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Article(id=1324044871278928341, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510067, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760025600000, receivedDateStr=2025-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606496877, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606496877, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606496877, creator=13701087609, updateTime=1793606496877, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1900, endPage=1906, ext={EN=ArticleExt(id=1324044871492837846, articleId=1324044871278928341, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Empirical evidence on the effect of internet use on cognitive function in older adults using the PSM-XGBoost framework, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between internet use and cognitive function in older adults, and to evaluate the impact of internet use on the predictive output of cognitive impairment risk.

Methods

Based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), propensity score matching (PSM) was used to control for confounding factors and analyze the effect of internet use on cognitive function in older adults. The XGBoost algorithm was employed to construct a risk prediction model for cognitive impairment, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive performance of the model. The SHapley Additive exPlanations (SHAP) method was applied to interpret the XGBoost model.

Results

A total of 3 685 older adults was included in the study. Propensity score matching using nearest neighbor matching, radius matching, and kernel matching showed that the average treatment effects of internet use on cognitive function were 0.564, 0.580, and 0.594, respectively (P<0.001). The XGBoost prediction model incorporating internet use achieved an AUC of 0.781 (95%CI: 0.761-0.799). SHAP analysis revealed that internet use was a key predictive factor for cognitive impairment in older adults.

Conclusion

Internet use has a positive effect on cognitive function in older adults. The XGBoost-based risk prediction model for cognitive impairment demonstrates high discriminative ability and good interpretability, which may assist in early screening and individualized clinical intervention.

, authors=Han ZHANG, Hai-xia JIA, Ying LI, Zhao-fang ZHU, authorsList=Han ZHANG, Hai-xia JIA, Ying LI, Zhao-fang ZHU, authorCompany=null, correspAuthors=Zhao-fang ZHU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044875783610863, articleId=1324044871278928341, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于PSM-XGBoost框架的互联网使用对老年人认知功能影响的实证研究, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

探索老年人群互联网使用与认知功能之间的关系，同时评估互联网使用对认知障碍风险预测的输出影响。

方法

基于2020年中国健康与养老追踪调查（CHARLS）数据，采用倾向得分匹配（PSM）方法控制混杂因素，分析互联网使用对老年人群认知功能的影响。使用XGBoost算法构建认知障碍风险预测模型，通过工作特征曲线下面积（AUC）评估模型预测能力。并利用Shapley加性解释（SHAP）方法对XGBoost模型进行可解释性分析。

结果

研究共纳入3 685名老年人，通过最近邻匹配、半径匹配和核匹配进行倾向得分匹配显示，互联网使用对老年人认知功能的平均处理效应分别为0.564、0.580、0.594（P<0.001）。纳入互联网使用的XGBoost预测模型AUC为0.781（95%CI：0.761~0.799）。SHAP分析显示，互联网使用是影响老年人认知障碍的重要相关因素。

结论

互联网使用对老年人认知功能具有积极的正向作用；基于 XGBoost 构建的认知障碍风险预测模型具有较高的辨别能力和良好解释性，可辅助临床的早期筛查与个体化干预。

, authors=张涵, 贾海霞, 李莹, 朱兆芳, authorsList=张涵, 贾海霞, 李莹, 朱兆芳, authorCompany=null, correspAuthors=朱兆芳, authorNote=

张涵（2000—），男，硕士在读，研究方向：公共卫生

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朱兆芳，E-mail：
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张涵（2000—），男，硕士在读，研究方向：公共卫生

