老年人志愿活动对认知功能的纵向影响:基于美国健康与退休研究的二次数据分析

Longitudinal impact of volunteering on the cognitive functioning of older adults:A secondary analysis from the US Health and Retirement Study

目的研究志愿活动与退休老年人认知活动、社会活动和身体活动的关系,以及与其不同时期认知功能的关系。方法资料来源于美国健康与退休研究小组数据中2008年、2012年和2016年的3波数据(n=2862)。使用自我报告问卷评估老年人的年度志愿服务频率(无志愿服务,<100 h和≥100 h),并使用认知状态电话访谈(Telephone Interview for Cognitive Status,TICS)修订版评估老年人的记忆、思维、知识、语言和定位等。应用结构方程模型评估退休老年人志愿活动对其认知功能的长期影响。结果与未参加志愿活动者相比,2012年参加志愿活动的老年人在2008—2012年中等体力活动增加(一年志愿活动少于100h者β=0.19,P<0.001;一年志愿活动至少100 h者β=0.21,P<0.001),社交活动增加(前者β=0.10,P=0.052;后者β=0.12,P=0.018),认知活动增加(一年志愿活动至少100h者β=0.13,P<0.001)。2008年和2012年较高的认知活动水平与随后的研究时间段较高认知功能存在关联(β=0.66,β=0.60,P<0.001)。讨论志愿活动是可人为改变的活动,可以通过增加老年人认知活动来改善老年人的认知功能。

Objectives:To examine the relationship of volunteering with cognitive activity,social activity,and physical activity among older adults and,ultimately,with later cognitive functioning across different time periods.Methods:We used individual responding to three waves of the US Health and Retirement Study panel data from 2008,2012,and 2016(n?2,862).Self-reported questionnaires were used to assess annual volunteering frequency(non volunteering,volunteering<100 h and100 h),and an adapted version of the Telephone Interview for Cognitive Status(TICS)was used to assess memory,mental processing,knowledge,language,and orientation.A structural equation model was estimated to assess effects on cognitive functioning throughout waves.Results:Those participants that were part of volunteering activities in 2012 showed an increase between 2008 and 2012 in moderate physical activity(b?0.19,P<0.001 for those volunteering less than 100 h and b?0.21,P<0.001 for those volunteering at least 100 h),increase in social activity(b?0.10,P?0.052 for those volunteering less than 100 h and b?0.12,P?0.018 for those volunteering at least 100 h)and increase in higher cognitive activity(b?0.13,P<0.001 for those volunteering at least 100 h),compared to participants who did not volunteer.Higher levels of cognitive activity in 2008 and 2012 were associated with higher cognitive functioning on the following waves(b?0.66 and b?0.60,P<0.001,respectively).Discussion:Volunteering is a modifiable activity that can be increased to bolster cognitive functioning in older adulthood,primarily mediated by increased cognitive activity.