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Article(id=1241035811676811909, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407047, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1720022400000, receivedDateStr=2024-07-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815594834, onlineDateStr=2026-03-18, pubDate=1733760000000, pubDateStr=2024-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815594834, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815594834, creator=13701087609, updateTime=1773815594834, updator=13701087609, issue=Issue{id=1241035810628235909, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815594584, creator=13701087609, updateTime=1773815743629, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241036435843764756, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241036435843764757, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4343, endPage=4348, ext={EN=ArticleExt(id=1241035813102875278, articleId=1241035811676811909, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Intergenerational support and its impact on cognitive function in the elderly in China, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the impact of intergenerational support on cognitive function among the elderly in China.

Methods

Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were utilized, and statistical analysis was performed using SPSS 27.0. Both univariate analysis and multiple linear regression analysis were conducted to assess the effects of intergenerational support on the cognitive function of individuals aged 60 and above.

Results

A total of 4 154 participants were included in the study. The findings indicated a positive correlation between cognitive function in the elderly and both bidirectional economic support from children and emotional comfort provided by them. However, the frequency of interaction between the elderly and their children did not show a statistically significant difference in cognitive function scores. The multiple linear regression model equation was as the following: Cognitive function score = 31.003 + 1.138 * log (child economic support) + 0.996 * log (parental economic support) - 0.173 * age - 12.939 * [education = no formal education (illiterate)] - 5.578 *(education = primary school or informal education) + 1.137 * (marital status = married) + 1.118 * (pension insurance = yes) +3.276 * (social health insurance = yes) - 3.541 * (daily living ability impaired = yes).

Conclusion

It is essential to maintain communication and interaction between generations. Communities and the government should integrate intergenerational support into preventive health care and elderly care policies as a robust support for “healthy aging”.

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目的

探究代际支持对我国老年人认知功能的影响。

方法

采用2020年中国健康与养老追踪调查数据，使用SPSS 27.0进行统计分析，运用单因素分析和多重线性回归分析代际支持对我国60岁及以上老年人认知功能的影响。

结果

本研究共纳入4 154名研究对象，结果表明，我国老年人认知功能与代际双向经济支持和子女精神慰藉正向关联；老年人与子女是否时常见面与其认知功能得分差异不具有统计学意义。多重线性回归模型方程为：老年人认知功能得分=31.003+1.138×老年人得到子女经济支持对数值+0.996×老年人给予子女经济支持对数值-0.173×年龄- 12.939×[教育=未受过教育（文盲）]-5.578×（教育=小学或私塾）+1.137×（婚姻=已婚）+1.118×（养老保险=有）+ 3.276×（社会医疗保险=有）-3.541×（日常生活能力受损=是）。

结论

代际间应保持交流互动，社区和国家应将代际支持与老年人认知功能的预防保健和养老政策结合，作为“健康老龄化”的有力支持。

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张馨予，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=vIdIXw6SzSe6uY3JiOGQdg==, magXml=qMulcGFUgywziN8xGPmqUA==, pdfUrl=null, pdf=vt/5+kY57py2XH5G1IW98g==, pdfFileSize=924681, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=NSKq7RgBRWaX8mSlNdXgFQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=4YJBif/di9VjfFPYaQ8T2A==, mapNumber=null, authorCompany=null, fund=null, authors=