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Association between sarcopenia and cognitive function in older Chinese adults：Evidence from the China health and retirement longitudinal study[J]. Front Public Health, 2022, 10: 1078304., articleTitle=Association between sarcopenia and cognitive function in older Chinese adults：Evidence from the China health and retirement longitudinal study, refAbstract=null), Reference(id=1324045042008076612, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=39, issue=19, pageStart=3256, pageEnd=3262, url=null, language=null, rfNumber=［2］, rfOrder=1, authorNames=黄明亮, 杨春晓, 饶丽丽, journalName=护理研究, refType=null, unstructuredReference=黄明亮，杨春晓，饶丽丽，等. 社区老年人握力变化轨迹与认知功能的关系[J]. 护理研究，2025, 39(19):3256-3262., articleTitle=社区老年人握力变化轨迹与认知功能的关系, refAbstract=null), Reference(id=1324045042075185477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=39, issue=19, pageStart=3256, pageEnd=3262, url=null, language=null, rfNumber=［2］, rfOrder=2, authorNames=Huang ML, Yang CX, Rao LL, journalName=Chinese Nursing Research, refType=null, unstructuredReference=Huang ML, Yang CX, Rao LL, et al. Relationship between grip strength change trajectory and cognitive function among community-dwelling elderly People[J]. Chinese Nursing Research, 2025, 39(19): 3256-3262. (In Chinese), articleTitle=Relationship between grip strength change trajectory and cognitive function among community-dwelling elderly People, refAbstract=null), Reference(id=1324045042150682950, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=11, pageStart=1210, pageEnd=1217, url=null, language=null, rfNumber=［3］, rfOrder=3, authorNames=Yang YY, Zhu Y, Dai B, journalName=Geriatrics & Gerontology International, refType=null, unstructuredReference=Yang YY, Zhu Y, Dai B, et al. Mediation analysis of cognitive function in the relationship between pulmonary function and depression among middle-aged and older adults[J]. Geriatrics & Gerontology International, 2024, 24(11): 1210-1217., articleTitle=Mediation analysis of cognitive function in the relationship between pulmonary function and depression among middle-aged and older adults, refAbstract=null), Reference(id=1324045042377175367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2022, volume=5, issue=11, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［4］, rfOrder=4, authorNames=Lin L, Cao B, Chen WQ, journalName=JAMA Netw Open, refType=null, unstructuredReference=Lin L, Cao B, Chen WQ, et al. Association of adverse childhood experiences and social isolation with Later-Life cognitive function among adults in China[J]. JAMA Netw Open, 2022, 5(11): e2241714., articleTitle=Association of adverse childhood experiences and social isolation with Later-Life cognitive function among adults in China, refAbstract=null), Reference(id=1324045042440089929, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=40, issue=15, pageStart=23, pageEnd=28, url=null, language=null, rfNumber=［5］, rfOrder=5, authorNames=杨巧玲, 刘慧, 段娅娟, journalName=护理学杂志, refType=null, unstructuredReference=杨巧玲，刘慧，段娅娟，等. 社会隔离与抑郁在农村老年人数字排斥与认知功能间的链式中介效应[J]. 护理学杂志，2025, 40(15):23-28., articleTitle=社会隔离与抑郁在农村老年人数字排斥与认知功能间的链式中介效应, refAbstract=null), Reference(id=1324045042700136778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=40, issue=15, pageStart=23, pageEnd=28, url=null, language=null, rfNumber=［5］, rfOrder=6, authorNames=Yang QL, Liu H, Duan YJ, journalName=Journal of Nursing Science, refType=null, unstructuredReference=Yang QL, Liu H, Duan YJ, et al. The chain mediation effect of social isolation and depression on the relationship be-tween digital exclusion and cognitive function in rural older adults[J]. Journal of Nursing Science, 2025, 40(15): 23-28. (In Chinese), articleTitle=The chain mediation effect of social isolation and depression on the relationship be-tween digital exclusion and cognitive function in rural older adults, refAbstract=null), Reference(id=1324045042804994379, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=14, pageStart=2613, pageEnd=2618, url=null, language=null, rfNumber=［6］, rfOrder=7, authorNames=张小宇, 王琪, 付春迎, journalName=现代预防医学, refType=null, unstructuredReference=张小宇，王琪，付春迎，等. 手机及网络使用情况与中老年人主、客观认知功能的关系[J]. 现代预防医学，2025, 52(14):2613-2618., articleTitle=手机及网络使用情况与中老年人主、客观认知功能的关系, refAbstract=null), Reference(id=1324045042867908940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=14, pageStart=2613, pageEnd=2618, url=null, language=null, rfNumber=［6］, rfOrder=8, authorNames=Zhang XY, Wang Q, Fu CY, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Zhang XY, Wang Q, Fu CY, et al. Relationship between Mobile phone and Internet usage and subjective and objective cognitive functions in middle-aged and elderly People[J]. Modern Preventive Medicine, 2025, 52(14): 2613-2618. (In Chinese), articleTitle=Relationship between Mobile phone and Internet usage and subjective and objective cognitive functions in middle-aged and elderly People, refAbstract=null), Reference(id=1324045042939212109, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=12, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［7］, rfOrder=9, authorNames=Shen L, Zheng YW, Wang MT, journalName=Front Public Health, refType=null, unstructuredReference=Shen L, Zheng YW, Wang MT, et al. Does Internet use promote the health of empty-nest older adults in rural China? The mediating role of social participation using a propensity score matching approach[J]. Front Public Health, 2024, 12: 1436525., articleTitle=Does Internet use promote the health of empty-nest older adults in rural China? The mediating role of social participation using a propensity score matching approach, refAbstract=null), Reference(id=1324045044608545102, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=12, pageStart=1366, pageEnd=1374, url=null, language=null, rfNumber=［8］, rfOrder=10, authorNames=钟霞, 赵天恩, 吕世盟, journalName=南京中医药大学学报, refType=null, unstructuredReference=钟霞，赵天恩，吕世盟，等. 基于中西医双维特征构建老年高血压轻度认知障碍机器学习预测模型[J]. 南京中医药大学学报，2024, 40(12):1366-1374., articleTitle=基于中西医双维特征构建老年高血压轻度认知障碍机器学习预测模型, refAbstract=null), Reference(id=1324045044688236879, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=12, pageStart=1366, pageEnd=1374, url=null, language=null, rfNumber=［8］, rfOrder=11, authorNames=Zhong X, Zhao TE, Lv SM, journalName=Journal of Nanjing University of Traditional Chinese Medicine, refType=null, unstructuredReference=Zhong X, Zhao TE, Lv SM, et al. Machine learning prediction model of mild cognitive impairment in elderly patients with hypertension based on Bi-Di-mensional features of Chinese and western medicine[J]. Journal of Nanjing University of Traditional Chinese Medicine, 2024, 40(12): 1366-1374. (In Chinese), articleTitle=Machine learning prediction model of mild cognitive impairment in elderly patients with hypertension based on Bi-Di-mensional features of Chinese and western medicine, refAbstract=null), Reference(id=1324045044772122960, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2022, volume=57, issue=6, pageStart=751, pageEnd=756, url=null, language=null, rfNumber=［9］, rfOrder=12, authorNames=丛慧文, 徐雅琪, 王爱民, journalName=郑州大学学报：医学版, refType=null, unstructuredReference=丛慧文，徐雅琪，王爱民，等. XGBoost算法在轻度认知障碍人群阿尔兹海默病发病预测中的应用[J]. 郑州大学学报：医学版，2022, 57(6):751-756., articleTitle=XGBoost算法在轻度认知障碍人群阿尔兹海默病发病预测中的应用, refAbstract=null), Reference(id=1324045044830843217, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2022, volume=57, issue=6, pageStart=751, pageEnd=756, url=null, language=null, rfNumber=［9］, rfOrder=13, authorNames=Cong HW, Xu YQ, Wang AM, journalName=Journal of Zhengzhou University（Medical Sciences）, refType=null, unstructuredReference=Cong HW, Xu YQ, Wang AM, et al. Application of XGBoost algorithm in predicting Alzheimer′s disease in patients with mild cognitive impairment[J]. Journal of Zhengzhou University（Medical Sciences）, 2022, 57(6): 751-756. (In Chinese), articleTitle=Application of XGBoost algorithm in predicting Alzheimer′s disease in patients with mild cognitive impairment, refAbstract=null), Reference(id=1324045044897952082, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2014, volume=43, issue=1, pageStart=61, pageEnd=68, url=null, language=null, rfNumber=［10］, rfOrder=14, authorNames=Zhao YH, Hu YS, Smith JP, journalName=International Journal of Epidemiology, refType=null, unstructuredReference=Zhao YH, Hu YS, Smith JP, et al. Cohort profile：the China Health and Retirement Longitudinal Study（CHARLS）[J]. International Journal of Epidemiology, 2014, 43(1): 61-68., articleTitle=Cohort profile：the China Health and Retirement Longitudinal Study（CHARLS）, refAbstract=null), Reference(id=1324045044977643859, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=12, pageStart=2236, pageEnd=2241, url=null, language=null, rfNumber=［11］, rfOrder=15, authorNames=苏文钰, 贾蕙毓, 常雯静, journalName=现代预防医学, refType=null, unstructuredReference=苏文钰，贾蕙毓，常雯静，等. 