderly compared to better social support.There was a linear dose-response relationship between male social support and the risk of cognitive impairment(Poverall-trend<0.05,Pnon-linear-0.16>0.05).The risk of female poor support was 1.50 times(95%confidence interval:1.08-2.07)of the elderly compared to better social support.There was a linear dose-response relationship between the risk of women social support and cognitive impairment(Poverall-trend<0.05,Pnon-linear=0.10>0.05).In addition,the risk of poor social participation for male was 3.28 times(95%confidence interval:2.19-4.92)compared to better social participation,and the risk of poor social participation for female was 2.31 times(95%confidence interval:1.59-3.34)compared to better social participation.There was a non-linear dose-response relationship between male and female social participation and the risk of cognitive impairment(Poverall-trend<0.05,Pnon-linear<0.05).(5)The structural equation model showed that social participation,life-diet,gender,and educational background had a direct effect on cognitive function(P<0.001),and the standardized path coefficients were 0.158,0.095,-0.032,and 0.136,respectively.Research hypotheses H2,H3,H4,and H6 were supported.The mediating effect test showed that the mediating effect value of social participation between gender and cognitive function was 0.008,the deviation-corrected Bootstrap confidence interval(0.004,0.012)at 95%confidence level,and P<0.001.It showed that social participation has a significant mediation effect between gender and cognitive function.The mediating effect test showed that the mediating effect value of social participation between partner and cognitive function was 0.023,the deviation-corrected Bootstrap confidence interval(0.009,0.038)at 95%confidence level,and P<0.001.It showed that social participation has a significant mediation effect between partner and cognitive function.The mediating effect test showed that the mediating effect value of social participation between educational background and cognitive function was 0.047,the deviation-corrected Bootstrap confidence interval(0.040,0.056)at 95%confidence level,and P<0.001.It showed that social participation has a significant mediation effect between educational background and cognitive function.Research hypotheses H4.2,H5.2,and H6.2 were supported.Conclusions:(1)Based on the longitudinal data of Chinese Longitudinal Healthy Longevity Survey,this paper was analyzed the relevant factors affecting cognitive impairment of the elderly from the perspective of social factors.It was concluded that the incidence of cognitive impairment among the elderly in China was higher,and the female had a higher incidence of cognitive impairment than the male.(2)The low level of social support was closely related to the high risk of cognitive impairment,and there was a non-linear dose-response relationship between the social support and the risk of cognitive impairment.There was a downtrend of the risk of cognitive impairment with increases the level of social support.(3)The low level of social participation was closely related to the high risk of cognitive impairment,and there was a non-linear dose-response relationship between the social participation and the risk of cognitive impairment.There was a downtrend of the risk of cognitive impairment with increases the level of social participation.(4)There was a linear dose-response relationship between the male and female social support and the risk of cognitive impairment.And there was a downtrend of the risk of cognitive impairment with increases of the male and female social support.Moreover,there was a non-linear dose-response relationship between the male and female social participation and the risk of cognitive impairment.And there was a downtrend of the risk of cognitive impairment with increases of the male and female social participation.(5)The structural equation model of the influence factors of cognitive function showed that social participation,life-diet,gender,and educational background have a direct impact on cognitive function,and social participation played an important mediating role in the influence of gender,partner and educational background on cognitive function.According to the total effect value,the order was education,partner,social participation,life-diet,gender,and social support.Social participation has greater impact on cognitive function than social support.