张婷婷（2003—），女，本科在读，研究方向：预防医学

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张婷婷（2003—），女，本科在读，研究方向：预防医学

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Alzheimer Disease & Associated Disorders, 2022, 36(2): 103-110., articleTitle=Assessing social cognition in older adults: a Population-Based study, refAbstract=null), Reference(id=1241069125502554477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, doi=null, pmid=null, pmcid=null, year=2005, volume=null, issue=6, pageStart=222, pageEnd=225, url=null, language=null, rfNumber=[24], rfOrder=35, authorNames=王萍, 李树茁, 张文娟, journalName=Journal of Psychological Science, refType=null, unstructuredReference=王萍，李树茁，张文娟.代际支持对中国农村老年人认知功能的影响研究[J].Journal of Psychological Science，2005,（6）：222-225., articleTitle=代际支持对中国农村老年人认知功能的影响研究, refAbstract=null), Reference(id=1241069125615800689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, doi=null, pmid=null, pmcid=null, year=2005, volume=null, issue=6, pageStart=222, pageEnd=225, url=null, language=null, rfNumber=[24], rfOrder=36, authorNames=Wang P, Li SZ, Zhang WJ, journalName=Journal of Psychological Science, refType=null, unstructuredReference=Wang P, Li SZ, Zhang WJ. The effects of intergenerational supports on the cognitive function of the rural elderly in China[J]. Journal of Psychological Science, 2005, (6): 222-225.(In Chinese), articleTitle=The effects of intergenerational supports on the cognitive function of the rural elderly in China, refAbstract=null), Reference(id=1241069125796155764, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, doi=null, pmid=null, pmcid=null, year=2000, volume=22, issue=1, pageStart=43, pageEnd=65, url=null, language=null, rfNumber=[25], rfOrder=37, authorNames=Chen X, Silverstein M, journalName=Research on Aging, refType=null, unstructuredReference=Chen X, Silverstein M. Social support and psychological well-being of the elderly in China[J]. Research on Aging, 2000, 22(1): 43-65., articleTitle=Social support and psychological well-being of the elderly in China, refAbstract=null), Reference(id=1241069125909401980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, doi=null, pmid=null, pmcid=null, year=2022, volume=400, issue=10367, pageStart=1967, pageEnd=2006, url=null, language=null, rfNumber=[26], rfOrder=38, authorNames=Chen XX, Giles J, Yao Y, journalName=Lancet, refType=null, unstructuredReference=Chen XX, Giles J, Yao Y, et al. The path to healthy ageing in China: a Peking University-Lancet Commission[J]. Lancet, 2022, 400(10367): 1967-2006., articleTitle=The path to healthy ageing in China: a Peking University-Lancet Commission, refAbstract=null), Reference(id=1241069126018453888, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, doi=null, pmid=null, pmcid=null, year=2024, volume=187, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[27], rfOrder=39, authorNames=Flicker L, journalName=Maturitas, refType=null, unstructuredReference=Flicker L. Evidence-based strategies to prevent cognitive decline in older People[J]. Maturitas, 2024, 187: 108062., articleTitle=Evidence-based strategies to prevent cognitive decline in older People, refAbstract=null)], funds=[Fund(id=1241069119961878637, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, awardId=71904142, language=CN, fundingSource=国家自然科学基金青年科学基金项目(71904142), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241069113167106809, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, xref=null, ext=[AuthorCompanyExt(id=1241069113179689723, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, companyId=1241069113167106809, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Tianjin Medical University, School of Public Health, Tianjin 300070, China), AuthorCompanyExt(id=1241069113183884028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, companyId=1241069113167106809, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=天津医科大学公共卫生学院，天津 300070)])], figs=[ArticleFig(id=1241069118728753153, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=EN, label=Figure 1, caption=Flow chart of inclusion and exclusion, figureFileSmall=u46rKIKf0SXa7Vwpl5o6sA==, figureFileBig=OcFBnXWLpTERCni/z+XMAw==, tableContent=null), ArticleFig(id=1241069118858776587, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=CN, label=图1, caption=纳排流程图, figureFileSmall=u46rKIKf0SXa7Vwpl5o6sA==, figureFileBig=OcFBnXWLpTERCni/z+XMAw==, tableContent=null), ArticleFig(id=1241069118963634201, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=EN, label=Table 1, caption=

Variable assignment table

, figureFileSmall=null, figureFileBig=null, tableContent=
变量变量赋值
因变量认知功能0～56，连续变量
自变量时常见面分类变量，0=否，1=是
精神慰藉分类变量，0=无，1=有
老年人得到子女经济支持连续变量，进行对数化处理
老年人给予子女经济支持连续变量，进行对数化处理
控制变量人口学特征
性别分类变量，0=女性，1=男性
年龄连续变量
婚姻分类变量，0=离异、丧偶或未婚，1=已婚
社会经济特征
分类变量，0=未受过教育
教育（文盲），1=小学或私塾，2=中学及以上
养老保险分类变量，0=无，1=有
社会医疗保险分类变量，0=无，1=有
健康状况
患慢病分类变量，0=否，1=是
利用医疗服务分类变量，0=否，1=是
日常生活能力受损分类变量，0=否，1=是
), ArticleFig(id=1241069119093657640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=CN, label=表1, caption=

