日常生活活动能力在老年人社会隔离与认知功能间的中介效应

Mediating effect of activities of daily living between social isolation and cognitive function in elderly people

目的:分析日常生活活动能力(ADL)在老年人社会隔离与认知功能间的中介作用。方法:基于2018年中国健康与养老追踪调查(CHARLS)数据,筛选出符合标准的研究对象6702人,采用结构方程模型分析ADL在老年人社会隔离与认知功能间的中介作用。结果:社会隔离和ADL是认知功能的显著预测因素(均P<0.05)。ADL在老年人社会隔离与认知功能间存在中介作用。结构方程模型拟合指标分别为:χ^(2)/df=4.407,TLI=0.983,GFI=0.997,CFI=0.986,RMSEA=0.023,显示模型拟合良好。社会隔离对认知功能的直接效应为0.277(95%CI:0.143~0.409),以ADL为中介的间接效应为0.041(95%CI:-0.074~-0.034)。结论:老年人的社会隔离、ADL可以预测其认知功能,其中社会隔离可以直接影响认知功能,也可以通过ADL的部分中介效应间接影响认知功能。

Objective:To analyze the mediating effect of activities of daily living(ADL)between social isolation and cognitive function in elderly people.Methods:Based on the 2018 China Health and Retirement Longitudinal Survey(CHARLS)data,6702 subjects who met the criteria were selected.Structural equation model was used to analyze the mediating effect of ADL between social isolation and cognitive function in elderly people.Results:Social isolation and ADL were significant predictors of cognitive function(both P<0.01).ADL had mediating effect between the social isolation and cognitive function in elderly people.The structural equation model fitted well(the fitting indexes including:χ^(2)/df=4.407,TLI=0.983,GFI=0.997,CFI=0.986,and RMSEA=0.023).The direct effect of social isolation on cognitive function was 0.277(95%CI:0.143-0.409),and the indirect effect mediated by ADL was 0.041(95%CI:-0.074--0.034).Conclusion:The social isolation and ADL of the elderly can predict their cognitive function.Social isolation can not only directly affect cognitive function,but also indirectly affect cognitive function of the elderly through some mediating effects of ADL.