Article(id=1241022952100131083, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410321, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729526400000, receivedDateStr=2024-10-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812528872, onlineDateStr=2026-03-18, pubDate=1742832000000, pubDateStr=2025-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812528872, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812528872, creator=13701087609, updateTime=1773812528872, updator=13701087609, issue=Issue{id=1241022939957621542, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812525976, creator=13701087609, updateTime=1773815469296, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241035285174219432, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241035285174219433, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1105, endPage=1110, ext={EN=ArticleExt(id=1241022952494395698, articleId=1241022952100131083, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Chain mediating role of adult socioeconomic status and depression in the relationship between childhood friendship experience and cognitive function in older adults, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the chain mediating roles of adult socioeconomic status and depression in the relationship between childhood friendship experiences and cognitive function in the elderly.

Methods

Based on the panel data of China Health and Retirement Tracking Survey (CHARLS) in 2014, 2018, and 2020, Partial correlation analysis was used to explore the correlation among childhood friendship experience, adult socioeconomic status, depression, and cognitive function of the elderly. The SPSS’s Process 4.1macro program was used to analyze the chain mediation effect, and Bootstrap method was used to verify the mediation variables.

Results

The direct effect of childhood friendship experiences on cognitive function in the elderly was significant(β=0.226, 95% CI: 0.109-0.343). The simple mediating effects of adult socioeconomic status and depression between childhood friendship experiences and cognitive function were significant (β=0.095, 95% CI: 0.067-0.126; β=0.023,95% CI:0.009-0.040). The chain mediating effect of adult socioeconomic status and depression between childhood friendship experiences and cognitive function was significant (β=0.006, 95% CI:0.003-0.010). The total mediating effect and the chain mediating effect respectively account for 35.33% and 1.71% of the total effect.

Conclusion

Childhood friendship experience can directly and positively influence cognitive function in the elderly, and also can influence cognitive function in the elderly through the separate and chain mediating effects of socioeconomic status and depression in adulthood.

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目的

探究成年期社会经济地位和抑郁在童年友谊经历与老年人认知功能间的中介作用。

方法

本文运用中国健康与养老追踪调查(CHARLS)2014、2018、2020年面板数据,运用偏相关分析法探究童年友谊经历、成年期社会经济地位、抑郁以及老年人认知功能间的相关性,使用SPSS的Process 4.1宏程序进行链式中介效应分析,并用Bootstrap法进行中介变量验证。

结果

童年友谊经历对老年人认知功能的直接效应显著(β=0.226,95% CI:0.109~0.343),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的单独中介效应显著(β=0.095,95% CI:0.067~0.126;β=0.023,95% CI:0.009~0.040),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的链式中介效应显著(β=0.006,95% CI:0.003~0.010),总中介效应和链式中介效应在总效应中分别占比35.33%和1.71%。

结论

童年友谊经历能够直接正向影响老年人认知功能,也可以通过成年期社会经济地位和抑郁的单独和链式中介作用影响老年人认知功能。

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李伟和秘玉清为共同通信作者。李伟, E-mail:
秘玉清,E-mail:
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王冉(2001—),女,硕士在读,研究方向:公共卫生与社区管理

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王冉(2001—),女,硕士在读,研究方向:公共卫生与社区管理