变量赋值表

, figureFileSmall=null, figureFileBig=null, tableContent=
变量变量赋值
因变量认知功能0～56，连续变量
自变量时常见面分类变量，0=否，1=是
精神慰藉分类变量，0=无，1=有
老年人得到子女经济支持连续变量，进行对数化处理
老年人给予子女经济支持连续变量，进行对数化处理
控制变量人口学特征
性别分类变量，0=女性，1=男性
年龄连续变量
婚姻分类变量，0=离异、丧偶或未婚，1=已婚
社会经济特征
分类变量，0=未受过教育
教育（文盲），1=小学或私塾，2=中学及以上
养老保险分类变量，0=无，1=有
社会医疗保险分类变量，0=无，1=有
健康状况
患慢病分类变量，0=否，1=是
利用医疗服务分类变量，0=否，1=是
日常生活能力受损分类变量，0=否，1=是
), ArticleFig(id=1241069119177543726, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=EN, label=Table 2, caption=

Basic characteristics of the elderly population [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数(%)不同认知功能得分的例数
0～18分19～38分39～56分
性别
女2 088(50.3)659(31.6)1 306(62.6)123(5.8)
男2 066(49.7)387(18.7)1 507(72.9)172(8.4)
年龄（岁）
60～692 391(57.5)487(20.4)1 707(71.3)197(8.3)
70～791 454(35.0)418(28.8)943(64.8)93(6.4)
80～89293(7.1)130(44.4)159(54.2)4(1.4)
≥9016(0.4)11(68.7)4(25.0)1(6.3)
婚姻
离异、丧偶或未婚644(15.5)241(37.8)376(58.3)27(4.2)
已婚3 510(84.5)805(22.9)2 437(69.4)268(7.7)
教育
未受过教育（文盲）1 122(27.1)592(52.7)521(46.4)9(0.9)
小学或私塾1 873(45.0)392(20.9)1 400(74.7)81(4.4)
中学及以上1 159(27.9)62(5.4)892(76.9)205(17.7)
养老保险
无468(11.3)137(29.2)308(65.8)23(5.0)
有3 686(88.7)909(24.7)2 505(67.9)272(7.4)
社会医疗保险
无175(4.3)75(42.8)97(55.4)3(1.8)
有3 979(95.7)971(24.4)2 716(68.2)292(7.4)
患慢病
否2 520(60.6)630(25.0)1 701(67.5)189(7.5)
是1 634(39.4)416(25.5)1 112(68.0)106(6.5)
利用医疗服务
否2 658(63.9)662(24.9)1 793(67.4)203(7.7)
是1 634(36.1)384(25.7)1 020(68.1)92(6.2)
日常生活能力受损
否3 924(94.4)949(24.2)2 681(68.3)294(7.5)
是230(5.6)97(42.2)132(57.3)1(0.5)
时常见面
否2 386(57.4)611(25.7)1 601(67.0)174(7.3)
是1 768(42.6)435(24.6)1 212(68.5)121(6.9)
精神慰藉
无1 484(35.7)448(30.2)943(63.5093(6.3)
有2 670(64.3)598(22.4)1 870(70.0)202(7.6)
老年人得到子女经济支持（元/年）
≤5 0002 317(55.7)637(27.5)1 545(66.6)135(5.9)
5 001～10 000937(22.6)228(24.3)627(66.9)82(8.8)
>10 000900(21.7)181(20.1)641(71.2)78(8.7)
老年人给予子女经济支持（元/年）
≤5 0003 374(81.2)921(27.3)2 245(66.8)199(5.9)
5 001～10 000297(7.2)56(18.8)231(71.7)28(9.5)
>10 000483(11.6)69(14.3)346(71.6)68(14.1)
), ArticleFig(id=1241069119265624119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=CN, label=表2, caption=