抑郁症状在老年人握力和日常生活活动能力间的中介效应[J]. 现代预防医学，2025, 52(12):2236-2241., articleTitle=抑郁症状在老年人握力和日常生活活动能力间的中介效应, refAbstract=null), Reference(id=1324045045036364116, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=12, pageStart=2236, pageEnd=2241, url=null, language=null, rfNumber=［11］, rfOrder=16, authorNames=Su WY, Jia HY, Chang WJ, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Su WY, Jia HY, Chang WJ, et al. Mediating effect of depressive symptoms between handgrip strength and activities of daily living in older adults[J]. Modern Preventive Medicine, 2025, 52(12): 2236-2241. (In Chinese), articleTitle=Mediating effect of depressive symptoms between handgrip strength and activities of daily living in older adults, refAbstract=null), Reference(id=1324045045095084373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=16, pageStart=3035, pageEnd=3039, 3060, url=null, language=null, rfNumber=［12］, rfOrder=17, authorNames=吴怡倩, 井淇, 苏文钰, journalName=现代预防医学, refType=null, unstructuredReference=吴怡倩，井淇，苏文钰，等. 躯体疼痛部位数量在老年人慢性病患病数量和抑郁症状间的中介效应研究[J]. 现代预防医学，2025, 52(16):3035-3039, 3060., articleTitle=躯体疼痛部位数量在老年人慢性病患病数量和抑郁症状间的中介效应研究, refAbstract=null), Reference(id=1324045045157998934, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=52, issue=16, pageStart=3035, pageEnd=3039, 3060, url=null, language=null, rfNumber=［12］, rfOrder=18, authorNames=Wu YQ, Jing Q, Su WY, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Wu YQ, Jing Q, Su WY, et al. A study on the mediating effect of the number of physical pain sites on the incidence of chronic diseases and depressive symptoms in elderly people[J]. Modern Preventive Medicine, 2025, 52(16): 3035-3039, 3060. (In Chinese), articleTitle=A study on the mediating effect of the number of physical pain sites on the incidence of chronic diseases and depressive symptoms in elderly people, refAbstract=null), Reference(id=1324045045216719191, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=32, issue=4, pageStart=137, pageEnd=143, url=null, language=null, rfNumber=［13］, rfOrder=19, authorNames=李玉周, 李禄一, 王蕊, journalName=体育学刊, refType=null, unstructuredReference=李玉周，李禄一，王蕊．中老年人体力活动水平与认知功能的双向因果关系研究[J]. 体育学刊，2025, 32(4):137-143., articleTitle=中老年人体力活动水平与认知功能的双向因果关系研究, refAbstract=null), Reference(id=1324045045288022360, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=32, issue=4, pageStart=137, pageEnd=143, url=null, language=null, rfNumber=［13］, rfOrder=20, authorNames=Li YZ, Li LY, Wang R, journalName=Journal of Physical Education, refType=null, unstructuredReference=Li YZ, Li LY, Wang R. Research on the bidirectional causal relationship between physical activity level and cognitive function in middle-aged and elderly people[J]. Journal of Physical Education, 2025, 32(4): 137-143. (In Chinese), articleTitle=Research on the bidirectional causal relationship between physical activity level and cognitive function in middle-aged and elderly people, refAbstract=null), Reference(id=1324045045376102745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=39, issue=4, pageStart=82, pageEnd=96, url=null, language=null, rfNumber=［14］, rfOrder=21, authorNames=周晓蒙, 姜琛, 周越, journalName=中国人口科学, refType=null, unstructuredReference=周晓蒙，姜琛，周越．老年劳动参与对认知功能的影响研究[J]. 中国人口科学，2025, 39(4):82-96., articleTitle=老年劳动参与对认知功能的影响研究, refAbstract=null), Reference(id=1324045045577429338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=39, issue=4, pageStart=82, pageEnd=96, url=null, language=null, rfNumber=［14］, rfOrder=22, authorNames=Zhou XM, Jiang C, Zhou Y, journalName=Chinese Journal of Population Science, refType=null, unstructuredReference=Zhou XM, Jiang C, Zhou Y. Research on the impact of elderly labor participation on cognitive function[J]. Chinese Journal of Population Science, 2025, 39(4): 82-96. (In Chinese), articleTitle=Research on the impact of elderly labor participation on cognitive function, refAbstract=null), Reference(id=1324045045703258459, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=7, issue=null, pageStart=693, pageEnd=null, url=null, language=null, rfNumber=［15］, rfOrder=23, authorNames=Zhu Y, Nan JH, Gao T, journalName=Neuropsychiatr, refType=null, unstructuredReference=Zhu Y, Nan JH, Gao T, et al. Predictive model for mild cognitive impairment in older Chinese adults with depression[J]. Neuropsychiatr, 2025, 7: 693., articleTitle=Predictive model for mild cognitive impairment in older Chinese adults with depression, refAbstract=null), Reference(id=1324045045824893276, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=10, pageStart=1174, pageEnd=1179, url=null, language=null, rfNumber=［16］, rfOrder=24, authorNames=马蕊, 许军, 廖生武, journalName=中国卫生事业管理, refType=null, unstructuredReference=马蕊，许军，廖生武，等. 社会参与和城镇老年人健康适能状况的关联效应分析[J]. 中国卫生事业管理，2024, 41(10):1174-1179., articleTitle=社会参与和城镇老年人健康适能状况的关联效应分析, refAbstract=null), Reference(id=1324045045929750877, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=10, pageStart=1174, pageEnd=1179, url=null, language=null, rfNumber=［16］, rfOrder=25, authorNames=Ma R, Xu J, Liao SW, journalName=Chinese Health Service Management, refType=null, unstructuredReference=Ma R, Xu J, Liao SW, et al. Analysis of the association effect between social participation and health fitness status of urban older adults[J]. Chinese Health Service Management, 2024, 41(10): 1174-1179. (In Chinese), articleTitle=Analysis of the association effect between social participation and health fitness status of urban older adults, refAbstract=null), Reference(id=1324045046042997086, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2020, volume=26, issue=4, pageStart=2345, pageEnd=2362, url=null, language=null, rfNumber=［17］, rfOrder=26, authorNames=Voinea C, Vicǎ C, Mihailov E, journalName=Science and Engineering Ethics, refType=null, unstructuredReference=Voinea C, Vicǎ C, Mihailov E, et al. The Internet as cognitive enhancement[J]. Science and Engineering Ethics, 2020, 26(4): 2345-2362., articleTitle=The Internet as cognitive enhancement, refAbstract=null), Reference(id=1324045046114300255, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=26, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［18］, rfOrder=27, authorNames=Chen BW, Yang C, Ren SS, journalName=Journal of Medical Internet Research, refType=null, unstructuredReference=Chen BW, Yang C, Ren SS, et al. Relationship between Internet use and cognitive function among Middle-Aged and older Chinese adults：5-Year longitudinal study[J]. Journal of Medical Internet Research, 2024, 26: e57301., articleTitle=Relationship between Internet use and cognitive function among Middle-Aged and older Chinese adults：5-Year longitudinal study, refAbstract=null), Reference(id=1324045046193992032, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=7, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［19］, rfOrder=28, authorNames=Jeon S, Charles ST, journalName=JMIR Aging, refType=null, unstructuredReference=Jeon S, Charles ST. Internet-Based social activities and cognitive functioning 2 years later among Middle-Aged and older adults：prospective cohort study[J]. JMIR Aging, 2024, 7: e63907., articleTitle=Internet-Based social activities and cognitive functioning 2 years later among Middle-Aged and older adults：prospective cohort study, refAbstract=null), Reference(id=1324045046298849633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2022, volume=10, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［20］, rfOrder=29, authorNames=Li W, Yue L, Xiao SF, journalName=Front Public Health, refType=null, unstructuredReference=Li W, Yue L, Xiao SF. Association between Internet use, cognitive function, and globus pallidus volumes：a study among the elderly in Chinese communities[J]. Front Public Health, 2022, 10: 886974., articleTitle=Association between Internet use, cognitive function, and globus pallidus volumes：a study among the elderly in Chinese communities, refAbstract=null), Reference(id=1324045046374347106, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2020, volume=22, issue=2, pageStart=179, pageEnd=187, url=null, language=null, rfNumber=［21］, rfOrder=30, authorNames=Small GW, Lee J, Kaufman A, journalName=Dialogues in Clinical Neuroscience, refType=null, unstructuredReference=Small GW, Lee J, Kaufman A, et al. Brain health Consequences of digital technology use[J]. Dialogues in Clinical Neuroscience, 2020, 22(2): 179-187., articleTitle=Brain health Consequences of digital technology use, refAbstract=null), Reference(id=1324045046458233187, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2023, volume=43, issue=7, pageStart=1758, pageEnd=1761, url=null, language=null, rfNumber=［22］, rfOrder=31, authorNames=何南芙, 崔莉, 董越, journalName=中国老年学杂志, refType=null, unstructuredReference=何南芙，崔莉，董越，等. 