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Article(id=1324050861386769140, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510297, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760803200000, receivedDateStr=2025-10-19, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607925029, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607925029, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607925029, creator=13701087609, updateTime=1793607925029, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1657, endPage=1662, ext={EN=ArticleExt(id=1324050862288544501, articleId=1324050861386769140, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The delayed effects of social participation on cognitive impairment among Chinese middle-aged and older adults, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To examine the association between social activity participation and incident cognitive impairment (CI) and to quantify the delay in onset among middle-aged and older adults in China.

Methods

Using five waves of longitudinal data from the China Health and Retirement Longitudinal Study (2011—2020), 9 245 participants without baseline CI were included in the study. A multi-state Markov model was constructed, and Cox models were used to estimate the association between social activity frequency and CI occurrence. Discrete-time Markov multi-state models and cumulative transition risks were utilized to compare the onset time differences between high and low social participation scenarios.

Results

Each 1 SD increase in social activity frequency was associated with a 10.36% lower risk of CI (HR=0.896, 95% CI: 0.864-0.928). Compared with low participation, high participation delayed the first CI occurrence by 0.81 years (95% CI: 0.64-1.13 years). Stratified analysis showed that males, those aged <65 years, those with higher education levels, urban residents, and those without chronic diseases were associated with longer delays in onset; whereas among females, those with higher education levels, and those with chronic diseases, the delay benefit of more frequent social participation was more pronounced.

Conclusion

Higher social participation is associated with both a lower CI risk and a later onset, with particularly notable delay among older adults with chronic conditions. Integrating social participation with chronic disease management may be a useful public-health strategy to prevent cognitive impairment among middle-aged and older adults in China.

, authors=Yuan-peng BAI, Pei-di XU, Jian ZHONG, Ya-ting ZHOU, Gong-hua WU, Ju-ying ZHANG, Xing ZHAO, authorsList=Yuan-peng BAI, Pei-di XU, Jian ZHONG, Ya-ting ZHOU, Gong-hua WU, Ju-ying ZHANG, Xing ZHAO, authorCompany=null, correspAuthors=Ju-ying ZHANG, 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=1324050869829903105, articleId=1324050861386769140, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=社会活动参与对中国中老年人认知功能障碍的延迟效应, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

探讨中国中老年人社会活动参与与认知功能障碍（cognitive impairments，CI）发生风险的关系，并量化其能延迟发病年数。

方法

基于中国健康与养老追踪调查2011—2020年五轮随访数据，纳入基线无CI的9 245名受试者。构建多状态Markov模型，并以Cox模型估计社会活动频率与CI发生的关联；基于离散时间马尔可夫多状态模型和转移累积风险比较高、低社会参与情景的发病时间差异。

结果

社会活动频率每升高1个标准差，CI发生风险降低10.36%（HR=0.896，95%CI：0.864～0.928）。与低参与者相比，高参与者总体可使首次CI发生延后0.81年（95%CI：0.64～1.13）。分层分析显示，男性、年龄<65岁、教育水平较高、城市居民及未患慢性病者与较长的发病延迟时间相关；而女性、较高教育水平者以及患有慢性病者更高频率社会参与带来的延迟效益更为显著。

结论

更高频率的社会参与与更低的CI发生风险及更晚的发病时间相关，尤其在老龄慢性病患者中，其延迟发病的效果更为显著。推动社会参与促进与慢性病管理相结合的干预策略，可作为我国预防中老年CI的重要公共卫生措施。

, authors=白元鹏, 徐沛蒂, 钟健, 周亚婷, 吴功华, 张菊英, 赵星, authorsList=白元鹏, 徐沛蒂, 钟健, 周亚婷, 吴功华, 张菊英, 赵星, authorCompany=null, correspAuthors=张菊英, authorNote=

白元鹏（2000—），男，硕士在读，研究方向：流行病与卫生统计学

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张菊英，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=+3u0QvKvVbNbgiFxqyDiJg==, magXml=Hul3tCNGBKqYIDEFZDmhkQ==, pdfUrl=null, pdf=HJfjY90B8TXmUbC9wgnWRQ==, pdfFileSize=1032142, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=GMyr2OGsITaw02URwNdCKA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=oc7+WAcFFAxQN6iI4jWkaw==, mapNumber=null, fund=null)}, authors=[Author(id=1324050871033668358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324050871495041800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, authorId=1324050871033668358, language=EN, stringName=Yuan-peng BAI, firstName=Yuan-peng, middleName=null, lastName=BAI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324050871889306377, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, authorId=1324050871033668358, language=CN, stringName=白元鹏, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041, bio={"content":"

