Social Engagement and Cognitive Impairment in Older Chinese Adults: The Mediating Role of Psychological Well-Being

Abstract

Objective: The objective of this study was to explore the association between social engagement and cognitive impairment with psychological well-being (PWB) as a mediator in older Chinese adults and to further test the gender differences in this association. Method: Data were drawn from the Chinese Longitudinal Healthy Longevity Survey of older Chinese adults, aged 65 and older (N = 6,998). The total effect was decomposed into direct and indirect effects by logistic regression based on the Karlson, Holm, and Breen method. Results: Higher social engagement was significantly associated with lower odds of cognitive impairment, odds ratio (OR) = 0.89, 95% confidence interval (CI) = [0.82, 0.97]. Moreover, a better PWB would decrease the odds of cognitive impairment (OR = 0.96, 95% CI = [0.94, 0.98]). The mediating effect was 15.4% in the full sample and 13.1% in the men subsample. However, mediation was not significant in the women subsample. Discussion: Higher social engagement was associated with a decreased odds of cognitive impairment in older men, and this association was mediated by PWB.

Keywords: cognitive impairment; gender differences; mediating analysis; psychological well-being; social engagement.