样本老年人口基本情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数(%)不同认知功能得分的例数
0～18分19～38分39～56分
性别
女2 088(50.3)659(31.6)1 306(62.6)123(5.8)
男2 066(49.7)387(18.7)1 507(72.9)172(8.4)
年龄（岁）
60～692 391(57.5)487(20.4)1 707(71.3)197(8.3)
70～791 454(35.0)418(28.8)943(64.8)93(6.4)
80～89293(7.1)130(44.4)159(54.2)4(1.4)
≥9016(0.4)11(68.7)4(25.0)1(6.3)
婚姻
离异、丧偶或未婚644(15.5)241(37.8)376(58.3)27(4.2)
已婚3 510(84.5)805(22.9)2 437(69.4)268(7.7)
教育
未受过教育（文盲）1 122(27.1)592(52.7)521(46.4)9(0.9)
小学或私塾1 873(45.0)392(20.9)1 400(74.7)81(4.4)
中学及以上1 159(27.9)62(5.4)892(76.9)205(17.7)
养老保险
无468(11.3)137(29.2)308(65.8)23(5.0)
有3 686(88.7)909(24.7)2 505(67.9)272(7.4)
社会医疗保险
无175(4.3)75(42.8)97(55.4)3(1.8)
有3 979(95.7)971(24.4)2 716(68.2)292(7.4)
患慢病
否2 520(60.6)630(25.0)1 701(67.5)189(7.5)
是1 634(39.4)416(25.5)1 112(68.0)106(6.5)
利用医疗服务
否2 658(63.9)662(24.9)1 793(67.4)203(7.7)
是1 634(36.1)384(25.7)1 020(68.1)92(6.2)
日常生活能力受损
否3 924(94.4)949(24.2)2 681(68.3)294(7.5)
是230(5.6)97(42.2)132(57.3)1(0.5)
时常见面
否2 386(57.4)611(25.7)1 601(67.0)174(7.3)
是1 768(42.6)435(24.6)1 212(68.5)121(6.9)
精神慰藉
无1 484(35.7)448(30.2)943(63.5093(6.3)
有2 670(64.3)598(22.4)1 870(70.0)202(7.6)
老年人得到子女经济支持（元/年）
≤5 0002 317(55.7)637(27.5)1 545(66.6)135(5.9)
5 001～10 000937(22.6)228(24.3)627(66.9)82(8.8)
>10 000900(21.7)181(20.1)641(71.2)78(8.7)
老年人给予子女经济支持（元/年）
≤5 0003 374(81.2)921(27.3)2 245(66.8)199(5.9)
5 001～10 000297(7.2)56(18.8)231(71.7)28(9.5)
>10 000483(11.6)69(14.3)346(71.6)68(14.1)
), ArticleFig(id=1241069119391453247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=EN, label=Table 3, caption=

Single factor analysis of the cognitive function in the elderly in China

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β(95%CI)P值
时常见面0.224(-0.408～0.857)0.3220.486
精神慰藉2.071(1.422～2.720)0.331<0.001
老年人给予子女经济支持2.994(2.607～3.382)0.198<0.001
老年人得到子女经济支持1.906(1.337～2.476)0.29<0.001
男性3.789(3.174～4.403)0.313<0.001
年龄-0.322(-0.370～-0.274)0.025<0.001
已婚4.213(3.359～5.067)0.436<0.001
教育[未受过教育（文盲） vs. 小学或私塾]-7.726(-8.378～-7.075)0.332<0.001
教育（中学及以上 vs. 小学或私塾）6.555(5.909～7.200)0.329<0.001
有养老保险1.861(0.874～2.847)0.503<0.001
有社会医疗保险5.781(4.236～7.327)0.788<0.001
患慢病-0.308(-0.948～0.331)0.3260.345
利用医疗服务-0.769(-1.420～-0.119)0.3320.020
日常生活能力受损-5.458(-6.814～-4.102)0.692<0.001
), ArticleFig(id=1241069119534059598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=CN, label=表3, caption=

我国老年人认知功能的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β(95%CI)P值
时常见面0.224(-0.408～0.857)0.3220.486
精神慰藉2.071(1.422～2.720)0.331<0.001
老年人给予子女经济支持2.994(2.607～3.382)0.198<0.001
老年人得到子女经济支持1.906(1.337～2.476)0.29<0.001
男性3.789(3.174～4.403)0.313<0.001
年龄-0.322(-0.370～-0.274)0.025<0.001
已婚4.213(3.359～5.067)0.436<0.001
教育[未受过教育（文盲） vs. 小学或私塾]-7.726(-8.378～-7.075)0.332<0.001
教育（中学及以上 vs. 小学或私塾）6.555(5.909～7.200)0.329<0.001
有养老保险1.861(0.874～2.847)0.503<0.001
有社会医疗保险5.781(4.236～7.327)0.788<0.001
患慢病-0.308(-0.948～0.331)0.3260.345
利用医疗服务-0.769(-1.420～-0.119)0.3320.020
日常生活能力受损-5.458(-6.814～-4.102)0.692<0.001
), ArticleFig(id=1241069119609557077, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=EN, label=Table 4, caption=

