Full
Outline
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.
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.
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.
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.
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| 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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