中国老年人认知障碍检出情况及其与睡眠时长的关系——基于2018年CHARLS数据的实证分析[J]. 中国老年学杂志，2023, 43(7):1758-1761., articleTitle=中国老年人认知障碍检出情况及其与睡眠时长的关系——基于2018年CHARLS数据的实证分析, refAbstract=null), Reference(id=1324045046529536356, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2023, volume=43, issue=7, pageStart=1758, pageEnd=1761, url=null, language=null, rfNumber=［22］, rfOrder=32, authorNames=He NF, Cui L, Dong Y, journalName=Chinese Journal of Gerontology, refType=null, unstructuredReference=He NF, Cui L, Dong Y, et al. Detection of cognitive impairment in elderly Chinese and its relationship with sleep duration：empirical analysis based on 2018 CHARLS data[J]. Chinese Journal of Gerontology, 2023, 43(7): 1758-1761. (In Chinese), articleTitle=Detection of cognitive impairment in elderly Chinese and its relationship with sleep duration：empirical analysis based on 2018 CHARLS data, refAbstract=null), Reference(id=1324045046655365477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=28, issue=3, pageStart=260, pageEnd=267, url=null, language=null, rfNumber=［23］, rfOrder=33, authorNames=黄玉洁, 罗雅楠, journalName=健康发展与政策研究, refType=null, unstructuredReference=黄玉洁，罗雅楠．中国老年人口认知障碍对功能能力的影响[J]. 健康发展与政策研究，2025, 28(3):260-267., articleTitle=中国老年人口认知障碍对功能能力的影响, refAbstract=null), Reference(id=1324045046743445862, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=28, issue=3, pageStart=260, pageEnd=267, url=null, language=null, rfNumber=［23］, rfOrder=34, authorNames=Huang YJ, Luo YN, journalName=Health Development and Policy Research, refType=null, unstructuredReference=Huang YJ, Luo YN. The impact of cognitive impairment on functional limitations among elderly population in China[J]. Health Development and Policy Research, 2025, 28(3): 260-267. (In Chinese), articleTitle=The impact of cognitive impairment on functional limitations among elderly population in China, refAbstract=null), Reference(id=1324045046814749031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=13, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［24］, rfOrder=35, authorNames=Zhang L, Chen W, Miao HJ, journalName=Front Public Health, refType=null, unstructuredReference=Zhang L, Chen W, Miao HJ, et al. Association between physical activity levels and mild cognitive impairment in Chinese older adults：a cross-sectional study from the China health and retirement longitudinal study[J]. Front Public Health, 2025, 13: 1564544., articleTitle=Association between physical activity levels and mild cognitive impairment in Chinese older adults：a cross-sectional study from the China health and retirement longitudinal study, refAbstract=null), Reference(id=1324045046890246504, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2022, volume=13, issue=6, pageStart=2944, pageEnd=2952, url=null, language=null, rfNumber=［25］, rfOrder=36, authorNames=Hu YS, Peng WJ, Ren RJ, journalName=Journal of Cachexia, Sarcopenia and Muscle, refType=null, unstructuredReference=Hu YS, Peng WJ, Ren RJ, et al. Sarcopenia and mild cognitive impairment among elderly adults：The first longitudinal evidence from CHARLS[J]. Journal of Cachexia, Sarcopenia and Muscle, 2022, 13(6): 2944-2952., articleTitle=Sarcopenia and mild cognitive impairment among elderly adults：The first longitudinal evidence from CHARLS, refAbstract=null), Reference(id=1324045046961549673, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=12, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［26］, rfOrder=37, authorNames=Liu GT, Zhang JA, journalName=Front Nutr, refType=null, unstructuredReference=Liu GT, Zhang JA. Association of a novel nutritional index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from the China Health and Retirement Longitudinal Study[J]. Front Nutr, 2025, 12: 1486917., articleTitle=Association of a novel nutritional index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from the China Health and Retirement Longitudinal Study, refAbstract=null), Reference(id=1324045047032852842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=13, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［27］, rfOrder=38, authorNames=Ma M, Dong FW, Lan JY, journalName=Front Public Health, refType=null, unstructuredReference=Ma M, Dong FW, Lan JY. Associations between sleep duration, physical activity, and cognitive impairment in older adults-empirical analysis based on CHARLS data[J]. Front Public Health, 2025, 13: 1589606., articleTitle=Associations between sleep duration, physical activity, and cognitive impairment in older adults-empirical analysis based on CHARLS data, refAbstract=null), Reference(id=1324045047112544619, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=12, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［28］, rfOrder=39, authorNames=Liu GT, Xu Q, Zhang SH, journalName=Front Nutr, refType=null, unstructuredReference=Liu GT, Xu Q, Zhang SH, et al. Association of a modified body shape index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from CHARLS[J]. Front Nutr, 2025, 12: 1589898., articleTitle=Association of a modified body shape index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from CHARLS, refAbstract=null), Reference(id=1324045047175459180, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=38, issue=9, pageStart=1, pageEnd=7, url=null, language=null, rfNumber=［29］, rfOrder=40, authorNames=刘欣怡, 张逦, journalName=Journal of Medicine and Society, refType=null, unstructuredReference=刘欣怡，张逦．我国老年人认知障碍患病率空间分布及影响因素[J]. Journal of Medicine and Society，2025, 38(9):1-7., articleTitle=我国老年人认知障碍患病率空间分布及影响因素, refAbstract=null), Reference(id=1324045047250956653, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2025, volume=38, issue=9, pageStart=1, pageEnd=7, url=null, language=null, rfNumber=［29］, rfOrder=41, authorNames=Liu XY, Zhang L, journalName=Journal of Medicine and Society, refType=null, unstructuredReference=Liu XY, Zhang L. The spatial distribution and influencing factors of cognitive impairment prevalence among elderly people in China[J]. Journal of Medicine and Society, 2025, 38(9): 1-7. (In Chinese), articleTitle=The spatial distribution and influencing factors of cognitive impairment prevalence among elderly people in China, refAbstract=null), Reference(id=1324045047334842734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=1, pageStart=406, pageEnd=null, url=null, language=null, rfNumber=［30］, rfOrder=42, authorNames=Wang YG, Wu ZG, Duan LZ, journalName=BMC Geriatrics, refType=null, unstructuredReference=Wang YG, Wu ZG, Duan LZ, et al. Digital exclusion and cognitive impairment in older People：findings from five longitudinal studies[J]. BMC Geriatrics, 2024, 24(1): 406., articleTitle=Digital exclusion and cognitive impairment in older People：findings from five longitudinal studies, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324045035792118035, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, xref=null, ext=[AuthorCompanyExt(id=1324045035804700948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, companyId=1324045035792118035, 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=1324045035808895253, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, companyId=1324045035792118035, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山东第二医科大学公共卫生学院 山东 潍坊 261053)])], figs=[ArticleFig(id=1324045037838938420, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Fig.1, caption=ROC curve plot, figureFileSmall=MTMIz8iVdKv4Bv74u92qgQ==, figureFileBig=uBRIQkAdkQ1OZORRyON50g==, tableContent=null), ArticleFig(id=1324045037910241589, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=图1, caption=ROC曲线图, figureFileSmall=MTMIz8iVdKv4Bv74u92qgQ==, figureFileBig=uBRIQkAdkQ1OZORRyON50g==, tableContent=null), ArticleFig(id=1324045038002516278, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Fig.2, caption=SHAP feature importance ranking diagram, figureFileSmall=QxrnJpkYY38ODWcEs3uxmg==, figureFileBig=uOLYa2Qlj3WsQggGj1vTfQ==, tableContent=null), ArticleFig(id=1324045038090596663, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=图2, caption=SHAP特征重要性排序图, figureFileSmall=QxrnJpkYY38ODWcEs3uxmg==, figureFileBig=uOLYa2Qlj3WsQggGj1vTfQ==, tableContent=null), ArticleFig(id=1324045038212231480, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Fig.3, caption=SHAP feature dependency map, figureFileSmall=oGwNvpeFgSZapI/nO1kfRw==, figureFileBig=lNAo0zAlYXJ2G0PsdXO23g==, tableContent=null), ArticleFig(id=1324045038287728953, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=图3, caption=SHAP特征依赖图