Multiple linear regression analysis of the effect of intergenerational support on cognitive function in the elderly in China

, figureFileSmall=null, figureFileBig=null, tableContent=
模型β(95%CI)P值
模型一
老年人得到子女经济支持1.065(0.494～1.636)0.291<0.001
老年人给予子女经济支持2.76(2.364～3.156)0.202<0.001
精神慰藉1.082(0.431～1.733)0.3320.001
模型二
老年人得到子女经济支持1.138(0.653～1.622)0.247<0.001
老年人给予子女经济支持0.996(0.646～1.347)0.179<0.001
), ArticleFig(id=1241069119743774812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035811676811909, language=CN, label=表4, caption=

代际支持对我国老年人认知功能影响的多重线性回归

, figureFileSmall=null, figureFileBig=null, tableContent=
模型β(95%CI)P值
模型一
老年人得到子女经济支持1.065(0.494～1.636)0.291<0.001
老年人给予子女经济支持2.76(2.364～3.156)0.202<0.001
精神慰藉1.082(0.431～1.733)0.3320.001
模型二
老年人得到子女经济支持1.138(0.653～1.622)0.247<0.001
老年人给予子女经济支持0.996(0.646～1.347)0.179<0.001
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代际支持对我国老年人认知功能的影响
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张婷婷 , 李俊然 , 蔡文璐 , 郭鑫 , 包振华 , 张馨予
现代预防医学 | 健康与社会行为 2024,51(23): 4343-4348
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现代预防医学 | 健康与社会行为 2024, 51(23): 4343-4348
代际支持对我国老年人认知功能的影响
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张婷婷, 李俊然, 蔡文璐, 郭鑫, 包振华, 张馨予
作者信息
  • 天津医科大学公共卫生学院，天津 300070

    • 张婷婷（2003—），女，本科在读，研究方向：预防医学

通讯作者:

张馨予，E-mail:
Intergenerational support and its impact on cognitive function in the elderly in China
Ting-ting ZHANG, Jun-ran LI, Wen-lu CAI, Xin GUO, Zhen-hua BAO, Xin-yu ZHANG
Affiliations
  • Tianjin Medical University, School of Public Health, Tianjin 300070, China
出版时间: 2024-12-10 doi: 10.20043/j.cnki.MPM.202407047
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摘要
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目的

探究代际支持对我国老年人认知功能的影响。

方法

采用2020年中国健康与养老追踪调查数据，使用SPSS 27.0进行统计分析，运用单因素分析和多重线性回归分析代际支持对我国60岁及以上老年人认知功能的影响。

结果

本研究共纳入4 154名研究对象，结果表明，我国老年人认知功能与代际双向经济支持和子女精神慰藉正向关联；老年人与子女是否时常见面与其认知功能得分差异不具有统计学意义。多重线性回归模型方程为：老年人认知功能得分=31.003+1.138×老年人得到子女经济支持对数值+0.996×老年人给予子女经济支持对数值-0.173×年龄- 12.939×[教育=未受过教育（文盲）]-5.578×（教育=小学或私塾）+1.137×（婚姻=已婚）+1.118×（养老保险=有）+ 3.276×（社会医疗保险=有）-3.541×（日常生活能力受损=是）。

结论

代际间应保持交流互动，社区和国家应将代际支持与老年人认知功能的预防保健和养老政策结合，作为“健康老龄化”的有力支持。

老年人  /  代际支持  /  认知
Objective

To investigate the impact of intergenerational support on cognitive function among the elderly in China.

Methods

Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were utilized, and statistical analysis was performed using SPSS 27.0. Both univariate analysis and multiple linear regression analysis were conducted to assess the effects of intergenerational support on the cognitive function of individuals aged 60 and above.

Results

A total of 4 154 participants were included in the study. The findings indicated a positive correlation between cognitive function in the elderly and both bidirectional economic support from children and emotional comfort provided by them. However, the frequency of interaction between the elderly and their children did not show a statistically significant difference in cognitive function scores. The multiple linear regression model equation was as the following: Cognitive function score = 31.003 + 1.138 * log (child economic support) + 0.996 * log (parental economic support) - 0.173 * age - 12.939 * [education = no formal education (illiterate)] - 5.578 *(education = primary school or informal education) + 1.137 * (marital status = married) + 1.118 * (pension insurance = yes) +3.276 * (social health insurance = yes) - 3.541 * (daily living ability impaired = yes).