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Effects of geriatric depression on cognitive function[D]. Zhengzhou: Zhengzhou University, 2020. (In Chinese), articleTitle=Effects of geriatric depression on cognitive function, refAbstract=null), Reference(id=1241022970110472218, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=41, authorNames=程兆鹏, journalName=null, refType=null, unstructuredReference=程兆鹏.童年社会隔离对中老年人健康相关生命质量的影响研究:社会经济地位的作用机制[D].南京:南京中医药大学,2024., articleTitle=童年社会隔离对中老年人健康相关生命质量的影响研究:社会经济地位的作用机制, refAbstract=null), Reference(id=1241022970177581083, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=42, authorNames=Cheng ZP, journalName=null, refType=null, unstructuredReference=Cheng ZP. 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(In Chinese), articleTitle=The impact of childhood social isolation on health-related quality of life in middle-aged and older adults: mechanisms of action of socioeconomic status, refAbstract=null)], funds=[Fund(id=1241022965131834314, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, awardId=71774119, language=CN, fundingSource=国家自然科学基金项目(71774119), fundOrder=null, country=null), Fund(id=1241022965203137486, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, awardId=SDYJSJGC2023067, language=CN, fundingSource=山东省研究生教育教学改革研究项目(SDYJSJGC2023067), fundOrder=null, country=null), Fund(id=1241022965303800784, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, awardId=ZR2023MG019, language=CN, fundingSource=山东省自然科学基金面上项目(ZR2023MG019), fundOrder=null, country=null), Fund(id=1241022965366715348, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, awardId=ZR2023MG004, language=CN, fundingSource=山东省自然科学基金面上项目(ZR2023MG004), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241022956533510703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, xref=1., ext=[AuthorCompanyExt(id=1241022956638368315, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, companyId=1241022956533510703, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China), AuthorCompanyExt(id=1241022956659339839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, companyId=1241022956533510703, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.山东第二医科大学公共卫生学院,山东 潍坊 261053)]), AuthorCompany(id=1241022956760003141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, xref=2., ext=[AuthorCompanyExt(id=1241022956772586055, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, companyId=1241022956760003141, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.山东第二医科大学管理学院)])], figs=[ArticleFig(id=1241022962145489779, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=EN, label=Fig.1, caption=Sample screening flow chart, figureFileSmall=cYiTZ2F813Xf7alZYDR3+A==, figureFileBig=ReKNC/2q8g5Dit546Ms3vw==, tableContent=null), ArticleFig(id=1241022962300679035, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=图1, caption=样本筛选流程图, figureFileSmall=cYiTZ2F813Xf7alZYDR3+A==, figureFileBig=ReKNC/2q8g5Dit546Ms3vw==, tableContent=null), ArticleFig(id=1241022962669777808, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=EN, label=Fig.2, caption=Diagram of the chain mediation effect model, figureFileSmall=/76K48wmSO61TZ4Vp8LyPA==, figureFileBig=CSR6REZtdqZ02x1VadzytQ==, tableContent=null), ArticleFig(id=1241022962770441107, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=图2, caption=链式中介效应模型图

注:*表示P<0.05。

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Demographic characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项频数(%)认知功能得分(t/FP
年龄(岁)60~691 825(67.72)9.33±2.4622.007<0.001
70~79781(28.98)8.87±2.61
≥8089(3.30)7.83±2.35
性别1 652(61.30)9.19±2.530.9840.325
1 043(38.70)9.09±2.52
婚姻状况已婚2 171(80.56)9.21±2.533.4670.008
分居122(4.53)8.84±2.42
离异24(0.89)10.31±2.01
丧偶370(13.73)8.83±2.53
单身8(0.30)8.56±2.78
与同龄人相比16岁前自评健康状况好很多494(18.33)8.96±2.393.9490.003
好一些612(22.71)9.33±2.49
差不多1 291(47.91)9.11±2.56
差一点199(7.38)9.59±2.43
差很多99(3.67)8.68±2.87
慢性病种类(种)01 689(62.67)9.19±2.551.5150.195
1661(24.53)9.17±2.45
2236(8.76)9.07±2.51
377(2.86)8.78±2.47
≥432(1.19)8.28±2.65
睡眠时间7~8 h883(32.76)9.24±2.45-1.3440.179
其他1 812(67.24)9.10±2.55
饮酒1 140(42.30)9.29±2.47-2.4170.016
1 555(57.70)9.05±2.55
吸烟1 492(55.36)9.16±2.52-0.2180.828
1 203(44.64)9.14±2.52
), ArticleFig(id=1241022963005322144, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=表1, caption=

人口学特征

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项频数(%)认知功能得分(t/FP
年龄(岁)60~691 825(67.72)9.33±2.4622.007<0.001
70~79781(28.98)8.87±2.61
≥8089(3.30)7.83±2.35
性别1 652(61.30)9.19±2.530.9840.325
1 043(38.70)9.09±2.52
婚姻状况已婚2 171(80.56)9.21±2.533.4670.008
分居122(4.53)8.84±2.42
离异24(0.89)10.31±2.01
丧偶370(13.73)8.83±2.53
单身8(0.30)8.56±2.78
与同龄人相比16岁前自评健康状况好很多494(18.33)8.96±2.393.9490.003
好一些612(22.71)9.33±2.49
差不多1 291(47.91)9.11±2.56
差一点199(7.38)9.59±2.43
差很多99(3.67)8.68±2.87
慢性病种类(种)01 689(62.67)9.19±2.551.5150.195
1661(24.53)9.17±2.45
2236(8.76)9.07±2.51
377(2.86)8.78±2.47
≥432(1.19)8.28±2.65
睡眠时间7~8 h883(32.76)9.24±2.45-1.3440.179
其他1 812(67.24)9.10±2.55
饮酒1 140(42.30)9.29±2.47-2.4170.016
1 555(57.70)9.05±2.55
吸烟1 492(55.36)9.16±2.52-0.2180.828
1 203(44.64)9.14±2.52
), ArticleFig(id=1241022963105985447, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=EN, label=Table 2, caption=