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doi=null, pmid=null, pmcid=null, year=2024, volume=20, issue=9, pageStart=6622, pageEnd=6631, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Cappa SF, Ribaldi F, Chicherio C, journalName=Alzheimer's & Dementia：the Journal of the Alzheimer's Association, refType=null, unstructuredReference=Cappa SF, Ribaldi F, Chicherio C, et al. Subjective cognitive decline：Memory complaints, cognitive awareness, and metacognition [J]. Alzheimer's & Dementia：the Journal of the Alzheimer's Association, 2024, 20(9): 6622-6631., articleTitle=Subjective cognitive decline：Memory complaints, cognitive awareness, and metacognition, refAbstract=null), Reference(id=1324050883574637378, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2020, volume=5, issue=12, pageStart=e661, pageEnd=e671, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Jia LF, Du YF, Chu L, journalName=LANCET PUBLIC HEALTH, refType=null, unstructuredReference=Jia LF, Du YF, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China：a cross-sectional study [J]. LANCET PUBLIC HEALTH, 2020, 5(12): e661-e671., articleTitle=Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China：a cross-sectional study, refAbstract=null), Reference(id=1324050883637551939, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=12, issue=3, pageStart=334, pageEnd=null, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Yin YH, Tam HL, Quint J, journalName=Healthcare, refType=null, unstructuredReference=Yin YH, Tam HL, Quint J, et al. Epidemiology of dementia in China in 2010-2020：A systematic review and Meta-Analysis [J]. Healthcare, 2024, 12(3): 334., articleTitle=Epidemiology of dementia in China in 2010-2020：A systematic review and Meta-Analysis, refAbstract=null), Reference(id=1324050883734020932, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2021, volume=20, issue=4, pageStart=317, pageEnd=337, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=任汝静, 殷鹏, 王志会, journalName=诊断学理论与实践, refType=null, unstructuredReference=任汝静，殷鹏，王志会，等. 中国阿尔茨海默病报告2021 [J]. 诊断学理论与实践，2021, 20(4):317-337., articleTitle=中国阿尔茨海默病报告2021, refAbstract=null), Reference(id=1324050883805324101, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2021, volume=20, issue=4, pageStart=317, pageEnd=337, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Ren RJ, Yin P, Wang ZH, journalName=Journal of Diagnostics Concepts & Practice, refType=null, unstructuredReference=Ren RJ, Yin P, Wang ZH, et al. China Alzheimer disease report 2021 [J]. Journal of Diagnostics Concepts & Practice, 2021, 20(4): 317-337. (In Chinese), articleTitle=China Alzheimer disease report 2021, refAbstract=null), Reference(id=1324050883876627270, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=404, issue=10452, pageStart=572, pageEnd=628, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Livingston G, Huntley J, Liu KY, journalName=Lancet, refType=null, unstructuredReference=Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care：2024 report of the Lancet standing Commission [J]. Lancet, 2024, 404(10452): 572-628., articleTitle=Dementia prevention, intervention, and care：2024 report of the Lancet standing Commission, refAbstract=null), Reference(id=1324050883952124743, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2023, volume=91, issue=2, pageStart=585, pageEnd=601, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=Overton M, Sjögren B, Elmsåthl S, journalName=Journal of Alzheimer's Disease, refType=null, unstructuredReference=Overton M, Sjögren B, Elmsåthl S, et al. Mild cognitive impairment, reversion rates, and associated factors：comparison of two diagnostic approaches [J]. Journal of Alzheimer's Disease, 2023, 91(2): 585-601., articleTitle=Mild cognitive impairment, reversion rates, and associated factors：comparison of two diagnostic approaches, refAbstract=null), Reference(id=1324050884031816520, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2022, volume=99, issue=15, pageStart=e1651, pageEnd=e1663, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Su SZ, Shi L, Zheng YB, journalName=Neurology, refType=null, unstructuredReference=Su SZ, Shi L, Zheng YB, et al. Leisure activities and the risk of dementia：a systematic review and meta-analysis [J]. Neurology, 2022, 99(15): e1651-e1663., articleTitle=Leisure activities and the risk of dementia：a systematic review and meta-analysis, refAbstract=null), Reference(id=1324050884111508297, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2023, volume=3, issue=5, pageStart=532, pageEnd=545, url=null, language=null, rfNumber=[8], rfOrder=8, authorNames=Sommerlad A, Kivimäki M, Larson EB, journalName=Nature Aging, refType=null, unstructuredReference=Sommerlad A, Kivimäki M, Larson EB, et al. Social participation and risk of developing dementia [J]. Nature Aging, 2023, 3(5): 532-545., articleTitle=Social participation and risk of developing dementia, refAbstract=null), Reference(id=1324050884187005770, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=37, issue=1, pageStart=7, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=9, authorNames=Ni P, Chen HX, Hu XY, journalName=Aging Clinical and Experimental Research, refType=null, unstructuredReference=Ni P, Chen HX, Hu XY. Association between social engagement decline and cognitive function changes：mediating effect of depressive symptoms [J]. Aging Clinical and Experimental Research, 2024, 37(1): 7., articleTitle=Association between social engagement decline and cognitive function changes：mediating effect of depressive symptoms, refAbstract=null), Reference(id=1324050884258308939, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2025, volume=12, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Li X, Feng HS, Chen QL, journalName=Front Med（Lausanne）, refType=null, unstructuredReference=Li X, Feng HS, Chen QL. Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment：a latent class analysis [J]. Front Med（Lausanne）, 2025, 12: 1493359., articleTitle=Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment：a latent class analysis, refAbstract=null), Reference(id=1324050884338000716, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=37, issue=1, pageStart=41, pageEnd=51, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=鲍瑞, 毛慧娟, 宋花玲, journalName=数理医药学杂志, refType=null, unstructuredReference=鲍瑞，毛慧娟，宋花玲，等. 社会活动参与对我国老年人认知功能的影响——基于中国健康与养老追踪调查数据 [J]. 数理医药学杂志，2024, 37(1):41-51., articleTitle=社会活动参与对我国老年人认知功能的影响——基于中国健康与养老追踪调查数据, refAbstract=null), Reference(id=1324050884413498189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=37, issue=1, pageStart=41, pageEnd=51, url=null, language=null, rfNumber=[11], rfOrder=12, authorNames=Bao R, Mao HJ, Song HL, journalName=Journal of Mathematical Medicine, refType=null, unstructuredReference=Bao R, Mao HJ, Song HL, et al. The impact of social activity participation on cognitive function among Chinese elderly：based on data from China Health and Retirement Longitudinal Study [J]. Journal of Mathematical Medicine, 2024, 37(1): 41-51. (In Chinese), articleTitle=The impact of social activity participation on cognitive function among Chinese elderly：based on data from China Health and Retirement Longitudinal Study, refAbstract=null), Reference(id=1324050884572881742, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2014, volume=43, issue=1, pageStart=61, pageEnd=68, url=null, language=null, rfNumber=[12], rfOrder=13, 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=1324050884656767823, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2022, volume=30, issue=6, pageStart=e4812, pageEnd=e4820, url=null, language=null, rfNumber=[13], rfOrder=14, authorNames=Fang BY, Huang JJ, Zhao XY, journalName=Health & Social Care in the Community, refType=null, unstructuredReference=Fang BY, Huang JJ, Zhao XY, et al. Concurrent and lagged associations of social participation and frailty among older adults [J]. Health & Social Care in the Community, 2022, 30(6): e4812-e4820., articleTitle=Concurrent and lagged associations of social participation and frailty among older adults, refAbstract=null), Reference(id=1324050884757431120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=11, pageStart=3318, pageEnd=3326, url=null, language=null, rfNumber=[14], rfOrder=15, authorNames=Li CS, Wang LL, Ding LY, journalName=Nature Medicine, refType=null, unstructuredReference=Li CS, Wang LL, Ding LY, et al. Determinants and inequities in healthy working Life expectancy in China [J]. Nature Medicine, 2024, 30(11): 3318-3326., articleTitle=Determinants and inequities in healthy working Life expectancy in China, refAbstract=null), Reference(id=1324050884832928593, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2025, volume=59, issue=3, pageStart=259, pageEnd=276, url=null, language=null, rfNumber=[15], rfOrder=16, authorNames=Wu WW, Chen GC, Ren XH, journalName=Neuroepidemiology, refType=null, unstructuredReference=Wu WW, Chen GC, Ren XH, et al. The prevalence of mild cognitive impairment in China：evidence from a Meta-Analysis and systematic review of 393, 525 adults [J]. Neuroepidemiology, 2025, 59(3): 259-276., articleTitle=The prevalence of mild cognitive impairment in China：evidence from a Meta-Analysis and systematic review of 393, 525 adults, refAbstract=null), Reference(id=1324050884933591890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=20, issue=2, pageStart=1465, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=Zhang X, Zhou W, journalName=Alzheimer's & Dementia: the Journal of the Alzheimer's Association, refType=null, unstructuredReference=Zhang X, Zhou W. Association of blood cell indices and anemia with risk of incident dementia：Missing important covariates in MRI analysis May be misleading [J]. Alzheimer's & Dementia: the Journal of the Alzheimer's Association, 2024, 20(2): 1465., articleTitle=Association of blood cell indices and anemia with risk of incident dementia：Missing important covariates in MRI analysis May be misleading, refAbstract=null), Reference(id=1324050885243970387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2023, volume=15, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Mose A, Chen YH, Tan XS, journalName=Frontiers in Aging Neuroscience, refType=null, unstructuredReference=Mose A, Chen YH, Tan XS, et al. Association of social integration with cognitive function trajectories among Chinese older adults：evidence from the China health and retirement longitudinal study（CHARLS） [J]. Frontiers in Aging Neuroscience, 2023, 15: 1322974., articleTitle=Association of social integration with cognitive function trajectories among Chinese older adults：evidence from the China health and retirement longitudinal study（CHARLS）, refAbstract=null), Reference(id=1324050885353022292, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=21, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=19, authorNames=Chen Y, Grodstein F, Capuano AW, journalName=Alzheimer's & Dementia: the Journal of the Alzheimer's Association, refType=null, unstructuredReference=Chen Y, Grodstein F, Capuano AW, et al. Late-Life social activity and subsequent risk of dementia and mild cognitive impairment [J]. Alzheimer's & Dementia: the Journal of the Alzheimer's Association, 2024, 21(1): e14316., articleTitle=Late-Life social activity and subsequent risk of dementia and mild cognitive impairment, refAbstract=null), Reference(id=1324050885663400789, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2022, volume=99, issue=2, pageStart=e164, pageEnd=e175, url=null, language=null, rfNumber=[19], rfOrder=20, authorNames=Shen C, Rolls , journalName=Neurology, refType=null, unstructuredReference=Shen C, Rolls . Cheng W, et al. Associations of social isolation and loneliness with later dementia [J]. Neurology, 2022, 99(2): e164-e175., articleTitle=Cheng W, et al. Associations of social isolation and loneliness with later dementia, refAbstract=null), Reference(id=1324050887345316694, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2025, volume=25, issue=1, pageStart=775, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=21, authorNames=Zhang W, Zhang JJ, Gao N, journalName=BMC Geriatrics, refType=null, unstructuredReference=Zhang W, Zhang JJ, Gao N. Social isolation and cognitive decline in older adults：a longitudinal study across 24 countries [J]. BMC Geriatrics, 2025, 25(1): 775., articleTitle=Social isolation and cognitive decline in older adults：a longitudinal study across 24 countries, refAbstract=null), Reference(id=1324050887445979991, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=70, issue=7, pageStart=776, pageEnd=784, url=null, language=null, rfNumber=[21], rfOrder=22, authorNames=Leung Y, Eramudugolla R, Cherbuin N, journalName=Gerontology, refType=null, unstructuredReference=Leung Y, Eramudugolla R, Cherbuin N, et al. Estimating gender differences in the association between cognitive resilience and mild cognitive impairment incidence [J]. Gerontology, 2024, 70(7): 776-784., articleTitle=Estimating gender differences in the association between cognitive resilience and mild cognitive impairment incidence, refAbstract=null), Reference(id=1324050887609557848, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=7, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[22], rfOrder=23, authorNames=Wang KL, Zhao S, Lee EKP, journalName=JAMA Netw Open, refType=null, unstructuredReference=Wang KL, Zhao S, Lee EKP, et al. Risk of dementia among patients with diabetes in a multidisciplinary, primary care management program [J]. JAMA Netw Open, 2024, 7(2): e2355733., articleTitle=Risk of dementia among patients with diabetes in a multidisciplinary, primary care management program, refAbstract=null), Reference(id=1324050887726998361, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2025, volume=25, issue=1, pageStart=765, pageEnd=null, url=null, language=null, rfNumber=[23], rfOrder=24, authorNames=Xu JP, Kang Z, Hao XN, journalName=BMC Geriatrics, refType=null, unstructuredReference=Xu JP, Kang Z, Hao XN, et al. Gender differences in the impact of emotional support networks on health-related quality of Life among floating elderly：a cross-sectional study in China [J]. BMC Geriatrics, 2025, 25(1): 765., articleTitle=Gender differences in the impact of emotional support networks on health-related quality of Life among floating elderly：a cross-sectional study in China, refAbstract=null), Reference(id=1324050887848633178, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=16, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=25, authorNames=Liu Y, Lu G, Liu L, journalName=Frontiers in Aging Neuroscience, refType=null, unstructuredReference=Liu Y, Lu G, Liu L, et al. Cognitive reserve over the Life course and risk of dementia：a systematic review and meta-analysis [J]. Frontiers in Aging Neuroscience, 2024, 16: 1358992., articleTitle=Cognitive reserve over the Life course and risk of dementia：a systematic review and meta-analysis, refAbstract=null), Reference(id=1324050887961879387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2024, volume=97, issue=4, pageStart=1689, pageEnd=null, url=null, language=null, rfNumber=[25], rfOrder=26, authorNames=Posis A, Shadyab AH, Parada H, journalName=J Alzheimers Dis：JAD, refType=null, unstructuredReference=Posis A, Shadyab AH, Parada H, et al. Multimorbidity, social engagement, and age-related cognitive decline in older adults from the Rancho Bernardo Study of Healthy Aging [J]. J Alzheimers Dis：JAD, 2024, 97(4): 1689., articleTitle=Multimorbidity, social engagement, and age-related cognitive decline in older adults from the Rancho Bernardo Study of Healthy Aging, refAbstract=null), Reference(id=1324050888196760412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2023, volume=18, issue=5, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=27, authorNames=Yoshikawa M, Goto E, Shin JH, journalName=PLOS One, refType=null, unstructuredReference=Yoshikawa M, Goto E, Shin JH, et al. Regional disparities in Dementia-free Life Expectancy in Japan：An ecological study, using the Japanese long-term care insurance claims database [J]. PLOS One, 2023, 18(5): e0280299., articleTitle=Regional disparities in Dementia-free Life Expectancy in Japan：An ecological study, using the Japanese long-term care insurance claims database, refAbstract=null), Reference(id=1324050888314200925, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, doi=null, pmid=null, pmcid=null, year=2023, volume=19, issue=10, pageStart=4532, pageEnd=4541, url=null, language=null, rfNumber=[27], rfOrder=28, authorNames=Brück CC, Wolters FJ, Ikram MA, journalName=Alzheimer's & Dementia：the Journal of the Alzheimer's Association, refType=null, unstructuredReference=Brück CC, Wolters FJ, Ikram MA, et al. Projections of costs and quality adjusted Life years lost due to dementia from 2020 to 2050：A population-based microsimulation study [J]. 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Characteristics of CI groups in middle-aged and elderly adults ［（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量未发生组发生组统计值P值
年龄（岁）68.31±9.5267.27±8.485.39<0.001
性别
男性2 690 (48.73)1 714 (46.01)6.590.010
女性2 830 (51.27)2 011 (53.99)
婚姻
无配偶575 (10.42)359 (9.64)1.490.223
有配偶4 945 (89.58)3 366 (90.36)
居住地
农村4 417 (80.02)3 253 (87.33)84.10<0.001
城镇1 103 (19.98)472 (12.67)
教育水平
文盲1 585 (28.71)1 051 (28.21)30.20<0.001
小学2 325 (42.12)1 459 (39.17)
中学1 513 (27.41)1 181 (31.70)
大学及以上97 (1.76)34 (0.91)
吸烟
否3 321 (60.16)2 278 (61.15)0.920.339
是2 199 (39.84)1 447 (38.85)
饮酒
否3 619 (65.56)2 501 (67.14)2.480.115
是1 901 (34.44)1 224 (32.86)
睡眠时长（h）6.42±1.696.31±1.902.840.004
自评健康
良好453 (8.21)264 (7.09)37.14<0.001
一般3 697 (66.97)2 325 (62.42)
较差1 370 (24.82)1 136 (30.50)
BMI
消瘦234 (4.24)213 (5.72)16.80<0.001
正常3 034 (54.96)2 107 (56.56)
超重1 701 (30.82)1 074 (28.83)
肥胖551 (9.98)331 (8.89)
高血压
否4 218 (76.41)2 948 (79.14)9.500.002
是1 302 (23.59)777 (20.86)
糖尿病
否5 222 (94.60)3 548 (95.25)1.910.167
是298 (5.40)177 (4.75)
社会活动
否2 765 (50.09)2 124 (57.02)42.86<0.001
是2 755 (49.91)1 601 (42.98)
), ArticleFig(id=1324050882815468347, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, language=CN, label=表1, caption=

