To explore the impact of psychological resilience and various types of social participation, as well as their interaction, on cognitive impairment in older adults.

This study utilized data from the 2018 China Longitudinal Healthy and Longevity Survey (CLHLS). Analyses were conducted using χ² tests, logistic regression, restricted cubic splines, and additive interaction models.

Cognitive impairment was observed in 1 421 elderly individuals (19.46%). Risk factors for cognitive impairment included lack of domestic participation (OR=1.73, 95% CI: 1.48-2.02), lack of socialization (OR=1.75,95% CI: 1.45-2.11), lack of leisure activities (OR=1.86, 95% CI: 1.52-2.28), and low psychological resilience (OR=1.58, 95%CI: 1.35-1.84). Among elderly individuals with low psychological resilience, non-linear dose-response relationships were observed between three types of social participation and cognitive impairment (P-overall<0.01, P-nonlinear<0.01). An additive interaction between low psychological resilience and lack of social participation in cognitive impairment was identified. Using elderly individuals with high psychological resilience and corresponding types of social participation as the control group, the risk of cognitive impairment for elderly individuals with low psychological resilience and no domestic, no socialization, or no leisure activities was 3.13 (OR=3.13, 95% CI: 2.51-3.91) times, 2.77 (OR=2.77, 95% CI: 2.06-3.72) times, and 3.75 (OR=3.75, 95% CI: 2.93-4.81) times higher, respectively, compared to the control group.

Lack of social participation, low psychological resilience, and their interactions increase the risk of cognitive impairment, suggesting that comprehensively enhancing both psychological resilience and social participation in older adults may improve cognitive function.