Correlation coefficient matrix

, figureFileSmall=null, figureFileBig=null, tableContent=
变量童年期友谊经历成年期社会经济地位抑郁认知功能
童年期友谊经历1.000
成年期社会经济地位0.212a1.000
抑郁-0.120a-0.131a1.000
认知功能0.114a0.178a-0.106a1.000
), ArticleFig(id=1241022963219231660, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=表2, caption=

相关系数矩阵

, figureFileSmall=null, figureFileBig=null, tableContent=
变量童年期友谊经历成年期社会经济地位抑郁认知功能
童年期友谊经历1.000
成年期社会经济地位0.212a1.000
抑郁-0.120a-0.131a1.000
认知功能0.114a0.178a-0.106a1.000
), ArticleFig(id=1241022964729181108, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=EN, label=Table 3, caption=

Results of regression analysis by multiple intermediary models

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1:成年期社会经济地位模型2:抑郁模型3:认知功能
β tβ tβ t
常量4.1720.12433.630a12.6890.62320.370a8.4170.28529.535a
童年友谊经历0.3150.03210.762a-0.6430.140-4.608a0.2260.0603.796a
成年期社会经济地位-0.4960.081-6.108a0.2730.0357.832a
抑郁状况-0.0360.008-4.326a
年龄-0.0740.049-1.502-0.4590.208-2.212b-0.4990.089-5.639a
婚姻-0.0170.025-0.6760.5630.1065.309a-0.0370.045-0.824
16岁前自评健康状况0.0190.0270.724-0.6230.112-5.551a-0.0800.048-1.669
饮酒0.2970.0535.568a-0.7600.226-3.363a0.0850.0960.877
R20.0560.0570.061
F32.14127.06625.105
), ArticleFig(id=1241022964829844407, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=表3, caption=

多重中介模型回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1:成年期社会经济地位模型2:抑郁模型3:认知功能
β tβ tβ t
常量4.1720.12433.630a12.6890.62320.370a8.4170.28529.535a
童年友谊经历0.3150.03210.762a-0.6430.140-4.608a0.2260.0603.796a
成年期社会经济地位-0.4960.081-6.108a0.2730.0357.832a
抑郁状况-0.0360.008-4.326a
年龄-0.0740.049-1.502-0.4590.208-2.212b-0.4990.089-5.639a
婚姻-0.0170.025-0.6760.5630.1065.309a-0.0370.045-0.824
16岁前自评健康状况0.0190.0270.724-0.6230.112-5.551a-0.0800.048-1.669
饮酒0.2970.0535.568a-0.7600.226-3.363a0.0850.0960.877
R20.0560.0570.061
F32.14127.06625.105
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Chain mediation path analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
效应分类效应量(95% CI 效应占比(%)
总效应0.351(0.235~0.466)0.059100.00
直接效应0.226(0.109~0.343)0.06064.39
总中介效应0.124(0.091~0.159)0.01735.33
友谊经历->成年期社会经济地位->认知功能0.095(0.067~0.126)0.01527.07
友谊经历->抑郁->认知功能0.023(0.009~0.040)0.0086.55
友谊经历->成年期社会经济地位->抑郁->认知功能0.006(0.003~0.010)0.0021.71
), ArticleFig(id=1241022965014393794, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022952100131083, language=CN, label=表4, caption=