中老年人不同发生CI组的特征 ［（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量未发生组发生组统计值P值
年龄（岁）68.31±9.5267.27±8.485.39<0.001
性别
男性2 690 (48.73)1 714 (46.01)6.590.010
女性2 830 (51.27)2 011 (53.99)
婚姻
无配偶575 (10.42)359 (9.64)1.490.223
有配偶4 945 (89.58)3 366 (90.36)
居住地
农村4 417 (80.02)3 253 (87.33)84.10<0.001
城镇1 103 (19.98)472 (12.67)
教育水平
文盲1 585 (28.71)1 051 (28.21)30.20<0.001
小学2 325 (42.12)1 459 (39.17)
中学1 513 (27.41)1 181 (31.70)
大学及以上97 (1.76)34 (0.91)
吸烟
否3 321 (60.16)2 278 (61.15)0.920.339
是2 199 (39.84)1 447 (38.85)
饮酒
否3 619 (65.56)2 501 (67.14)2.480.115
是1 901 (34.44)1 224 (32.86)
睡眠时长（h）6.42±1.696.31±1.902.840.004
自评健康
良好453 (8.21)264 (7.09)37.14<0.001
一般3 697 (66.97)2 325 (62.42)
较差1 370 (24.82)1 136 (30.50)
BMI
消瘦234 (4.24)213 (5.72)16.80<0.001
正常3 034 (54.96)2 107 (56.56)
超重1 701 (30.82)1 074 (28.83)
肥胖551 (9.98)331 (8.89)
高血压
否4 218 (76.41)2 948 (79.14)9.500.002
是1 302 (23.59)777 (20.86)
糖尿病
否5 222 (94.60)3 548 (95.25)1.910.167
是298 (5.40)177 (4.75)
社会活动
否2 765 (50.09)2 124 (57.02)42.86<0.001
是2 755 (49.91)1 601 (42.98)
), ArticleFig(id=1324050882987434812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, language=EN, label=Table 2, caption=

