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  • Prospective association between social engagement and cognitive impairment among middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study

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Public health
Original research
Prospective association between social engagement and cognitive impairment among middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study
  1. Shuduo Zhou1,2,
  2. Suhang Song3,
  3. Yinzi Jin1,2,
  4. Zhi-Jie Zheng1,2
  1. 1Department of Global Health, Peking University Health Science Centre, Beijing, China
  2. 2Institute for Global Health, Peking University, Beijing, China
  3. 3China Center for Health Development Studies, Peking University, Beijing, China
  1. Correspondence to Dr Yinzi Jin; yzjin{at}bjmu.edu.cn

Abstract

Objectives Cognitive impairment is a precursor of dementia. This study aimed to examine the association of social engagement with cognitive decline during the process of normal ageing.

Methods We used data from the China Health and Retirement Longitudinal Study. The cognitive functions were tested at baseline, and 2-year and 4-year follow-up visits. Social engagement was constructed as a comprehensive measure including the quantity and frequency of social activities. Activities of social engagement were classified into three types. Multilevel logistic model was fitted to evaluate the prospective association between social engagement and cognitive impairment.

Results After 2-year follow-up, compared with participants with the lowest level of social engagement, those with level-2, level-3 and level-4 social engagement had a 12% (OR=0.88, 95% CI 0.71 to 1.09, p=0.242), 17% (OR=0.83, 95% CI 0.71 to 0.97, p=0.020) and 25% (OR=0.75, 95% CI 0.61 to 0.93, p=0.008) lower risk for developing cognitive impairment, respectively. A similar pattern of significantly protective association was found at 4-year follow-up. Combined effect analysis showed that participants who attended one type of social engagement had a lower risk of developing cognitive impairment and the protective effect was even larger with those who attended two or three types of social engagement.

Conclusions Social engagement had a protective effect on cognitive impairment among middle-aged and older adults in China. Given the growing epidemic of dementia and rapid pace of ageing in low-income and middle-income countries, our study shed lights on comprehensive and tailored public health programmes for improving social engagement, to delay cognitive impairment at mid-age and later life.

  • health policy
  • dementia
  • public health
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-040936

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    Footnotes

    • Contributors SZ: drafting the manuscript, study design, data analysis and interpretation. SS: critical revision of article for important intellectual content. YJ: study concept and design, data analysis and critical revision of article for important intellectual content. Z-JZ: critical revision of article for important intellectual content. All authors gave final approval of the version to be published.

    • Funding This paper was supported by the Beijing Municipal Natural Science Foundation (No. 9204025). The study sponsor has no role in study design, data analysis and interpretation of data, the writing of manuscript, or the decision to submit the paper for publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval All participants provided written informed consent, and ethical approval for collecting data on human subjects was received and updated annually at Peking University Institutional Review Board (IRB00001052-11015). Ethics approval for the use of China Health and Retirement Longitudinal Study data was obtained from the University of Newcastle Human Research Ethics Committee (H-2015-0290).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open access repository at http://charls.pku.edu.cn.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.