链式中介路径分析

, figureFileSmall=null, figureFileBig=null, tableContent=
效应分类效应量(95% CI 效应占比(%)
总效应0.351(0.235~0.466)0.059100.00
直接效应0.226(0.109~0.343)0.06064.39
总中介效应0.124(0.091~0.159)0.01735.33
友谊经历->成年期社会经济地位->认知功能0.095(0.067~0.126)0.01527.07
友谊经历->抑郁->认知功能0.023(0.009~0.040)0.0086.55
友谊经历->成年期社会经济地位->抑郁->认知功能0.006(0.003~0.010)0.0021.71
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成年期社会经济地位和抑郁在童年友谊经历与老年人认知功能间的链式中介作用
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王冉 1 , 冯晓晨 2 , 刘玉琢 1 , 王欣 2 , 罗盛 2 , 李伟 1 , 秘玉清 1
现代预防医学 | 健康与社会行为 2025,52(6): 1105-1110
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现代预防医学 | 健康与社会行为 2025, 52(6): 1105-1110
成年期社会经济地位和抑郁在童年友谊经历与老年人认知功能间的链式中介作用
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王冉1, 冯晓晨2, 刘玉琢1, 王欣2, 罗盛2, 李伟1 , 秘玉清1
作者信息
  • 1.山东第二医科大学公共卫生学院,山东 潍坊 261053
  • 2.山东第二医科大学管理学院
  • 王冉(2001—),女,硕士在读,研究方向:公共卫生与社区管理

通讯作者:

李伟和秘玉清为共同通信作者。李伟, E-mail:
秘玉清,E-mail:
Chain mediating role of adult socioeconomic status and depression in the relationship between childhood friendship experience and cognitive function in older adults
Ran WANG1, Xiao-chen FENG2, Yu-zhuo LIU1, Xin WANG2, Sheng LUO2, Wei LI1 , Yu-qing MI1
Affiliations
  • School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2025-03-25 doi: 10.20043/j.cnki.MPM.202410321
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目的

探究成年期社会经济地位和抑郁在童年友谊经历与老年人认知功能间的中介作用。

方法

本文运用中国健康与养老追踪调查(CHARLS)2014、2018、2020年面板数据,运用偏相关分析法探究童年友谊经历、成年期社会经济地位、抑郁以及老年人认知功能间的相关性,使用SPSS的Process 4.1宏程序进行链式中介效应分析,并用Bootstrap法进行中介变量验证。

结果

童年友谊经历对老年人认知功能的直接效应显著(β=0.226,95% CI:0.109~0.343),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的单独中介效应显著(β=0.095,95% CI:0.067~0.126;β=0.023,95% CI:0.009~0.040),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的链式中介效应显著(β=0.006,95% CI:0.003~0.010),总中介效应和链式中介效应在总效应中分别占比35.33%和1.71%。

结论

童年友谊经历能够直接正向影响老年人认知功能,也可以通过成年期社会经济地位和抑郁的单独和链式中介作用影响老年人认知功能。

童年友谊经历  /  认知功能  /  老年人  /  中介效应
Objective

To explore the chain mediating roles of adult socioeconomic status and depression in the relationship between childhood friendship experiences and cognitive function in the elderly.

Methods

Based on the panel data of China Health and Retirement Tracking Survey (CHARLS) in 2014, 2018, and 2020, Partial correlation analysis was used to explore the correlation among childhood friendship experience, adult socioeconomic status, depression, and cognitive function of the elderly. The SPSS’s Process 4.1macro program was used to analyze the chain mediation effect, and Bootstrap method was used to verify the mediation variables.

Results

The direct effect of childhood friendship experiences on cognitive function in the elderly was significant(β=0.226, 95% CI: 0.109-0.343). The simple mediating effects of adult socioeconomic status and depression between childhood friendship experiences and cognitive function were significant (β=0.095, 95% CI: 0.067-0.126; β=0.023,95% CI:0.009-0.040). The chain mediating effect of adult socioeconomic status and depression between childhood friendship experiences and cognitive function was significant (β=0.006, 95% CI:0.003-0.010). The total mediating effect and the chain mediating effect respectively account for 35.33% and 1.71% of the total effect.

Conclusion

Childhood friendship experience can directly and positively influence cognitive function in the elderly, and also can influence cognitive function in the elderly through the separate and chain mediating effects of socioeconomic status and depression in adulthood.