Associations between social activities frequency and CI in middle-aged and elderly adults and stratified analysis results [HR (95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
模型与分层取值HR (95%CI)P值
模型30.896 (0.864～0.928)<0.001
年龄（岁）<650.901 (0.854～0.952)<0.001
≥650.898 (0.857～0.942)<0.001
性别男性0.893 (0.845～0.942)<0.001
女性0.900 (0.858～0.944]<0.001
教育水平低0.915 (0.865～0.968)<0.001
高0.886 (0.845～0.930)<0.001
), ArticleFig(id=1324050883075515197, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050861386769140, language=CN, label=表2, caption=

中老年人参与社会活动频率与CI之间关联与的分层分析 [HR(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
模型与分层取值HR (95%CI)P值
模型30.896 (0.864～0.928)<0.001
年龄（岁）<650.901 (0.854～0.952)<0.001
≥650.898 (0.857～0.942)<0.001
性别男性0.893 (0.845～0.942)<0.001
女性0.900 (0.858～0.944]<0.001
教育水平低0.915 (0.865～0.968)<0.001
高0.886 (0.845～0.930)<0.001
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社会活动参与对中国中老年人认知功能障碍的延迟效应
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白元鹏 , 徐沛蒂 , 钟健 , 周亚婷 , 吴功华 , 张菊英 , 赵星
现代预防医学 | 健康与社会行为 2026,53(9): 1657-1662
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现代预防医学 |健康与社会行为 2026 , 53 (9) : 1657 -1662
社会活动参与对中国中老年人认知功能障碍的延迟效应
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白元鹏, 徐沛蒂, 钟健, 周亚婷, 吴功华, 张菊英 , 赵星
作者信息
  • 四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041
通讯作者:
张菊英，E-mail：
作者简介:

白元鹏（2000—），男，硕士在读，研究方向：流行病与卫生统计学

The delayed effects of social participation on cognitive impairment among Chinese middle-aged and older adults
Yuan-peng BAI, Pei-di XU, Jian ZHONG, Ya-ting ZHOU, Gong-hua WU, Ju-ying ZHANG , Xing ZHAO
Affiliations
  • Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202510297
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摘要
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目的

探讨中国中老年人社会活动参与与认知功能障碍（cognitive impairments，CI）发生风险的关系，并量化其能延迟发病年数。

方法

基于中国健康与养老追踪调查2011—2020年五轮随访数据，纳入基线无CI的9 245名受试者。构建多状态Markov模型，并以Cox模型估计社会活动频率与CI发生的关联；基于离散时间马尔可夫多状态模型和转移累积风险比较高、低社会参与情景的发病时间差异。

结果

社会活动频率每升高1个标准差，CI发生风险降低10.36%（HR=0.896，95%CI：0.864～0.928）。与低参与者相比，高参与者总体可使首次CI发生延后0.81年（95%CI：0.64～1.13）。分层分析显示，男性、年龄<65岁、教育水平较高、城市居民及未患慢性病者与较长的发病延迟时间相关；而女性、较高教育水平者以及患有慢性病者更高频率社会参与带来的延迟效益更为显著。

结论

更高频率的社会参与与更低的CI发生风险及更晚的发病时间相关，尤其在老龄慢性病患者中，其延迟发病的效果更为显著。推动社会参与促进与慢性病管理相结合的干预策略，可作为我国预防中老年CI的重要公共卫生措施。

社会参与  /  认知功能障碍  /  中老年人  /  多状态模型  /  CHARLS
Objective

To examine the association between social activity participation and incident cognitive impairment (CI) and to quantify the delay in onset among middle-aged and older adults in China.

Methods

Using five waves of longitudinal data from the China Health and Retirement Longitudinal Study (2011—2020), 9 245 participants without baseline CI were included in the study. A multi-state Markov model was constructed, and Cox models were used to estimate the association between social activity frequency and CI occurrence. Discrete-time Markov multi-state models and cumulative transition risks were utilized to compare the onset time differences between high and low social participation scenarios.

Results

Each 1 SD increase in social activity frequency was associated with a 10.36% lower risk of CI (HR=0.896, 95% CI: 0.864-0.928). Compared with low participation, high participation delayed the first CI occurrence by 0.81 years (95% CI: 0.64-1.13 years). Stratified analysis showed that males, those aged <65 years, those with higher education levels, urban residents, and those without chronic diseases were associated with longer delays in onset; whereas among females, those with higher education levels, and those with chronic diseases, the delay benefit of more frequent social participation was more pronounced.

Conclusion

Higher social participation is associated with both a lower CI risk and a later onset, with particularly notable delay among older adults with chronic conditions. Integrating social participation with chronic disease management may be a useful public-health strategy to prevent cognitive impairment among middle-aged and older adults in China.