Conclusion

It is essential to maintain communication and interaction between generations. Communities and the government should integrate intergenerational support into preventive health care and elderly care policies as a robust support for “healthy aging”.

Elderly  /  Intergenerational support  /  Cognition
张婷婷, 李俊然, 蔡文璐, 郭鑫, 包振华, 张馨予. 代际支持对我国老年人认知功能的影响. 现代预防医学, 2024 , 51 (23) : 4343 -4348 . DOI: 10.20043/j.cnki.MPM.202407047
Ting-ting ZHANG, Jun-ran LI, Wen-lu CAI, Xin GUO, Zhen-hua BAO, Xin-yu ZHANG. Intergenerational support and its impact on cognitive function in the elderly in China[J]. Modern Preventive Medicine, 2024 , 51 (23) : 4343 -4348 . DOI: 10.20043/j.cnki.MPM.202407047
正文
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代际支持指父母与子女相互提供经济、生活的照料帮助及情感互动[1]。代际支持并不局限于子女对老年人的赡养[2]，而是包含父代和子代自下而上和自上而下两个层面的交流[3]。认知功能包括感知觉、记忆、言语思维等[4]，是保障老年人健康的重要因素，同时也受到代际支持的影响[5]。认知功能衰退泛指各种程度的认知功能损害，老年人是其主要发病人群[6]。第七次全国人口普查数据显示我国60岁及以上人口26 402万人，占总人口的18.70%[7]。伴随着人口老龄化和高龄化，老年人面临不同程度的认知功能衰退[8]。到2050年，65岁以上的中国人口预计将达到3.8亿，占总人口的27.9%[9]，认知功能衰退将成为老年人沉重的疾病负担。在中国传统家庭理念的影响下，研究代际支持对认知功能的影响对我国老年健康管理具有深远意义。而代际支持和认知功能的关系尚不明确，缺乏中国老年人的实证数据研究。因此本研究采用中国健康与养老追踪调查（China health and retirement longitudinal study, CHARLS)[10]数据来探究代际支持对我国老年人认知功能的影响，通过分析代际支持与认知功能的关联，为我国老年健康管理提供数据支撑和决策依据。
1 对象与方法
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1.1 研究对象
本文数据来自CHARLS 2020调查结果，该调查覆盖全国28省域、150个县、450个社区（村），提供了客观详实的基础。研究对象纳入标准：CHARLS 2020调查中年龄60岁及以上；有子女。排除标准：“代际支持”数据缺失（即CHARLS 2020调查中CA015～CA018信息缺失）；“认知功能”数据缺失（即DC001～DC014或DC028信息缺失）。最终纳入研究对象4 154人。纳排流程见图1。
1.2 代际支持
本研究从时常见面、精神慰藉和经济支持对代际支持进行考量。经济支持为连续变量，时常见面和精神慰藉为分类变量。将“老年人与子女见面频率大于等于每周一次”定义为时常见面，反映子女和老年人的见面频率；将“老年人跟子女通过电话、短信、微信、信件或者电子邮件联系的频率大于等于每周一次”定义为精神慰藉，反映代际情感交流；将“过去一年老年人从子女得到的经济支持”定义为老年人得到子女经济支持；将“过去一年老年人给予子女的经济支持”定义为老年人给予子女经济支持，因经济支持原始数据离散性较大，为让数据更加服从正态分布，在一定程度上消除模型异方差、降低共线性等，故对经济支持数据进行对数化处理。
1.3 认知功能
认知功能为连续变量。CHARLS 2020关于认知功能的调查包括日常记忆、自评记忆力、词语回忆、算术、画图和延迟回忆六部分。自评记忆力按照“极好、很好、好、一般、不好、不知道”依次赋分为5、4、3、2、1和0。其余各部分如被调查者对某一问题回答正确,赋分为1；否则为0[11]。认知功能得分为0～56分，数值越高则认知功能越强。
1.4 控制变量
