Factors associated with cognitive function among community-dwelling older adults in Korea: A cross-sectional study in...

Cognitive decline is an increasingly important public health issue among older adults, particularly those residing in medically underserved areas with limited access to healthcare services. This study aimed to examine the associations of presbycusis, loneliness, frailty, and depression with cognitive function and to identify factors independently associated with cognitive function among community-dwelling older adults residing in medically underserved areas. A cross-sectional survey was conducted among 149 community-dwelling older adults aged 65 years or older residing in medically underserved areas of South Korea. Standardized questionnaires were administered to assess presbycusis, loneliness, frailty, depression, and cognitive function. Data were analyzed using Pearson correlation coefficients and stepwise multiple linear regression to identify factors independently associated with cognitive function. Cognitive function was significantly and negatively correlated with presbycusis (r = -.32, P < .001), loneliness (r = -.20, P = .001), frailty (r = -.40, P < .001), and depression (r = -.43, P < .001). In the multiple regression analysis, completion of middle school or higher (β = .47, P < .001), age 65 to 74 years (β = .29, P < .001), completion of elementary school (β = .25, P < .001), absence of back pain (β = .16, P = .010), lower depression scores (β = -.14, P = .027), and absence of stroke (β = .13, P = .024) were independently associated with cognitive function. The final stepwise regression model was statistically significant (F = 29.88, P < .001) and explained 53.9% of the variance in cognitive function. Educational attainment, age, depression, stroke, and back pain were independently associated with cognitive function among community-dwelling older adults residing in medically underserved areas. These findings support the importance of community-based strategies that consider educational, physical, and psychological factors to promote cognitive health in this population. However, because of the cross-sectional design, causal relationships could not be established. Future longitudinal studies are warranted to confirm these associations and further clarify the mechanisms underlying these associations among older adults living in medically underserved areas.