Childhood friendship experience  /  Cognitive function  /  Elderly  /  Effect of mediation
王冉, 冯晓晨, 刘玉琢, 王欣, 罗盛, 李伟, 秘玉清. 成年期社会经济地位和抑郁在童年友谊经历与老年人认知功能间的链式中介作用. 现代预防医学, 2025 , 52 (6) : 1105 -1110 . DOI: 10.20043/j.cnki.MPM.202410321
Ran WANG, Xiao-chen FENG, Yu-zhuo LIU, Xin WANG, Sheng LUO, Wei LI, Yu-qing MI. Chain mediating role of adult socioeconomic status and depression in the relationship between childhood friendship experience and cognitive function in older adults[J]. Modern Preventive Medicine, 2025 , 52 (6) : 1105 -1110 . DOI: 10.20043/j.cnki.MPM.202410321
认知功能指个体获取、处理、利用信息的心理过程[1],涉及到语言、理解、记忆和计算等多个认知领域,是衡量老年人功能状态的重要指标[2],老年人由于增龄性衰老更容易出现认知功能减退,从而成为认知障碍的易发人群[3]。WHO报告显示,2021年全球认知障碍患病约5 520万人,其相关经济负担约为1.3万亿美元,到2050年认知障碍人数将达到1.39亿[4],认知障碍已然成为严重威胁人民健康和阻碍社会可持续发展的重大疾病之一[5]
研究表明,具有更多不良童年友谊经历与成年后较低的认知功能相关,童年友谊经历不良程度较高的受访者在成年后认知功能下降速度更快[6]。社会经济因素是中老年人认知功能的重要影响因素,社会经济地位较低的老年人与具有较高社会经济地位的老年人相比患认知障碍的风险高60%~67%[7]。社交孤立、人际关系差等社会因素可以直接引起抑郁情绪从而导致认知功能的下降[8],在抑郁症确诊患者中,有童年创伤经历的患者在功能性脑连结上与无此经历的患者呈现出不同的特征[9],抑郁症状与中老年社会经济地位均对认知障碍有直接影响,中晚年社会经济地位对个体认知功能负向影响显著[10]
目前我国对老年人认知功能的研究多聚焦于横断面数据探讨其影响因素和中介路径[11-12],累积优势/劣势理论以及生命历程理论的引入为研究增添了新视角,童年经历对中老年健康的影响得到了越来越多学者的关注,现有研究验证了童年经历[13]、社会经济地位[14]、抑郁[15]和认知功能之间的相互关系,但对四个变量相互作用机制的研究有所空缺。本研究基于生命历程理论,探讨童年友谊经历对老年人认知功能的影响效应以及成年期社会经济地位和抑郁的中介效应,为缓解我国目前的老年人认知障碍状况提供参考依据。
本研究基于中国健康与养老追踪调查(China Health and Retirement Longitudinal study, CHARLS)2014、2018和2020年三期面板数据进行研究,该项目由北京大学国家发展研究院主持,旨在构建全国大型45岁及以上人群代表性追踪调查数据的高质量微观数据库,涵盖健康状况和社会经济状况等多维度信息。根据研究目的,本研究选取老年人为研究对象,纳入标准:①2020年年龄≥60岁;②核心变量未有缺失值。最终纳入2 695名研究对象。筛选过程如图1所示。
老年人认知功能在2020年CHARLS问卷中通过精神状态、情景记忆能力、视觉空间记忆能力三个方面进行衡量[16],包含时间定向力、算术能力、即时回忆能力、延时回忆能力和画图等内容,精神状态和视觉空间能力共11个问题(错误=0,正确=1);情景记忆能力共20个问题(错误=0,正确=0.5),加总求和后变量取值范围为0~21,取值越高认知功能越好,Cronbach α系数为0.763。
童年友谊经历来自2014年CHARLS生命历程调查问卷中童年时期的友谊和经历部分,参考Burr等人[6]的研究,包含因缺乏朋友而导致孤独的频率(经常或有时=0,很少或从没有=1)、和朋友一起玩的频率(很少或从没有=0,经常或有时=1)以及是否有好朋友(没有=0,有=1)三个问题,加总求和后该变量的取值范围为0~3,取值越高童年时期的友谊经历越好,Cronbach α系数为0.759。