注: 本图展示了XGBoost模型中两个教育程度、互联网使用对模型预测结果的边际贡献（SHAP值），横轴为特征值，纵轴为SHAP值；A为互联网使用特征对模型预测的SHAP值随特征值变化的依赖关系；B为教育程度特征对模型预测的SHAP值随特征值变化的依赖关系。

, figureFileSmall=oGwNvpeFgSZapI/nO1kfRw==, figureFileBig=lNAo0zAlYXJ2G0PsdXO23g==, tableContent=null), ArticleFig(id=1324045038363226426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Table 1, caption=

Difference tests were conducted to compare the Internet-using and non-Internet-using groups

, figureFileSmall=null, figureFileBig=null, tableContent=
变量非互联网使用组
（n=2 262）		互联网使用组
（n=1 423）		Z/χ2P值
年龄(岁,)68.5±5.765.8±4.873.930<0.001
日常生活活动能力(分,)13.1±2.612.7±2.0201.551<0.001
社会参与(分,)0.7±0.91.2±1.2316.905<0.001
认知功能(分,)13.6±3.015.0±2.817.782<0.001
定向力(分,)4.3±0.84.6±0.7173.123<0.001
计算力(分,)3.4±1.73.8±1.647.409<0.001
记忆力(分,)5.5±1.96.2±1.829.430<0.001
注意力与协调力(分,)0.3±0.50.4±0.5388.832<0.001
性别［n(%)］0.5370.464
男1 377(60.9)849(59.7)
女885(39.1)574(40.3)
配偶/伴侣［n(%)］19.286<0.001
无402(17.8)176(12.4)
有1 860(82.2)1 247(87.6)
教育程度［n(%)］485.612<0.001
未受过教育221(9.8)42(2.9)
小学1 294(57.2)431(30.3)
初中514(22.7)455(32.0)
高中及以上233(10.3)495(34.8)
居住地［n(%)］296.826<0.001
农村1 400(61.9)466(32.7)
城镇862(38.1)957(67.3)
吸烟史［n(%)］1.1400.286
无1 145(50.6)746(52.4)
有1 117(49.4)677(47.6)
饮酒史［n(%)］16.563<0.001
无1 390(61.5)778(54.7)
有872(38.5)645(45.3)
抑郁症状［n(%)］58.644<0.001
否1 464(64.7)1 091(76.7)
是798(35.3)332(23.3)
认知障碍［n(%)］70.041<0.001
否1 799(79.5)1 281(90.0)
是463(20.5)142(10.0)
夜晚睡眠时长［h, n(%)］16.900<0.001
<61 339(59.2)905(63.6)
6~8779(34.4)468(32.9)
>8144(6.4)50(3.5)
), ArticleFig(id=1324045038472278331, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=表1, caption=

