Association between change in social participation and improved cognitive function among older adults in China: A...

We aimed to assess the association between change in social participation and long-term improved cognitive function among older adults. Data were obtained from 9648 participants aged ≥60 years in the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, a national prospective cohort study. Cox regression models were used to calculate adjusted risk ratios (aRRs). Social participation was increased in 20.5% of the participants, decreased in 37.8% of the participants and stable in 41.7% of the participants from the 2011 wave to the 2014-2018 waves. The improved cognitive function rate was 17.9% at follow-up. Compared to individuals with decreased social participation from the 2011 wave to the 2014-2018 waves, individuals with unchanged total social participation were 59% (aRR = 1.59, 95% CI: 1.35-1.87) more likely to have improved cognitive function in the 2014-2018 waves, and individuals with increased social participation were 61% (aRR = 1.61, 95% CI: 1.43-1.82) more likely to have improved cognitive function, regardless of the baseline social participation status. As for the three forms of social participation, compared with the participants with decreased social participation, those with increased participation in organised social activities, increased participation in group leisure-time activities, unchanged informal social interactions and increased informal social interactions were 24% (aRR = 1.24, 95% CI: 1.02-1.51), 49% (aRR = 1.49, 95% CI: 1.21-1.84), 55% (aRR = 1.55, 95% CI: 1.37-1.76) and 57% (aRR = 1.57, 95% CI: 1.34-1.84) more likely to have improved cognitive function (all p < 0.05) respectively. The results were stable in the sensitivity analysis. Our findings highlight the importance of promoting social participation from a multidimensional perspective (duration, frequency and forms) to improve cognitive function among older adults, for policy makers and healthcare workers in the community.