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Incontinence and cognitive function in Chinese old adults: multiple mediating effects of social participation and
Xinlin Li1, Tingyao Nie1, Lu Lin2
1Department of Geriatrics, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
Background:
China has entered a stage of deep aging. The cognitive function level of the old adults is not only an important indicator to measure their health status and quality of life, but also a key factor reflecting their social adaptability and overall physical and mental state. Against this backdrop, incontinence, as a common health issue among the old adults, not only affects their daily lives but may also further impair cognitive functions through multiple psychological and social mechanisms. Therefore, in order to gain a more comprehensive understanding of the potential pathways of interaction between incontinence and cognitive function in the old adults, this study aims to explore the multiple mediating effects of social participation and depressive symptoms in the relationship between the two, providing theoretical basis and practical reference for promoting cognitive health and enhancing the overall well-being of the old adults.
Methods:
According to the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, a total of 9,299 Chinese old adults aged 65 and above were selected. Firstly, the basic socio-demographic characteristics of the sample population were described. Secondly, a Spearman correlation analysis was conducted to examine the associations among incontinence, social participation, depressive symptoms and cognitive function in the old adults. Finally, sequential multiple mediating analysis was conducted using SPSS Macro PROCESS 4.0 to evaluate the potential mediating role of social participation and depressive symptoms.
Results:
Incontinence, social participation, depressive symptoms and cognitive function were significantly correlated (p < 0.01). Incontinence is not only directly related to the cognitive function of the old adults (effect = -4.1964; but also has a standard error of 0.2219. 95% confidence interval: LL = -4.6314, UL = -3.7615), and the independent mediating effect of social participation (effect = -0.2256; standard error = 0.0271; 95% confidence interval: LL = -0.2795, UL = -0.1722), independent mediating effect of depressive symptoms (effect = -0.0856; standard error = 0.0285; 95% confidence interval: LL = -0.1438, UL = -0.0328), the chain mediating effect between social participation and depressive symptoms (effect = -0.0096; standard error = 0.0022;95% confidence interval: LL = -0.0142, UL = -0.0057) was associated with major cognitive function.
Conclusion:
This study suggested that social participation and depressive symptoms may be involved in the association between incontinence and cognitive function among older adults in China. These findings highlight the importance of paying attention to social participation and depressive symptoms in older adults with incontinence, which may help inform strategies for cognitive health promotion.