(1)参照以往研究[17]采用受教育程度、家庭人均年支出、职业和医疗保险来衡量成年期社会经济地位。受教育程度划分为未接受教育、小学及以下、初中及以上三类并依次赋值0~2;家庭人均年消费水平利用过去一年的家庭消费和家庭人口数进行计算,按照四分位数间距法划分为低、中、高三级并依次赋值0~2;职业分为未就业、农业、非农业三类并依次赋值为0~2;医疗保险按照未缴纳保险、缴纳城乡居民医疗保险、城镇职工医疗保险、其他依次赋值为0~3;加总求和后该变量的取值范围为0~9,取值越高成年期社会经济地位越高,Cronbach α系数为0.783。
(2)抑郁水平采用简版流调中心抑郁自评量表(CES-D10)[18]进行测量 ,该量表包含10个条目,对条目5和8进行反向赋值,其他条目赋值很少或者根本没有=0,不太多=1,有时或者说有一半的时间=2,大多数的时间=3,加总求和后该变量的取值范围为0~30,取值越高抑郁水平越高,Cronbach α系数为0.790。
参考既往研究与实际情况[7],本研究纳入年龄、性别、婚姻、吸烟、饮酒、睡眠时间、慢性病患病情况、与同龄人相比16岁前自评健康状况作为控制变量,具体变量描述性统计见表1
使用Stata MP 18、SPSS 26.0软件对数据进行筛选、整理和分析,计量资料的描述采用(),计数资料采用结构相对数表示。相关性分析采用偏相关分析法;共同方法偏差检验运用Harman单因素检验。运用多元线性回归,结合SPSS Process宏程序,经Bootstrap法重复抽样5 000次进行链式中介效应检验,检验水准α=0.05。
本研究共纳入2 695名老年人作为研究对象,其中60~69岁共1 825人(67.72%),70~79岁有781人(28.98%),80岁及以上有89人(3.30%);男性1 652人(61.30%);婚姻状况已婚2 171人(80.56%);16岁前与同龄人健康状况差不多1 291人(47.91%);睡眠时间7~8小时883人(32.76%);饮酒1 140人(42.30%),吸烟1 492人(55.36%),具体情况见表1
为控制混杂因素的影响,本研究采用偏相关分析法分析变量之间的相关关系,童年期友谊经历与成年期社会经济地位、认知功能呈正相关(r=0.212,r=0.114,P<0.001),与抑郁呈负相关(r=-0.120,P<0.01);成年期社会经济地位与抑郁呈负相关(r=-0.131,P<0.01),与认知功能呈正相关(r=0.178,P<0.01);抑郁与认知功能呈负相关(r=-0.106,P<0.01),见表2
应用Harman单因素检验法对相关变量进行未旋转探索性分析,结果显示有21个因子特征值大于1,第一个因子的解释率为7.45%(<40%),因此本研究不存在严重的共同方法偏差问题。
本研究以童年期友谊经历为自变量,以认知功能为因变量,以成年期社会经济地位和抑郁为中介变量,在控制年龄、婚姻状况、与同龄人相比16岁前自评健康状况、饮酒等混杂因素的基础上进行多重中介效应分析。分析结果显示,童年友谊经历能够正向预测成年期社会经济地位(β=0.315,P<0.001)和认知功能(β=0.226,P<0.001),负向预测抑郁(β=-0.643,P<0.001);成年期社会经济地位能够负向预测抑郁(β=-0.496,P<0.001),正向预测老年人认知功能(β=0.273,P<0.001);抑郁能够负向预测老年人认知功能(β=-0.036,P<0.001),见表3
根据多重中介模型分析结果,童年友谊经历对老年人认知功能的直接效应显著(β=0.226,95% CI:0.109~0.343),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的单独中介效应显著(β=0.095,95% CI:0.067~0.126;β=0.023,95% CI:0.009~0.040),成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能间的链式中介效应显著(β=0.006,95% CI:0.003~0.010)。总效应值为0.351,总中介效应值为0.124。见表4图2
本研究基于2014、2018以及2020年CHARLS三期数据,选取≥60岁老年人进行纵向研究。剖析童年友谊经历、成年期社会经济地位、抑郁和老年人认知功能之间的相互关系以及作用机制。研究结果表明,良好的童年友谊经历正向影响老年人认知功能,直接效应占总效应的64.39%,成年期社会经济地位和抑郁在童年友谊经历和老年人认知功能之间起单独中介作用,其效应值占总效应的27.07%和6.55%;成年期社会经济地位和抑郁在童年友谊经历和认知功能之间存在链式中介效应,在总效应中占比为1.71%。