Social participation  /  Cognitive impairment  /  Middle-aged and older adults  /  Multistate model  /  CHARLS
白元鹏, 徐沛蒂, 钟健, 周亚婷, 吴功华, 张菊英, 赵星. 社会活动参与对中国中老年人认知功能障碍的延迟效应. 现代预防医学, 2026 , 53 (9) : 1657 -1662 . DOI: 10.20043/j.cnki.MPM.202510297
Yuan-peng BAI, Pei-di XU, Jian ZHONG, Ya-ting ZHOU, Gong-hua WU, Ju-ying ZHANG, Xing ZHAO. The delayed effects of social participation on cognitive impairment among Chinese middle-aged and older adults[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1657 -1662 . DOI: 10.20043/j.cnki.MPM.202510297
正文
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认知功能障碍（cognitive impairments, CI）泛指记忆、注意、执行功能等认知域出现的持续性下降，表现为从主观认知下降至轻度认知障碍，最终进展为痴呆的连续谱系，其中痴呆是该谱系中最严重、最具负担的阶段[1]。痴呆的发病率随年龄增长而增加，随着全球人口老龄化，痴呆症患者数量迅速攀升[2]。在中国，因死亡率下降与预期寿命延长的人口结构转变，疾病谱正向年龄相关疾病倾斜，痴呆已成为老年人群重要的致残与死亡原因之一[3]。2019年我国老年痴呆症伤残调整生命年（disability-adjusted life years, DALYs）占总DALYs的1.56%，构成了巨大的公共卫生与社会经济压力[4]。
尽管痴呆发病与年龄及遗传易感性密切相关，但近年更多的证据表明，约45%的痴呆病例可通过干预生活方式及环境因素实现预防或延迟发作[5]。并且在该疾病谱中，CI阶段在一定程度上具有可逆性，因此，及早识别和干预CI，延缓其向痴呆的转归，是当前痴呆预防的重要策略与关键切入点[6]。在众多可干预因素中，社会参与被广泛认为与认知健康密切相关。目前，无论是国际研究还是基于中国老年人数据，如中国健康与养老追踪调查中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS），均显示频繁参与社会活动能够有效减缓认知衰退速率，显著降低CI发生风险[7-11]。然而，这些研究仍以认知功能水平或相对风险作为主要结局指标，仍缺乏基于中国中老年人群的研究系统量化社会参与对延迟CI发病的时间效应，并比较不同人群间的差异[6-7]。因此，本研究拟利用CHARLS 2011—2020年共五轮随访数据，分析社会参与与45岁及以上中老年人CI发生之间的关联，估算其延迟首次发病的时间，并进一步在不同人口学特征亚组中比较差异，从而为改善中老年人认知功能的干预策略提供具有时间尺度意义的实证依据及实践指导。
1　资料与方法
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1.1　数据来源
本研究数据源于CHARLS 2011—2020年的五轮全国随访[12]。研究对象纳入标准：（1）基线年龄≥45岁；（2）无阿尔茨海默病、帕金森病、脑萎缩等记忆相关疾病史；（3）基线完成认知测试且后续至少完成一次随访测试。排除标准：（1）基线已存在CI或相关疾病；（2）基线社会活动及关键协变量数据缺失；（3）后续四轮随访认知功能数据缺失。最终共纳入9 245名受访者，具体纳排流程见图1。
1.2　研究变量
1.2.1　认知功能
CHARLS 采用认知状态电话访谈（telephone interview for cognitive status-10,TICS-10）、10个词语回忆和图形绘制进行认知功能评估，具体包括：（1）日期定向，能否正确回答年、月、日、季节、星期，正确回答1项计1分；（2）计算能力，能否正确100连续减7计算五次，每正确回答1项计1分；（3）词语记忆，包括10个词的即时回忆和延迟回忆，每正确回忆1个词语计1分，取2次回忆平均分；（4）图形绘制，能否正确模仿绘制两个重叠的五边形，正确完成计1分。将上述各项得分相加，得到整体认知功能总分（范围0～21分），得分越高表明认知功能越好。若受试者认知功能评定得分低于该年龄组（每 5 岁分组）及受教育程度调整的均值减去标准差时，则判定为发生CI。事件发生时间定义为相邻两次访视的时间中点。
1.2.2　社会参与
社交活动参与频率通过询问参与者过去一个月内是否参与六项社交活动及其频率来评估。这六项社交活动包括：（1）与朋友互动；（2）打麻将、下棋、打牌或参加社区俱乐部；（3）为与你同住且不付费的家庭成员、朋友或邻居提供帮助；（4）参加体育、社交或其他类型的俱乐部；（5）参与社区相关组织；（6）做志愿者或慈善工作。参考先前研究[13]，每项活动评分：0=未参与，1=每周或更少，2=几乎每天。总分范围0～12，分数越高代表社会参与度越高。
1.2.3　协变量
参考既往文献中被反复证实社会参与与认知功能关系相关的变量以及潜在因果路径进行确定，纳入的协变量包括：（1）社会人口学特征变量包括年龄、性别（男性/女性）、婚姻状况（有配偶/无配偶）、居住地（城镇/乡村）、受教育情况（文盲、小学、中学、大学及以上），进一步以文盲和小学定义为低教育水平，中学和大学及以上定义为高教育水平，用于分层分析；（2）健康行为特征变量包括吸烟（是/否）、饮酒（是/否）、睡眠时长；（3）健康状况特征变量包括自评健康（良好、一般、差）、身体质量指数（body mass index,BMI）（消瘦、正常、超重、肥胖）、是否患有高血压（是/否）和是否患有糖尿病（是/否）。
1.3　统计方法
1.3.1　描述性分析
采用描述性统计方法描述受访者的基线特征。符合正态分布的连续变量以（均值±标准差）表示，非正态分布变量以中位数（四分位数间距）表示，组间比较采用t检验或Wilcoxon秩和检验；分类变量以频数（百分比）描述，组间比较采用χ2检验。检验水准α=0.05。
1.3.2　多状态模型
采用多状态Markov模型分析认知状态的转移过程。基于该模型估计各状态间的转移概率，并用于后续计算无CI年数和发病延迟时间。采用Cox比例风险模型估计社会参与与CI发生之间的关联。依次构建三个模型：模型1 仅调整调查时间和标准化社会活动频率总分（除以标准差）；模型2 在模型1基础上增加社会人口学特征变量；模型3在模型2基础上进一步增加所有其他协变量。以模型3作为最终模型进行分层分析。
1.3.3　延迟时间估计
为量化社会参与的延迟发病效应，设定两种暴露情景：社会参与总分的上四分位数（高参与度）与下四分位数（低参与度）。基于离散时间马尔可夫多状态模型和年龄特异性转换概率估算了无CI年数，其差值即为社会参与所延迟的发病时间[14]。采用bootstrap计算延迟时间的95%置信区间。采用双侧检验，检验水准α=0.05。分析使用R（版本：4.3.0）。
1.3.4　敏感性分析
敏感性分析通过修改年龄组（每10岁分组和不分年龄组），调整认知障碍判定标准，以验证结果稳健性。
2　结果
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2.1　基线特征
共纳入符合条件的9 245研究对象，平均年龄67.87岁，其中男性4 404人（47.6%），女性4 841人（52.4%）。在随访调查期间，共有3 725人（40.29%）发生CI。基线调查中4 356人参与过至少一次社会活动，4 889人未参加过任何社会的活动。两组基线分析结果显示，年龄、性别、居住地、教育水平、睡眠时长、高血压患病情况和参与社会活动情况的差异有统计学意义（P<0.05）；CI发生组中，未参与社会活动者比例更高。婚姻情况，吸烟、饮酒和糖尿病患病情况在两组间差异无统计学意义（P>0.05）。见表1。
2.2　关联分析
以是否发生CI为因变量，以参与社会活动频率除以标准差为自变量，将性别、婚姻状况、居住地、教育水平、吸烟、饮酒、睡眠时长、自评健康、BMI、高血压和糖尿病患病情况等协变量纳入Cox比例风险模型。模型1：HR=0.889（95%CI：0.859～0.921。模型2：HR=0.897（95%CI：0.856～0.919）。模型3在完全调整协变量后，社会活动频率分数每升高1个标准差，可以降低CI约10.36%的发生风险（HR=0.896, 95%CI：0.864～0.928）。自变量社会活动频率的标准化得分基本满足比例风险假设（χ2=1.960，P=0.162）。分别按照年龄、性别、教育水平分层后，社会活动频率升高均能降低CI风险。见表2。
2.3　不同人群的发生CI的延迟年数
在全部研究人群中，高社会活动频率和低社会活动频率的平均“无CI年数”分别为4.19和3.38年，即高社会活动频率可以延迟CI发生0.81（95%CI：0.64～1.13）年。与低社会活动频率者相比，高社会活动频率总体可将CI的发生延后约0.5～1.0年，除无糖尿病组外，其他亚组差异具有统计学意义。其中，男性、<65岁、高教育水平、城镇居民以及不患有高血压或糖尿病者中，其发病延迟时间更长；而社会参与带来的延迟效益在患有高血压、高教育水平以及女性中更为明显。其余各亚组结果见图2。
