journal articles
TRAJECTORIES OF SOCIAL PARTICIPATION AND RISK OF COGNITIVE IMPAIRMENT IN CHINESE OLDER ADULTS: A SIX-YEAR LONGITUDINAL STUDY
Kangle Wang, Ruihan Wan, Jiale Peng, Huanghao Zhou, Kaifeng Xu, Hao Liu, Lidian Chen, Zhizhen Liu
BACKGROUND: The growing burden of cognitive decline represents a significant public health concern in aging populations, particularly in China. Social participation is a modifiable factor that may protect against cognitive decline, yet its long-term dynamic association with cognitive impairment remains insufficiently characterized.
OBJECTIVES: This study aimed to delineate long-term trajectories of social participation and determine their association with cognitive impairment in Chinese older adults.
DESING: Longitudinal cohort study.
SETTING: The study utilized data collected in 2013, 2015, and 2018 from the China Health and Retirement Longitudinal Study.
PARTICIPANTS: We included 3074 Chinese adults aged ≥60 years who were free of cognitive impairment in 2013, had complete social participation data in 2013/2015/2018, and completed cognitive assessments in 2018
INTERVENTION(S): Not applicable.
MEASUREMENTS: Social participation was derived from CHARLS self-reported activity items and frequency and summed into a composite score (range 0–33). Cognitive performance was assessed using episodic memory (immediate and delayed 10-word recall) and mental status (orientation, serial subtraction, and figure drawing), yielding a global score (range 0–31); cognitive impairment was defined as a score <11. Group-based trajectory modeling identified five social participation trajectories. Multivariable logistic regression estimated odds ratios (ORs) for cognitive impairment adjusting for sociodemographic, health, and behavioral covariates.
RESULTS: Five distinct social participation trajectories were identified. In the fully adjusted model, relative to the “stable low” group, those in the “low baseline–increasing” (OR = 0.66, 95% CI: 0.47–0.92), “stable intermediate” (OR = 0.75, 95% CI: 0.58–0.97), and “stable high” (OR = 0.41, 95% CI: 0.22–0.76) groups had markedly reduced chances of cognitive impairment, while no significant link was found for the “moderate decline” group (OR = 0.90, 95% CI: 0.71–1.17).
CONCLUSIONS: Maintaining or increasing one’s social activities was linked to a notably lower likelihood of cognitive decline. These results highlight the importance of social involvement patterns as a modifiable factor for fostering cognitive strength. Interventions to maintain or enhance participation are therefore a viable strategy for the primary prevention of cognitive decline in older adults.
CITATION:
Kangle Wang ; Ruihan Wan ; Jiale Peng ; Huanghao Zhou ; Kaifeng Xu ; Hao Liu ; Lidian Chen ; Zhizhen Liu (2026): Trajectories of social participation and risk of cognitive impairment in Chinese older adults: A six-year longitudinal study. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjpad.2026.100499