使用互联网组与不使用互联网组之间的差异检验

, figureFileSmall=null, figureFileBig=null, tableContent=
变量非互联网使用组
（n=2 262）		互联网使用组
（n=1 423）		Z/χ2P值
年龄(岁,)68.5±5.765.8±4.873.930<0.001
日常生活活动能力(分,)13.1±2.612.7±2.0201.551<0.001
社会参与(分,)0.7±0.91.2±1.2316.905<0.001
认知功能(分,)13.6±3.015.0±2.817.782<0.001
定向力(分,)4.3±0.84.6±0.7173.123<0.001
计算力(分,)3.4±1.73.8±1.647.409<0.001
记忆力(分,)5.5±1.96.2±1.829.430<0.001
注意力与协调力(分,)0.3±0.50.4±0.5388.832<0.001
性别［n(%)］0.5370.464
男1 377(60.9)849(59.7)
女885(39.1)574(40.3)
配偶/伴侣［n(%)］19.286<0.001
无402(17.8)176(12.4)
有1 860(82.2)1 247(87.6)
教育程度［n(%)］485.612<0.001
未受过教育221(9.8)42(2.9)
小学1 294(57.2)431(30.3)
初中514(22.7)455(32.0)
高中及以上233(10.3)495(34.8)
居住地［n(%)］296.826<0.001
农村1 400(61.9)466(32.7)
城镇862(38.1)957(67.3)
吸烟史［n(%)］1.1400.286
无1 145(50.6)746(52.4)
有1 117(49.4)677(47.6)
饮酒史［n(%)］16.563<0.001
无1 390(61.5)778(54.7)
有872(38.5)645(45.3)
抑郁症状［n(%)］58.644<0.001
否1 464(64.7)1 091(76.7)
是798(35.3)332(23.3)
认知障碍［n(%)］70.041<0.001
否1 799(79.5)1 281(90.0)
是463(20.5)142(10.0)
夜晚睡眠时长［h, n(%)］16.900<0.001
<61 339(59.2)905(63.6)
6~8779(34.4)468(32.9)
>8144(6.4)50(3.5)
), ArticleFig(id=1324045040233886012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Table 2, caption=

PSM data balance test results

, figureFileSmall=null, figureFileBig=null, tableContent=
变量匹配状态均值偏差
（%）		绝对值削减t值P值
处理组对照组
性别匹配前1.4031.3912.531.30.730.464
匹配后1.3921.3831.70.420.675
年龄匹配前1.8012.322-49.487.2-14.31<0.001
匹配后1.8711.8046.31.690.091
居住地匹配前1.6731.38161.087.117.96<0.001
匹配后1.6271.5897.91.880.060
教育程度匹配前2.9862.33677.998.123.30<0.001
匹配后2.8652.878-1.5-0.350.723
配偶或伴侣匹配前0.8760.82215.184.64.40<0.001
匹配后0.8730.881-2.3-0.620.535
吸烟匹配前0.4760.494-3.6-52.3-1.070.286
匹配后0.4910.518-5.5-1.350.178
饮酒匹配前0.4530.38615.079.14.08<0.001
匹配后0.4340.44813.8-0.700.485
社会参与匹配前1.1880.66649.193.315.06<0.001
匹配后0.9690.9343.30.830.405
教育程度匹配前2.9612.38671.095.030.67<0.001
匹配后2.9472.9183.61.660.096
抑郁症状匹配前0.2330.353-26.592.3-7.72<0.001
匹配后0.2430.2332.00.530.598
夜晚睡眠时长匹配前1.3991.472-12.471.3-3.62<0.001
匹配后1.3981.3783.60.920.358
日常活动能力匹配前12.66113.073-17.893.1-5.11<0.001
匹配后12.66212.691-1.2-0.340.736
), ArticleFig(id=1324045040435212605, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=表2, caption=

PSM数据平衡性检验结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量匹配状态均值偏差
（%）		绝对值削减t值P值
处理组对照组
性别匹配前1.4031.3912.531.30.730.464
匹配后1.3921.3831.70.420.675
年龄匹配前1.8012.322-49.487.2-14.31<0.001
匹配后1.8711.8046.31.690.091
居住地匹配前1.6731.38161.087.117.96<0.001
匹配后1.6271.5897.91.880.060
教育程度匹配前2.9862.33677.998.123.30<0.001
匹配后2.8652.878-1.5-0.350.723
配偶或伴侣匹配前0.8760.82215.184.64.40<0.001
匹配后0.8730.881-2.3-0.620.535
吸烟匹配前0.4760.494-3.6-52.3-1.070.286
匹配后0.4910.518-5.5-1.350.178
饮酒匹配前0.4530.38615.079.14.08<0.001
匹配后0.4340.44813.8-0.700.485
社会参与匹配前1.1880.66649.193.315.06<0.001
匹配后0.9690.9343.30.830.405
教育程度匹配前2.9612.38671.095.030.67<0.001
匹配后2.9472.9183.61.660.096
抑郁症状匹配前0.2330.353-26.592.3-7.72<0.001
匹配后0.2430.2332.00.530.598
夜晚睡眠时长匹配前1.3991.472-12.471.3-3.62<0.001
匹配后1.3981.3783.60.920.358
日常活动能力匹配前12.66113.073-17.893.1-5.11<0.001
匹配后12.66212.691-1.2-0.340.736
), ArticleFig(id=1324045040678482238, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Table 3, caption=

Average treatment effect on the treated (ATT) of internet use

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量平均处理效应标准误t值
认知功能0.564c0.1573.60
定向力0.163c0.0433.81
计算力0.1430.0951.50
记忆力0.253a0.1022.48
注意力与协调力0.0160.0270.58
), ArticleFig(id=1324045040795922752, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=表3, caption=

互联网使用的平均处理效应（ATT）

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量平均处理效应标准误t值
认知功能0.564c0.1573.60
定向力0.163c0.0433.81
计算力0.1430.0951.50
记忆力0.253a0.1022.48
注意力与协调力0.0160.0270.58
), ArticleFig(id=1324045041051775297, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=EN, label=Table 4, caption=

Sensitivity analysis results

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量半径匹配核匹配
平均处理效应标准误t值平均处理效应标准误t值
认知功能0.580c0.1364.250.594c0.1334.48
定向力0.115b0.0363.170.114b0.0353.23
计算力0.1230.0781.580.128a0.0761.68
记忆力0.306c0.0863.550.316c0.0843.76
注意力与协调力0.0360.0221.580.0380.0221.72
), ArticleFig(id=1324045041135661378, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044871278928341, language=CN, label=表4, caption=

敏感性分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
因变量半径匹配核匹配
平均处理效应标准误t值平均处理效应标准误t值
认知功能0.580c0.1364.250.594c0.1334.48
定向力0.115b0.0363.170.114b0.0353.23
计算力0.1230.0781.580.128a0.0761.68
记忆力0.306c0.0863.550.316c0.0843.76
注意力与协调力0.0360.0221.580.0380.0221.72
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基于PSM-XGBoost框架的互联网使用对老年人认知功能影响的实证研究
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张涵 , 贾海霞 , 李莹 , 朱兆芳
现代预防医学 | 健康与社会行为 2026,53(10): 1900-1906
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现代预防医学 |健康与社会行为 2026 , 53 (10) : 1900 -1906
基于PSM-XGBoost框架的互联网使用对老年人认知功能影响的实证研究
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张涵, 贾海霞, 李莹, 朱兆芳
作者信息
  • 山东第二医科大学公共卫生学院 山东 潍坊 261053
通讯作者:
朱兆芳，E-mail：
作者简介:

张涵（2000—），男，硕士在读，研究方向：公共卫生

Empirical evidence on the effect of internet use on cognitive function in older adults using the PSM-XGBoost framework
Han ZHANG, Hai-xia JIA, Ying LI, Zhao-fang ZHU
Affiliations
  • School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2026-05-25 doi: 10.20043/j.cnki.MPM.202510067
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摘要
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目的

探索老年人群互联网使用与认知功能之间的关系，同时评估互联网使用对认知障碍风险预测的输出影响。

方法

基于2020年中国健康与养老追踪调查（CHARLS）数据，采用倾向得分匹配（PSM）方法控制混杂因素，分析互联网使用对老年人群认知功能的影响。使用XGBoost算法构建认知障碍风险预测模型，通过工作特征曲线下面积（AUC）评估模型预测能力。并利用Shapley加性解释（SHAP）方法对XGBoost模型进行可解释性分析。

结果

研究共纳入3 685名老年人，通过最近邻匹配、半径匹配和核匹配进行倾向得分匹配显示，互联网使用对老年人认知功能的平均处理效应分别为0.564、0.580、0.594（P<0.001）。纳入互联网使用的XGBoost预测模型AUC为0.781（95%CI：0.761~0.799）。SHAP分析显示，互联网使用是影响老年人认知障碍的重要相关因素。

结论

互联网使用对老年人认知功能具有积极的正向作用；基于 XGBoost 构建的认知障碍风险预测模型具有较高的辨别能力和良好解释性，可辅助临床的早期筛查与个体化干预。

老年人  /  认知功能  /  认知障碍  /  倾向得分匹配  /  极端梯度提升算法
Objective

To explore the relationship between internet use and cognitive function in older adults, and to evaluate the impact of internet use on the predictive output of cognitive impairment risk.