敏感性分析中，社会活动参与与CI发生之间的关联和效应量与主分析基本一致。年龄组每10岁分组下，发生CI 3 795人，社会活动频率分数每升高1个标准差，可以降低CI 10.43%的发生风险（HR=0.896, 95%CI：0.865～0.930）；高社会活动频率和低社会活动频率的平均“无CI年数”分别为4.17和3.39年，即高社会活动频率可以延迟CI发生0.78（95%CI：0.57～1.09）年。不使用年龄组分组下，发生CI 3 980人，社会活动频率分数每升高1个标准差，可以降低CI 10.31%的发生风险（HR=0.880, 95%CI：0.848～0.913）；高社会活动频率和低社会活动频率的平均“无CI年数”分别为4.34和3.52年，即高社会活动频率可以延迟CI发生0.82（95%CI：0.66～1.15）年。
3　讨论
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本研究提供了关于中国中老年人社会活动参与频率与延迟CI发生时间的定量证据。研究显示，社会参与频率每增加1个标准差，CI发生风险降低约10.36%（HR=0.896, 95%CI：0.864～0.928）。相较于低社会活动频率者，高社会活动频率参与者的CI发生时间平均延迟0.81年（95%CI：0.64～1.13）。分层分析显示，男性、年龄<65岁、教育水平较高、城市居民及未患慢性病者与较长的发病延迟时间相关；而在女性、较高教育水平者以及患有慢性病的人群中，社会参与带来的延迟效益更为显著。
本研究与既往研究一致，社会参与总体呈现对认知健康的保护作用[15-16]。与既往基于中国中老年人的CLHLS和 CHARLS 研究相比，本研究也得出一致结论，并具有一定补充意义[9-11,17]。在延迟效应方面，近期美国MAP数据提示高社会活动频率者痴呆发病平均晚约5年[18]，与本研究观察到的延后在方向上一致。文献指出，积极的社会互动可以减少社会隔离和孤独感，增强海马功能、默认网络连接性及全脑灰质体积[19]，从而缓解心理压力、提供认知刺激，延缓认知衰退进程[18,20]。以上证据共同表明，鼓励中老年人参与社会活动，是延缓痴呆发生的有效社区干预策略。
本研究分层分析显示，女性、低教育水平、居住农村以及患有慢性病的中老年人中与较短发病延迟年数相关。与现有研究一致，农村女性、教育水平偏低、脑力活动机会较少、以及患有糖尿病者均与痴呆风险升高相关，且发病年龄越早，后续认知衰退风险越高[21-22]。另一方面，本研究发现更高频率的社会参与可对女性、高教育水平及患有慢性病的人群带来更大的发病延迟时间获益。可能机制包括：女性更善于从高质量社会关系中获取支持[23]；高教育水平者更倾向于积极参与社会活动，形成认知保护的协同效应[24]；社会参与可部分缓解共病相关的认知下降[25]等因素有关。丰富的社区资源有助于提供优质社会活动，进而保护认知功能延长健康预期寿命[26]，若能将痴呆发病平均延迟1年，可以显著降低照护负担[27]。在共病老年人日益增多的背景下，政府与社区应在应将促进社会参与与慢病管理相结合，实施综合性干预，同时拓展为老服务项目，鼓励社会文化参与，从而在降低痴呆发生、提升老年人整体认知健康中发挥关键作用。
本研究基于全国代表性队列，采用多状态模型校正竞争风险，量化了社会参与对中国中老年人CI发生时间的影响，为相关防控策略的制定提供了依据。本研究也存在一定局限：首先，作为观察性研究，虽已控制多种混杂因素，但仍难以完全避免残余混杂（如环境、遗传等）以及失访与死亡导致的信息偏倚；其次，社会活动与认知评估依赖问卷与量表，可能存在测量误差与结局错分，未来可结合医疗诊断数据提升准确性；最后，结论外推至其他社会文化背景地区时需谨慎，建议后续开展跨文化比较研究。
综上所述，在中国中老年人群中，更高频率的社会参与与CI发生风险降低及发病时间延迟显著相关。在人口老龄化持续深化的背景下，推动中老年人可及、可持续的社区社会参与，并将其与慢性病管理有机结合，有助于为地方政府与基层卫生系统提供可行的干预路径，推动实现“健康老龄化”与“积极老龄化”的战略目标，切实维护与提升老年人群的认知健康水平。
基金
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  • 国家自然科学基金(81973151)
  • 四川省自然科学基金项目(2025ZNSFSC1774)
  • 国家资助博士后研究人员计划(GZB20250191)
文献
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参考文献 引证文献
排序方式：
[1]
Cappa SF, Ribaldi F, Chicherio C, et al. Subjective cognitive decline：Memory complaints, cognitive awareness, and metacognition [J]. Alzheimer's & Dementia：the Journal of the Alzheimer's Association, 2024, 20(9): 6622-6631.
[2]
Jia LF, Du YF, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China：a cross-sectional study [J]. LANCET PUBLIC HEALTH, 2020, 5(12): e661-e671.
[3]
Yin YH, Tam HL, Quint J, et al. Epidemiology of dementia in China in 2010-2020：A systematic review and Meta-Analysis [J]. Healthcare, 2024, 12(3): 334.
[4]
任汝静，殷鹏，王志会，等. 中国阿尔茨海默病报告2021 [J]. 诊断学理论与实践，2021, 20(4):317-337.
Ren RJ, Yin P, Wang ZH, et al. China Alzheimer disease report 2021 [J]. Journal of Diagnostics Concepts & Practice, 2021, 20(4): 317-337. (In Chinese)
[5]
Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care：2024 report of the Lancet standing Commission [J]. Lancet, 2024, 404(10452): 572-628.
[6]
Overton M, Sjögren B, Elmsåthl S, et al. Mild cognitive impairment, reversion rates, and associated factors：comparison of two diagnostic approaches [J]. Journal of Alzheimer's Disease, 2023, 91(2): 585-601.
[7]
Su SZ, Shi L, Zheng YB, et al. Leisure activities and the risk of dementia：a systematic review and meta-analysis [J]. Neurology, 2022, 99(15): e1651-e1663.
[8]
Sommerlad A, Kivimäki M, Larson EB, et al. Social participation and risk of developing dementia [J]. Nature Aging, 2023, 3(5): 532-545.
[9]
Ni P, Chen HX, Hu XY. Association between social engagement decline and cognitive function changes：mediating effect of depressive symptoms [J]. Aging Clinical and Experimental Research, 2024, 37(1): 7.
[10]
Li X, Feng HS, Chen QL. Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment：a latent class analysis [J]. Front Med（Lausanne）, 2025, 12: 1493359.
[11]
鲍瑞，毛慧娟，宋花玲，等. 社会活动参与对我国老年人认知功能的影响——基于中国健康与养老追踪调查数据 [J]. 数理医药学杂志，2024, 37(1):41-51.