本研究控制变量包括人口学特征、社会经济特征和健康状况。人口学特征包括性别、年龄和婚姻；性别和婚姻为分类变量，年龄为连续变量。社会经济特征包括教育、养老保险和社会医疗保险，皆为分类变量。健康状况包括是否患慢病、医疗服务利用和日常生活能力受损，皆为分类变量。患慢病指罹患CHARLS 2020中15种慢性病中的某一种，具体指高血压病、血脂异常（高血脂或低血脂）、糖尿病或血糖升高（包括糖耐量异常和空腹血糖升高）、癌症等恶性肿瘤（不包括轻度皮肤癌）、慢性肺部疾患如慢性支气管炎或肺气肿、肺心病（不包括肿瘤或癌）、肝脏疾病（除脂肪肝、肿瘤或癌外）、心脏病（如心肌梗塞、冠心病、心绞痛、充血性心力衰竭和其他心脏疾病）、中风、肾脏疾病（不包括肿瘤或癌）、胃部疾病或消化系统疾病（不包括肿瘤或癌）、情感及精神问题、与记忆有关的疾病（老年痴呆症、脑萎缩）、帕金森症、关节炎或风湿病、哮喘（非肺部疾病）。医疗服务利用指过去一月内是否去医疗机构看过门诊或者接受过上门医疗服务或过去一年内是否住过院。日常生活能力测量采用Katz指数量表中具代表性的六项日常活动:是否能独立完成穿衣服、洗澡、进食、上下床、上厕所和大小便控制[12]。变量赋值见表1。
1.5 统计学方法
本研究使用SPSS 27.0进行统计分析，描述性统计方法采用频数、构成比、均值和标准差；推断性统计方法采用简单线性回归和多重线性回归。运用简单线性回归进行单因素分析，分析我国60岁及以上老年人认知功能在不同人口学特征、社会经济特征、健康状况和代际支持因素下的差异；用多重线性回归分析自变量代际支持和控制变量对我国老年人认知功能的影响。检验水准α=0.05。
2 结果
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2.1 基本情况
本研究共纳入4 154名研究对象，平均年龄（69.29±6.364）岁，男女比例1∶1.01。认知功能得分（24.99±10.273）分；295位（7.1%）老年人认知功能得分39～56分，认知功能损害程度较轻；2 813位（67.7%）老年人认知功能得分19～38分，认知功能损害程度中等；1 046位（25.2%）老年人认知功能得分0～18分，认知功能损害程度较重。1 768位（42.6%）老年人与子女见面频率大于等于每周一次，2 670位（64.3%）老年人跟子女通过电话、短信、微信、信件或者电子邮件联系的频率大于等于每周一次；过去一年，老年人从子女得到经济支持（7 571.14±12 825.136）元，老年人给予子女经济支持（7 290.21±42 076.327）元。样本老年人口基本情况见表2。
2.2 我国老年人认知功能的单因素分析
结果显示，精神慰藉、老年人得到子女经济支持、老年人给予子女经济支持、性别、年龄、婚姻、教育、养老保险、社会医疗保险、利用医疗服务和日常生活能力受损共11项指标是我国老年人认知功能影响因素；而时常见面和患慢病对其认知功能无显著相关。见表3。
2.3 代际支持与认知功能
为进一步探究不同因素对老年人认知功能的影响，本研究分两步进行了多重线性回归分析，见表4。首先将单因素分析中显著性较强（P<0.05）的自变量（精神慰藉、老年人得到子女经济支持和老年人给予子女经济支持）纳入多重线性回归得到初步模型（模型一）。结果显示，我国老年人认知功能与子女精神慰藉、得到子女经济支持和给予子女经济支持正向关联。模型一回归方程为：老年人认知功能=12.072+1.082×（精神慰藉=有）+1.065×老年人得到子女经济支持对数值+2.76×老年人给予子女经济支持对数值。模型一拟合度较好（P<0.001）。
考虑到人口学特征、社会经济特征和健康状况等控制变量对老年人认知功能的影响，将单因素分析中显著性较强（P<0.05）的自变量和控制变量性别、年龄、婚姻、教育、养老保险、社会医疗保险、利用医疗服务和日常生活能力受损纳入多重线性回归，排除结果中显著性不强（P>0.05）的精神慰藉、性别和利用医疗服务共三个变量后再次回归分析得到模型二。结果显示，我国老年人认知功能与其得到子女经济支持、给予子女经济支持、已婚、教育程度、有养老保险和有社会医疗保险正向关联；与年龄和日常生活能力受损负向关联。这八个变量解释认知功能总变异的30.9%。模型二回归方程为：老年人认知功能得分= 31.003+1.138×老年人得到子女经济支持对数值+ 0.996×老年人给予子女经济支持对数值-0.173×年龄-12.939×[教育=未受过教育（文盲）]-5.578×（教育=小学或私塾）+1.137×（婚姻=已婚）+1.118×（养老保险=有）+3.276×（社会医疗保险=有）- 3.541×（日常生活能力受损=是）。模型二拟合度较好（P<0.001）。
3 讨论