Methods

Based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), propensity score matching (PSM) was used to control for confounding factors and analyze the effect of internet use on cognitive function in older adults. The XGBoost algorithm was employed to construct a risk prediction model for cognitive impairment, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive performance of the model. The SHapley Additive exPlanations (SHAP) method was applied to interpret the XGBoost model.

Results

A total of 3 685 older adults was included in the study. Propensity score matching using nearest neighbor matching, radius matching, and kernel matching showed that the average treatment effects of internet use on cognitive function were 0.564, 0.580, and 0.594, respectively (P<0.001). The XGBoost prediction model incorporating internet use achieved an AUC of 0.781 (95%CI: 0.761-0.799). SHAP analysis revealed that internet use was a key predictive factor for cognitive impairment in older adults.

Conclusion

Internet use has a positive effect on cognitive function in older adults. The XGBoost-based risk prediction model for cognitive impairment demonstrates high discriminative ability and good interpretability, which may assist in early screening and individualized clinical intervention.

Older adults  /  Cognitive function  /  Cognitive impairment  /  Propensity Score Matching  /  Extreme Gradient Boosting
张涵, 贾海霞, 李莹, 朱兆芳. 基于PSM-XGBoost框架的互联网使用对老年人认知功能影响的实证研究. 现代预防医学, 2026 , 53 (10) : 1900 -1906 . DOI: 10.20043/j.cnki.MPM.202510067
Han ZHANG, Hai-xia JIA, Ying LI, Zhao-fang ZHU. Empirical evidence on the effect of internet use on cognitive function in older adults using the PSM-XGBoost framework[J]. Modern Preventive Medicine, 2026 , 53 (10) : 1900 -1906 . DOI: 10.20043/j.cnki.MPM.202510067
正文
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随着中国人口老龄化程度的不断加深，年龄相关的健康问题日益成为社会与公共卫生领域的重点关注对象。认知功能下降是人类衰老过程中的多维度功能损伤，涉及注意力、记忆、计算力等多个方面[1]。这种综合性认知衰退不仅会降低生活质量，还可能增加认知功能障碍、阿尔兹海默症[2]、抑郁症状[3]以及死亡的风险，并进而对家庭成员及社会造成严重的经济负担[4]。因此，探索与认知功能相关的风险因素，对于促进健康老龄化具有重要的理论与实证意义。在互联网快速发展的背景下，已有研究表明互联网使用与认知障碍之间存在密切关联[5-6]，但也有研究显示互联网使用与认知功能之间未发现显著关联[7]，这种结论的不一致，可能与不同研究在人群选择、变量定义及混杂因素控制等方面的差异有关。本研究采用倾向得分匹配（Propensity Score Matching, PSM）来平衡互联网使用与不使用人群在多维特征上的差异，进一步探索互联网使用对我国老年人认知功能的影响。此外，机器学习在医疗卫生领域的广泛应用为认知障碍的预测与风险因素识别提供了新的视角，有助于建立更精准的风险分层与干预路径，尤其是极端梯度提升（Extreme Gradient Boosting, XGBoost）作为一种高效的集成算法，已在多项认知障碍相关研究中得到应用，并在预测风险以及诊断辅助等任务上展现出良好的性能与鲁棒性[8-9]。但目前针对认知障碍的风险预测研究仍缺乏对模型的可解释性分析。这不仅限制了对模型决策机制的理解，也削弱了临床医生对模型结果的信任与应用。基于此，本研究将结合PSM框架与机器学习方法，系统评估互联网使用对老年人认知功能及认知障碍的影响。
1　对象与方法
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1.1　研究对象
本研究使用中国健康与养老追踪调查（CHARLS）2020年的调查数据。该数据库采用多阶段抽样设计，涉及全国28个省（自治区、直辖市），150个区（县），450个村级单位，样本具有较高的代表性[10]。本研究排除了所需人口学资料、健康相关资料异常或缺失的样本，实际纳入7 751例样本。
1.2　研究工具
1.2.1　一般资料调查表
选取了11个与本研究相关的重要变量，包括年龄、性别、居住地、配偶/伴侣、教育程度、吸烟、饮酒、夜晚睡眠时长、抑郁症状、社会参与、日常生活活动能力。其中，社会参与变量的获取基于 CHALRS问卷中关于过去一个月参与各类社会活动的自报情况的判定。涵盖的活动包括串门或与朋友交往、打麻将或下棋或打牌或参与社区活动室活动、参加社团组织等。对参与者而言，参与活动的数量即为社会参与的分数[12]。
日常生活活动能力的判定是根据问卷中提供的基础性日常活动能力与工具性日常活动能力进行的。共计12项活动，总分范围是12~48分，分数越高代表日常生活活动能力越差[11]。而抑郁症状的判断则是根据CHARLS中提供的流行病学研究中心简版量表(CESD-10)进行测量，得分≥10 分则视为存在抑郁症状[12]。
1.2.2　认知功能
认知功能的测量涵盖定向力（0~5分）、计算力（0~5分）、记忆力（0~20分）、注意力与协调力（0~1分），具体评判标准包括：定向力要求受访者确定当前的年份、月份、星期几及季节，回答正确计1分；计算力要求参与者从数字100开始，连续减去7的五次，每一次得到正确结果计1分；记忆力通过选读10个词语让受访者进行即时回忆和延时记忆进行判断；注意力与协调力通过图片的绘制任务评估，参与者绘制正确计1分[13-14]。本研究认知障碍的判定是基于年龄相关认知衰退（AACD）进行的，60岁以上的参与者被划分为每5年一组的年龄区间，每组中符合AACD标准（即评分至少比年龄特定标准低一个标准差）[15]。
1.2.3　互联网使用
本研究互联网使用的判定依据来自 CHARLS 2020 问卷中的一个条目，该条目询问受访者在上个月是否使用过互联网。在本研究中，若受访者在移动网络环境下进行聊天、看新闻、看视频、玩游戏、理财等，则被归类为互联网用户；若回答“否”，则被归类为非互联网用户[7]。
1.2.4　倾向得分匹配
本研究采用倾向得分匹配法以平衡互联网使用组与非互联网使用组之间的协变量，旨在减少观测数据引入的偏差并提升研究结果的可信度[16]。PSM过程采用Stata 17软件来实现，通过logistic回归估计倾向性评分值，采用1:1最近邻匹配法，将具有相同或相近倾向得分的受试者成对配对，未能匹配的个体将从后续统计分析中排除，以确保两组之间的协变量平衡。
1.2.5　机器学习建模与可解释性分析
本研究按 7:3 的比例将数据划分为训练集与验证集，训练集用于构建认知障碍的 XGBoost 预测模型，验证集用于评估模型预测性能。模型性能以 AUC、准确度、灵敏度、特异度及 F1 分数等指标进行评估，并通过 bootstrap 方法计算各指标的95%置信区间。为了进一步探索互联网使用对目标变量的影响，本研究在包含互联网使用及其他协变量的预测模型中，结合SHapley Additive exPlanation (SHAP)，量化互联网使用对模型输出的贡献值。
1.3　统计分析
本研究的分类变量采用频数和构成比表示；连续变量采用表示。分类变量采用χ2检验，连续变量采用t检验或方差分析，比较互联网使用组和非互联网使用组的人口学特征。所有统计学分析均使用 IBM SPSS 27.0 版实现。检验水准α=0.05。
2　结果
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2.1　匹配前人群基本特征
在本研究纳入的3 685名样本中，其中互联网使用人群有1 423人（38.6%），女性1 459人（39.6%），认知障碍605人（16.4%）。与非互联网用户组相比，互联网用户组的认知功能及认知功能各维度得分均高于非互联网使用组，并且表现出更高的社会参与、日常生活活动能力，见表1。
2.2　PSM结果及检验
本研究采用最近邻匹配法，共匹配成功 1 383 对，即互联网使用与非使用组均纳入1 383人。匹配后协变量的标准化差距均小于10%，同时，匹配后各变量的t检验P值均大于0.05，表明处理组与对照组协变量分布无显著差异，匹配效果良好，具体结果见表2。基于匹配得到的平均处理效应（ATT），互联网使用对我国老年人群的整体认知功能、定向力与记忆力均呈正向影响，提示互联网使用在一定程度上提升了老年人的认知功能水平，见表3。
2.3　敏感性分析
为检验结果的稳健性，本研究除了最近邻匹配外，进一步采用半径匹配与核匹配进行敏感性分析。在控制其他混杂因素后，整体认知功能、定向力、记忆力的匹配结果与最近邻匹配的结论基本一致。然而，在核匹配的分析中，互联网使用对计算力的正向影响变得显著，表明该效应对匹配方法的选择在一定程度上具有敏感性，并提示结果的鲁棒性存在一定限制。详细结果见表4。
2.4　认知障碍的XGBoost风险预测模型
本研究的初始数据集中认知障碍样本为 605例，为缓解不平衡对模型性能的影响，使用自适应综合过采样对训练集中的少数类进行合成采样。该方法能根据样本密度分布为标准来自动决定需要为每个少数类样本生成的合成样本数量，有效减少了数据不平衡带来的偏差。在测试集上，XGBoost 模型的准确度为0.706（95%CI: 0.684~0.726），F1分数为0.701（95%CI: 0.679~0.736），工作特征曲线下面积（AUC）为0.781（95%CI: 0.761~0.799），灵敏度是0.696（95%CI: 0.674~0.716），特异度为0.715（95%CI: 0.694~0.726）。ROC曲线见图1。
2.5　基于SHAP方法的预测模型可解释性分析
采用SHAP方法对XGBoost模型进行可解释性分析，其中SHAP特征重要性排序表明，教育程度与互联网使用是该模型预测认知障碍风险中特征重要性最高的两个变量。这表明，这两个特征对于区分个体的认知风险水平具有最强的预测关联，具体见图2。为进一步解释特征对模型预测的影响，本研究绘制了SHAP依赖图。图3A进一步揭示了互联网使用与认知障碍风险之间的关系，未使用互联网的群体SHAP值基本大于0，而互联网使用者的SHAP值小于0，这也说明互联网使用者更不容易发生认知障碍。此外，图3B显示，当教育程度为小学及以下时，SHAP值基本大于0，而初中及以上教育水平的SHAP值小于零，这表明受教育水平越低，认知障碍的出现概率越高。
3　讨论
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3.1　本研究实现了方法的互补性与结论的聚合性
本研究首先采用PSM方法，通过平衡处理组与对照组间的多维协变量，在组间可比的基础上评估了互联网使用对老年认知的促进作用。随后，构建XGBoost预测模型，从数据驱动角度将“互联网使用”识别为关键预测变量，进一步提供独立验证。这种来自不同方法学路径的证据汇聚，极大地增强了“互联网使用与老年认知功能存在密切关联”这一核心发现的可信度与稳健性。通过这种整合分析框架，不仅强化了主要结论，也为理解互联网使用这类复杂健康行为与认知结局的关系提供了更丰富的多维视角。此外，本研究对XGBoost预测模型进行 SHAP 解释分析，直观呈现了影响认知障碍风险输出的关键特征，提升了模型输出的可解释性与临床可用性。综合而言，这一整合框架实现了方法上的优势互补与结论上的交叉印证，提升了研究的整体说服力与潜在应用价值。
3.2　互联网使用对老年人认知功能具有一定的促进作用
本研究基于2020年CHARLS数据，探讨我国老年人群互联网使用与认知功能的关联，并构建认知障碍的风险预测模型。在控制其他可能影响的变量后，倾向得分匹配分析结果显示互联网使用对认知功能起正向促进作用。目前已有研究将互联网视为是一种强大的认知增强技术[17]，互联网使用被认为能够改善即时记忆、延迟记忆以及语言能力等认知维度。另一项以 CHARLS 数据为基础的研究亦发现互联网使用与认知功能之间存在正相关关系[18]。互联网使用能够增加社会互动、降低社会孤立，并促使获取新知识，从而提升对互联网相关技能的认知需求。相关证据显示，参与基于互联网的社交活动水平较高的个体，其认知功能水平往往较高，且认知下降速度较慢[19]。此外，互联网使用可能通过影响苍白球体积来预防认知能力的下降，有研究发现，互联网用户组左苍白球、右苍白球体积均大于非互联网用户组[20]。但需要注意的是互联网的使用应适度，例如：尽管电子游戏训练可改善空间可视化、视觉注意力和反应时等，但过度使用可能增加肥胖等风险[21]。因此，在证实互联网使用与认知功能存在正向关联的基础上，除了推动互联网普及外，更应深入探讨使用频率、工具类型及使用情境，以更好地引导老年人合理、高效地利用互联网，并为制定相关政策与开发数字产品与服务提供科学依据。
3.3　互联网使用是认知障碍的重要相关因素
全球人口快速老龄化所带来的认知障碍患病率上升，对公共卫生系统构成重大挑战。在本研究中，认知障碍检出率为16.4%，低于2018年CHARLS采用简易精神状态检查（MMSE）中文版的评估结果[22]，高于黄玉洁等人[23] 基于中国老年健康影响因素跟踪调查数据（CLHLS）分析的结果（14.2%），但与采用同年数据相同标准的研究所报告的15.8%的检出率相近[24]。除了数据来源与人群特征的差异外，检出率的差异主要源于认知障碍的诊断标准不统一。目前缺乏统一的诊断规范，CHARLS数据库的认知障碍判定主要有以下几种判定标准：衰老相关认知能力下降（AACD）标准[25]；总分为31分，<11分定义为认知障碍[26]；使用简易精神状态量表（MMSE）评估认知状态[27]；以低于认知功能平均值至少一个标准差为界定标准[28]。本研究的 SHAP 分析显示，低学历是认知障碍的重要风险因素，这与既往研究一致[29]。此外，互联网使用也是与认知障碍密切相关的重要行为特征，适度的互联网使用与较低的认知障碍发生率相关。结合既往研究推测，其潜在机制可能是：未使用互联网的人群更易出现社会孤独和抑郁风险，而孤独与抑郁不仅直接影响心血管功能，还通过降低脑血流量、抑制神经血管耦合，进而损害记忆、计算、定向等认知维度，增加认知障碍风险[30]。因此，推动互联网的适度使用与数字素养提升，对维持多维度认知功能具有积极作用。
本研究仍存在若干局限。首先，模型尚未经过外部验证，因而其泛化能力在其他数据中的稳健性尚待确认，未来需要在多中心、跨区域的数据集上进行重复验证。其次，可能存在重要但未被收录的潜在预测因素。此外，尽管本研究采用的认知障碍判定标准，不可避免的依赖样本分布，缺乏临床金标准的效度。

