Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China
Abstract Background Living arrangements are critical to the survival and well-being of older people, especially in China where the filial piety culture demands adult children care for and serve their parents. The study aimed to explore the association between living arrangements and cognitive declin...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-03473-x |
| _version_ | 1828098597508349952 |
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| author | Yifan Yu Junqi Lv Jing Liu Yueqiao Chen Kejin Chen Yanfang Yang |
| author_facet | Yifan Yu Junqi Lv Jing Liu Yueqiao Chen Kejin Chen Yanfang Yang |
| author_sort | Yifan Yu |
| collection | DOAJ |
| description | Abstract Background Living arrangements are critical to the survival and well-being of older people, especially in China where the filial piety culture demands adult children care for and serve their parents. The study aimed to explore the association between living arrangements and cognitive decline among older people in China. Methods Participants included 6,074 older adults over 60 years old (49.65% male, mean age 67.2 years [range 60–98]) from four waves (2011–2018) of the China Health and Retirement Longitudinal Study. Two to four assessments were conducted over a follow-up of an average of 5.3 years (range, 2–7). Cognitive function was assessed using an adapted Chinese version of Mini-Mental State Examination (MMSE). Living arrangements were classified as follows: living alone, living with spouse, living with adult children, living with spouse and adult children and living with others. Multilevel models were used to investigate the relationship between living arrangements and cognitive decline, as well as the gender difference. Results As the main type of living arrangements of the study participants (44.91%), living with spouse was taken as the reference group. Compared to the reference group, living alone (β=-0.126, P < 0.001), living with adult children (β=-0.136, P < 0.001), living with spouse and adult children (β=-0.040, P < 0.05) and living with others (β=-0.155, P < 0.05) were all related to a faster rate of cognitive decline. Further, the association between living arrangements and cognitive decline varied by gender. Living alone (β=-0.192, P < 0.001) was associated with a faster cognitive decline only in older men. Living with spouse and adult children (β=-0.053, P < 0.05) and living with others (β=-0.179, P < 0.05) were associated with faster cognitive decline only in older women. Conclusion This study suggests that living arrangements in older people in China were associated with cognitive decline, and these associations varied by gender. Greater attention to living arrangements might yield practical implications for preserving the cognitive function of the older population. |
| first_indexed | 2024-04-11T08:03:35Z |
| format | Article |
| id | doaj.art-5936af7a219d4ea2a52b0aa7b634ad88 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-11T08:03:35Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-5936af7a219d4ea2a52b0aa7b634ad882022-12-22T04:35:37ZengBMCBMC Geriatrics1471-23182022-11-0122111210.1186/s12877-022-03473-xAssociation between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in ChinaYifan Yu0Junqi Lv1Jing Liu2Yueqiao Chen3Kejin Chen4Yanfang Yang5Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityAbstract Background Living arrangements are critical to the survival and well-being of older people, especially in China where the filial piety culture demands adult children care for and serve their parents. The study aimed to explore the association between living arrangements and cognitive decline among older people in China. Methods Participants included 6,074 older adults over 60 years old (49.65% male, mean age 67.2 years [range 60–98]) from four waves (2011–2018) of the China Health and Retirement Longitudinal Study. Two to four assessments were conducted over a follow-up of an average of 5.3 years (range, 2–7). Cognitive function was assessed using an adapted Chinese version of Mini-Mental State Examination (MMSE). Living arrangements were classified as follows: living alone, living with spouse, living with adult children, living with spouse and adult children and living with others. Multilevel models were used to investigate the relationship between living arrangements and cognitive decline, as well as the gender difference. Results As the main type of living arrangements of the study participants (44.91%), living with spouse was taken as the reference group. Compared to the reference group, living alone (β=-0.126, P < 0.001), living with adult children (β=-0.136, P < 0.001), living with spouse and adult children (β=-0.040, P < 0.05) and living with others (β=-0.155, P < 0.05) were all related to a faster rate of cognitive decline. Further, the association between living arrangements and cognitive decline varied by gender. Living alone (β=-0.192, P < 0.001) was associated with a faster cognitive decline only in older men. Living with spouse and adult children (β=-0.053, P < 0.05) and living with others (β=-0.179, P < 0.05) were associated with faster cognitive decline only in older women. Conclusion This study suggests that living arrangements in older people in China were associated with cognitive decline, and these associations varied by gender. Greater attention to living arrangements might yield practical implications for preserving the cognitive function of the older population.https://doi.org/10.1186/s12877-022-03473-xLiving arrangementsOlder adultsCognitive declineMultilevel modellingLongitudinal study |
| spellingShingle | Yifan Yu Junqi Lv Jing Liu Yueqiao Chen Kejin Chen Yanfang Yang Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China BMC Geriatrics Living arrangements Older adults Cognitive decline Multilevel modelling Longitudinal study |
| title | Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China |
| title_full | Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China |
| title_fullStr | Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China |
| title_full_unstemmed | Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China |
| title_short | Association between living arrangements and cognitive decline in older adults: A nationally representative longitudinal study in China |
| title_sort | association between living arrangements and cognitive decline in older adults a nationally representative longitudinal study in china |
| topic | Living arrangements Older adults Cognitive decline Multilevel modelling Longitudinal study |
| url | https://doi.org/10.1186/s12877-022-03473-x |
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