Bao R, Mao HJ, Song HL, et al. The impact of social activity participation on cognitive function among Chinese elderly：based on data from China Health and Retirement Longitudinal Study [J]. Journal of Mathematical Medicine, 2024, 37(1): 41-51. (In Chinese)
[12]
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.
[13]
Fang BY, Huang JJ, Zhao XY, et al. Concurrent and lagged associations of social participation and frailty among older adults [J]. Health & Social Care in the Community, 2022, 30(6): e4812-e4820.
[14]
Li CS, Wang LL, Ding LY, et al. Determinants and inequities in healthy working Life expectancy in China [J]. Nature Medicine, 2024, 30(11): 3318-3326.
[15]
Wu WW, Chen GC, Ren XH, et al. The prevalence of mild cognitive impairment in China：evidence from a Meta-Analysis and systematic review of 393, 525 adults [J]. Neuroepidemiology, 2025, 59(3): 259-276.
[16]
Zhang X, Zhou W. Association of blood cell indices and anemia with risk of incident dementia：Missing important covariates in MRI analysis May be misleading [J]. Alzheimer's & Dementia: the Journal of the Alzheimer's Association, 2024, 20(2): 1465.
[17]
Mose A, Chen YH, Tan XS, et al. Association of social integration with cognitive function trajectories among Chinese older adults：evidence from the China health and retirement longitudinal study（CHARLS） [J]. Frontiers in Aging Neuroscience, 2023, 15: 1322974.
[18]
Chen Y, Grodstein F, Capuano AW, et al. Late-Life social activity and subsequent risk of dementia and mild cognitive impairment [J]. Alzheimer's & Dementia: the Journal of the Alzheimer's Association, 2024, 21(1): e14316.
[19]
Shen C, Rolls . Cheng W, et al. Associations of social isolation and loneliness with later dementia [J]. Neurology, 2022, 99(2): e164-e175.
[20]
Zhang W, Zhang JJ, Gao N. Social isolation and cognitive decline in older adults：a longitudinal study across 24 countries [J]. BMC Geriatrics, 2025, 25(1): 775.
[21]
Leung Y, Eramudugolla R, Cherbuin N, et al. Estimating gender differences in the association between cognitive resilience and mild cognitive impairment incidence [J]. Gerontology, 2024, 70(7): 776-784.
[22]
Wang KL, Zhao S, Lee EKP, et al. Risk of dementia among patients with diabetes in a multidisciplinary, primary care management program [J]. JAMA Netw Open, 2024, 7(2): e2355733.
[23]
Xu JP, Kang Z, Hao XN, et al. Gender differences in the impact of emotional support networks on health-related quality of Life among floating elderly：a cross-sectional study in China [J]. BMC Geriatrics, 2025, 25(1): 765.
[24]
Liu Y, Lu G, Liu L, et al. Cognitive reserve over the Life course and risk of dementia：a systematic review and meta-analysis [J]. Frontiers in Aging Neuroscience, 2024, 16: 1358992.
[25]
Posis A, Shadyab AH, Parada H, et al. Multimorbidity, social engagement, and age-related cognitive decline in older adults from the Rancho Bernardo Study of Healthy Aging [J]. J Alzheimers Dis：JAD, 2024, 97(4): 1689.
[26]
Yoshikawa M, Goto E, Shin JH, et al. Regional disparities in Dementia-free Life Expectancy in Japan：An ecological study, using the Japanese long-term care insurance claims database [J]. PLOS One, 2023, 18(5): e0280299.
[27]
Brück CC, Wolters FJ, Ikram MA, et al. Projections of costs and quality adjusted Life years lost due to dementia from 2020 to 2050：A population-based microsimulation study [J]. Alzheimer's & Dementia：the Journal of the Alzheimer's Association, 2023, 19(10): 4532-4541.
2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202510297
  • 接收时间：2025-10-19
  • 首发时间：2026-11-02
  • 出版时间：2026-05-10
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  • 收稿日期：2025-10-19
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国家自然科学基金(81973151)
四川省自然科学基金项目(2025ZNSFSC1774)
国家资助博士后研究人员计划(GZB20250191)
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    四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041

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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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