认知功能在老年人社会资本与身体功能健康间的中介作用

Mediating effect of cognition on the relationship between social capital and functional health of elderly people

目的分析认知功能在社会资本对身体功能健康影响中的中介效应。方法基于2015年中国健康与养老全国追踪调查(CHARLS)数据,选取4451名老年人为研究对象,以社会信任、社会支持(经济支持和生活照料支持)、社会参与和互惠测量社会资本。总效应被分解为直接效应和间接效应,采用基于Karlson-Holm-Breen方法的Logistic回归分析探讨各效应。结果调整潜在混杂因素(包括年龄、婚姻状况、个人存款、识字状况、居住地、吸烟、饮酒、夜间睡眠时长、自评健康、所患慢性病情况及残疾状况)后,老年人中的高社会信任(OR=1.249,95%CI:1.072~1.455)、有照料支持(OR=1.351,95%CI:1.180~1.546)及有社会参与(OR=1.167,95%CI:1.021~1.334)者的身体功能更健康。认知功能在社会参与对身体功能健康影响的总效应中发挥了中介效应(OR=1.046,95%CI:1.008~1.085)。中介效应占总效应的29.22%。结论认知功能在社会资本对身体功能健康的影响中具有中介效应。提高老年人的社会资本水平不仅直接有助于提升其身体功能,而且还可通过增强其认知功能进而改善其身体功能。

Objective To estimate the mediating effect of cognition on the association between social capital and functional health.Methods The database of China Health and Retirement Longitudinal Study(CHARLS) was applied in the study and 4,451 seniors aged 60 years and above in Wave 4(2015) of the survey were retrieved.Social capital was measured by social trust,social support,social participation and reciprocity.The total effect was classified as direct effect and indirect effect through Logistic regression analysis based on the Karlson-Holm-Breen method.Results After the potential confounders were adjusted,including age,marital status,bank deposit,literacy,residence,smoking,drinking,sleep duration at night,self-rated health,chronic diseases and disability,older adults with high social trust(OR=1.249,95%CI:1.072-1.455),care(OR=1.351,95%CI:1.180-1.546) and social participation(OR=1.167,95%CI:1.021-1.334) had better functional health.Cognition played a mediating role in the total effect of social participation on functional health(OR=1.046,95%CI:1.008-1.085).The mediating effect of cognition accounted for 29.22% of the total effect.Conclusion Cognition has a mediating effect on the association between social capital and functional health.Improving the level of social capital of older adults can directly improve their functional health,and contribute to their physical function by enhancing cognition.