文献
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参考文献 引证文献
排序方式：
［1］
Du HZ, Yu M, Xue HM, et al. Association between sarcopenia and cognitive function in older Chinese adults：Evidence from the China health and retirement longitudinal study[J]. Front Public Health, 2022, 10: 1078304.
［2］
黄明亮，杨春晓，饶丽丽，等. 社区老年人握力变化轨迹与认知功能的关系[J]. 护理研究，2025, 39(19):3256-3262.
Huang ML, Yang CX, Rao LL, et al. Relationship between grip strength change trajectory and cognitive function among community-dwelling elderly People[J]. Chinese Nursing Research, 2025, 39(19): 3256-3262. (In Chinese)
［3］
Yang YY, Zhu Y, Dai B, et al. Mediation analysis of cognitive function in the relationship between pulmonary function and depression among middle-aged and older adults[J]. Geriatrics & Gerontology International, 2024, 24(11): 1210-1217.
［4］
Lin L, Cao B, Chen WQ, et al. Association of adverse childhood experiences and social isolation with Later-Life cognitive function among adults in China[J]. JAMA Netw Open, 2022, 5(11): e2241714.
［5］
杨巧玲，刘慧，段娅娟，等. 社会隔离与抑郁在农村老年人数字排斥与认知功能间的链式中介效应[J]. 护理学杂志，2025, 40(15):23-28.
Yang QL, Liu H, Duan YJ, et al. The chain mediation effect of social isolation and depression on the relationship be-tween digital exclusion and cognitive function in rural older adults[J]. Journal of Nursing Science, 2025, 40(15): 23-28. (In Chinese)
［6］
张小宇，王琪，付春迎，等. 手机及网络使用情况与中老年人主、客观认知功能的关系[J]. 现代预防医学，2025, 52(14):2613-2618.
Zhang XY, Wang Q, Fu CY, et al. Relationship between Mobile phone and Internet usage and subjective and objective cognitive functions in middle-aged and elderly People[J]. Modern Preventive Medicine, 2025, 52(14): 2613-2618. (In Chinese)
［7］
Shen L, Zheng YW, Wang MT, et al. Does Internet use promote the health of empty-nest older adults in rural China? The mediating role of social participation using a propensity score matching approach[J]. Front Public Health, 2024, 12: 1436525.
［8］
钟霞，赵天恩，吕世盟，等. 基于中西医双维特征构建老年高血压轻度认知障碍机器学习预测模型[J]. 南京中医药大学学报，2024, 40(12):1366-1374.
Zhong X, Zhao TE, Lv SM, et al. Machine learning prediction model of mild cognitive impairment in elderly patients with hypertension based on Bi-Di-mensional features of Chinese and western medicine[J]. Journal of Nanjing University of Traditional Chinese Medicine, 2024, 40(12): 1366-1374. (In Chinese)
［9］
丛慧文，徐雅琪，王爱民，等. XGBoost算法在轻度认知障碍人群阿尔兹海默病发病预测中的应用[J]. 郑州大学学报：医学版，2022, 57(6):751-756.
Cong HW, Xu YQ, Wang AM, et al. Application of XGBoost algorithm in predicting Alzheimer′s disease in patients with mild cognitive impairment[J]. Journal of Zhengzhou University（Medical Sciences）, 2022, 57(6): 751-756. (In Chinese)
［10］
Zhao YH, Hu YS, Smith JP, et al. Cohort profile：the China Health and Retirement Longitudinal Study（CHARLS）[J]. International Journal of Epidemiology, 2014, 43(1): 61-68.
［11］
苏文钰，贾蕙毓，常雯静，等. 抑郁症状在老年人握力和日常生活活动能力间的中介效应[J]. 现代预防医学，2025, 52(12):2236-2241.
Su WY, Jia HY, Chang WJ, et al. Mediating effect of depressive symptoms between handgrip strength and activities of daily living in older adults[J]. Modern Preventive Medicine, 2025, 52(12): 2236-2241. (In Chinese)
［12］
吴怡倩，井淇，苏文钰，等. 躯体疼痛部位数量在老年人慢性病患病数量和抑郁症状间的中介效应研究[J]. 现代预防医学，2025, 52(16):3035-3039, 3060.
Wu YQ, Jing Q, Su WY, et al. A study on the mediating effect of the number of physical pain sites on the incidence of chronic diseases and depressive symptoms in elderly people[J]. Modern Preventive Medicine, 2025, 52(16): 3035-3039, 3060. (In Chinese)
［13］
李玉周，李禄一，王蕊．中老年人体力活动水平与认知功能的双向因果关系研究[J]. 体育学刊，2025, 32(4):137-143.
Li YZ, Li LY, Wang R. Research on the bidirectional causal relationship between physical activity level and cognitive function in middle-aged and elderly people[J]. Journal of Physical Education, 2025, 32(4): 137-143. (In Chinese)
［14］
周晓蒙，姜琛，周越．老年劳动参与对认知功能的影响研究[J]. 中国人口科学，2025, 39(4):82-96.
Zhou XM, Jiang C, Zhou Y. Research on the impact of elderly labor participation on cognitive function[J]. Chinese Journal of Population Science, 2025, 39(4): 82-96. (In Chinese)
［15］
Zhu Y, Nan JH, Gao T, et al. Predictive model for mild cognitive impairment in older Chinese adults with depression[J]. Neuropsychiatr, 2025, 7: 693.
［16］
马蕊，许军，廖生武，等. 社会参与和城镇老年人健康适能状况的关联效应分析[J]. 中国卫生事业管理，2024, 41(10):1174-1179.
Ma R, Xu J, Liao SW, et al. Analysis of the association effect between social participation and health fitness status of urban older adults[J]. Chinese Health Service Management, 2024, 41(10): 1174-1179. (In Chinese)
［17］
Voinea C, Vicǎ C, Mihailov E, et al. The Internet as cognitive enhancement[J]. Science and Engineering Ethics, 2020, 26(4): 2345-2362.
［18］
Chen BW, Yang C, Ren SS, et al. Relationship between Internet use and cognitive function among Middle-Aged and older Chinese adults：5-Year longitudinal study[J]. Journal of Medical Internet Research, 2024, 26: e57301.
［19］
Jeon S, Charles ST. Internet-Based social activities and cognitive functioning 2 years later among Middle-Aged and older adults：prospective cohort study[J]. JMIR Aging, 2024, 7: e63907.
［20］
Li W, Yue L, Xiao SF. Association between Internet use, cognitive function, and globus pallidus volumes：a study among the elderly in Chinese communities[J]. Front Public Health, 2022, 10: 886974.
［21］
Small GW, Lee J, Kaufman A, et al. Brain health Consequences of digital technology use[J]. Dialogues in Clinical Neuroscience, 2020, 22(2): 179-187.
［22］
何南芙，崔莉，董越，等. 中国老年人认知障碍检出情况及其与睡眠时长的关系——基于2018年CHARLS数据的实证分析[J]. 中国老年学杂志，2023, 43(7):1758-1761.
He NF, Cui L, Dong Y, et al. Detection of cognitive impairment in elderly Chinese and its relationship with sleep duration：empirical analysis based on 2018 CHARLS data[J]. Chinese Journal of Gerontology, 2023, 43(7): 1758-1761. (In Chinese)
［23］
黄玉洁，罗雅楠．中国老年人口认知障碍对功能能力的影响[J]. 健康发展与政策研究，2025, 28(3):260-267.
Huang YJ, Luo YN. The impact of cognitive impairment on functional limitations among elderly population in China[J]. Health Development and Policy Research, 2025, 28(3): 260-267. (In Chinese)
［24］
Zhang L, Chen W, Miao HJ, et al. Association between physical activity levels and mild cognitive impairment in Chinese older adults：a cross-sectional study from the China health and retirement longitudinal study[J]. Front Public Health, 2025, 13: 1564544.
［25］
Hu YS, Peng WJ, Ren RJ, et al. Sarcopenia and mild cognitive impairment among elderly adults：The first longitudinal evidence from CHARLS[J]. Journal of Cachexia, Sarcopenia and Muscle, 2022, 13(6): 2944-2952.
［26］
Liu GT, Zhang JA. Association of a novel nutritional index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from the China Health and Retirement Longitudinal Study[J]. Front Nutr, 2025, 12: 1486917.
［27］
Ma M, Dong FW, Lan JY. Associations between sleep duration, physical activity, and cognitive impairment in older adults-empirical analysis based on CHARLS data[J]. Front Public Health, 2025, 13: 1589606.
［28］
Liu GT, Xu Q, Zhang SH, et al. Association of a modified body shape index with cognitive impairment in middle-aged and elderly Chinese adults：a cross-sectional analysis from CHARLS[J]. Front Nutr, 2025, 12: 1589898.
［29］
刘欣怡，张逦．我国老年人认知障碍患病率空间分布及影响因素[J]. Journal of Medicine and Society，2025, 38(9):1-7.
Liu XY, Zhang L. The spatial distribution and influencing factors of cognitive impairment prevalence among elderly people in China[J]. Journal of Medicine and Society, 2025, 38(9): 1-7. (In Chinese)
［30］
Wang YG, Wu ZG, Duan LZ, et al. Digital exclusion and cognitive impairment in older People：findings from five longitudinal studies[J]. BMC Geriatrics, 2024, 24(1): 406.
2026年第53卷第10期
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doi: 10.20043/j.cnki.MPM.202510067
  • 接收时间：2025-10-10
  • 首发时间：2026-11-02
  • 出版时间：2026-05-25
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    山东第二医科大学公共卫生学院 山东 潍坊 261053

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2种不同金属材料的力学参数
科
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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