研究结果表明,良好的童年友谊经历对老年人认知功能有显著正向影响,即经历越好,老年人认知功能表现越佳,反之则越差,与Xie等人[19]研究结论一致。童年时期是认知发展的敏感期,对中后期认知功能具有深远影响,同伴接纳和群体归属感对童年早期阶段的个体具有重要意义,从生命历程角度考虑,营造良好的童年社交环境对健康的认知老龄化至关重要[20]
研究结果表明,童年友谊经历能够通过成年期社会经济地位间接影响老年人认知功能。社会资本理论认为,个体的社会网络强度是影响其经济状况的主要因素之一,Chetty等人发现经济关联度(即不同社会经济地位个体之间的友谊)与中低收入家庭儿童日后的收入流动和生活改善最为相关[21]。良好的友谊经历促使个体自我效能感提升,使其相信自己有能力处理好与朋友的沟通交往、解决冲突和管理人际情绪[22],不良的童年友谊经历可能会通过影响个体的社交行为妨碍其建立有效的社交网络和进行良好的职业发展,从而对其成年期社会经济地位产生负面影响。而有研究表明,处于较高社会经济地位的个体认知储备较好,从而在低于认知损伤阙值情况下能够承受更大的认知刺激和衰退,而不同维度处于劣势社会经济地位的人群的认知功能亦处于劣势[16]
研究结果表明,童年友谊经历能通过抑郁影响老年人认知功能,童年友谊经历越差的个体抑郁水平越高,其老年期认知功能越差,与既往研究结果一致[23]。根据压力敏感理论,童年逆境使个体对压力事件出现抑郁反应的阈值降低,进而导致个体面对轻度压力源即产生抑郁反应的影响会一直持续到老年[24]。从生物学机制来看,抑郁可能会通过刺激糖皮质激素的产生或β样淀粉的沉积,反过来对海马体构成损伤从而对认知能力产生影响,另外,抑郁会导致促炎性细胞因子分泌增加而减少神经营养因子,从而导致认知功能的降低[25]
研究结果表明,童年友谊经历能够通过成年期社会经济地位和抑郁影响老年人认知功能。童年社会隔离对个体生理及心理层面产生的负面影响可能导致生命历程中教育和就业机会的限制,从而对个体的成年期社会经济地位造成影响[26]。成年期社会经济地位对抑郁有负向预测作用,社会经济地位较低的老年人拥有较少的社会资源,更容易面对各种慢性和急性压力源,产生负面情绪的可能性更高[10],更容易伴随较高的抑郁水平,从而引起认知功能下降,这印证了“成年期社会经济地位-抑郁”的链式中介作用。
本研究证实了成年期社会经济地位和抑郁在童年友谊经历和老年认知功能关系中的单独中介作用和链式中介作用。理论层面,深化了既往研究中童年经历与老年人认知功能的相关关系和作用路径,为之后的研究提供了新思路,有利于推动老年人认知功能的研究进展。实践层面,通过此链式中介效应路径,可以提示有关部门通过社区儿童兴趣小组、儿童俱乐部等进行早期社交和认知刺激行为,促进良好的童年期友谊关系的建立,以减少因童年不良友谊经历而导致的老年认知障碍。本研究仍存在一定的局限性,第一,研究所用童年友谊经历资料通常依赖于受访者的回忆,且存在较长的时间跨度,可能存在回忆偏倚;第二,受数据限制可能无法完全控制混杂因素的影响,后续会对此进行深入研究。
  • 国家自然科学基金项目(71774119)
  • 山东省研究生教育教学改革研究项目(SDYJSJGC2023067)
  • 山东省自然科学基金面上项目(ZR2023MG019)
  • 山东省自然科学基金面上项目(ZR2023MG004)
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2025年第52卷第6期
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doi: 10.20043/j.cnki.MPM.202410321
  • 接收时间:2024-10-22
  • 首发时间:2026-03-18
  • 出版时间:2025-03-25
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  • 收稿日期:2024-10-22
基金
国家自然科学基金项目(71774119)
山东省研究生教育教学改革研究项目(SDYJSJGC2023067)
山东省自然科学基金面上项目(ZR2023MG019)
山东省自然科学基金面上项目(ZR2023MG004)
作者信息
    1.山东第二医科大学公共卫生学院,山东 潍坊 261053
    2.山东第二医科大学管理学院

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2种不同金属材料的力学参数

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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