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代际双向支持与精神慰藉正向影响老年人认知功能。家庭代际支持流动的核心是代际双向经济支持、生活照料和感情交流[13]。不少学者在研究代际支持对认知的影响时，常聚焦于子女对老年人的向上代际支持[5]，忽略了向下代际支持。代际双向支持不仅是物质的转移，更是年长的父母与子女间“感情纽带”有形的呈现形式。父母对子女从幼时起的投资和与子女的持续交往，在可能性和数量上都增加了他们从成年子女处得到的代际支持。老年赡养行为由年长父母的感知需求所促使，并受子女自身经济能力的制约。因此，年迈父母和子女间代际支持和资源转移是以双方资源趋于均等的方式进行的[14]。本研究中，老年人认知功能与其获子女精神慰藉、得到子女经济支持与给予子女经济支持正向关联。老年人与子女是否时常见面这一变量与子女对父母的生活照料有关，但其在认知功能影响因素的单因素分析中显著性不强（P=0.486）。本研究结果也在其他学者的研究中得到了印证。有研究发现，来自子女的照料支持损害了父母的认知功能;而为子女提供经济支持和相互情感支持对其认知产生积极影响；此外，代际支持对认知水平的影响消失或因其拥有养老金或赚取自己的税后收入而减弱[15]。王萍等[16]研究表明，双向经济支持和情感支持能减缓老年人认知功能衰退速度，但老年人从成年子女处获得日常照料却加速其认知功能衰退速度，且代际支持影响力会以老人需求为中心产生不同变化。
代际支持与老年人口健康之间可能存在反向因果效应[17]或内生性问题。本研究聚焦于老年人与子女间的代际支持对其认知功能的影响，但如老年人认知功能受损，与子女间代际支持也会增多。老年人在获取代际支持时存在内生性选择，例如健康状况较差的老年人更多获得生活照料等支持[18]。社会科学研究领域不少研究会受内生性问题困扰，这是由于大多实证研究数据是调查数据而非实验数据[19]。
代际支持对老年人认知功能影响的具体机制复杂。其直接影响与代际支持对健康的选择效应[20]和用进废退理论[21]有关。代际支持还可通过影响老年人心理健康从而间接影响认知功能。有研究表明代际支持与老年人抑郁有关[22],而抑郁是损害认知功能的危险因素[23]。贺惠惠[24]研究指出，老年人为子女提供经济支持及与子女间频繁的情感联系均可通过日常生活能力和抑郁症状间接作用于认知功能，未获子女经济支持与日常生活能力受损将使老年人轻度认知障碍风险增加。孙靖凯[1]研究表明，为子女提供经济支持的老年人发挥了其家庭角色，其自我效能感和自我价值感较高，进而改善了老年人的认知功能。Chen[25]研究发现，为子女提供代际支持和对子女的满意度改善了父母的心理幸福感，从子女处获得支持的好处由父母对子女的满意度中介；在坚持传统代际支持传承的父母中，提供代际支持的积极影响较为显著。
代际间应保持交流互动，社会可将代际支持作为支持养老政策的重要工具。随着老年人年龄增长，其生命机能和认知功能逐渐衰退。子女可促进代际双向经济支持，跟老年人通过电话或微信等方式联系，提供精神慰藉；时常探望老年人，提供力所能及的照料。社区和国家应将代际支持与老年人认知功能的预防保健和养老政策结合，作为“健康老龄化”[26]的有力支持。
本研究仍存在一定的局限性：一是，本研究为横断面研究，无法反映研究对象认知功能变化趋势；二是，老年人认知衰退是神经结构、行为环境和躯体事件共同作用的结果[27]，本研究尚未对此深入探讨，未来可进一步探索。
基金
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  • 国家自然科学基金青年科学基金项目(71904142)
文献
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2024年第51卷第23期
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doi: 10.20043/j.cnki.MPM.202407047
  • 接收时间：2024-07-04
  • 首发时间：2026-03-18
  • 出版时间：2024-12-10
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  • 收稿日期：2024-07-04
基金
国家自然科学基金青年科学基金项目(71904142)
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    天津医科大学公共卫生学院，天津 300070

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
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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