童年社会经济地位对中老年认知功能影响的中介效应路径分析

A Path Analysis of the Effect of Childhood Socioeconomic Status on Cognitive Function in Middle-aged and Older Adults

背景童年经历对中老年健康的影响已成为研究热点,但其对中老年认知功能的影响效应及路径尚不明确。目的从全生命周期视角分析童年社会经济地位对中老年认知功能的影响,探讨中老年认知功能的促进策略。方法本研究运用中国家庭追踪调查(CFPS)2010、2012、2020年数据,构建多重中介效应模型,研究童年社会经济地位对中老年认知功能影响的中介效应路径。采用Pearson相关性分析探讨各指标的关系。结果本研究共纳入1034位中老年人,平均年龄为(62.33±9.89)岁。其童年社会经济地位得分为(0.000±0.797)分,个体受教育水平得分为(1.970±1.111)分,社会参与得分为(1.150±0.967)分,抑郁状况得分为(5.960±4.681)分,中老年认知得分为(0.000±1.000)分。童年社会经济地位与受教育水平、社会参与、中老年认知功能均呈正相关(P<0.05),与抑郁状态呈负相关(P<0.05)。多重中介模型回归结果显示,在控制年龄、性别、城乡、慢性病患病、医疗服务利用的情况下,童年社会经济地位对中老年认知功能影响的直接效应不显著(β=0.054,t=1.400,P=0.162),受教育水平、社会参与、抑郁状况显著影响中老年认知功能(β=0.335,t=11.622,P<0.05;β=0.064,t=2.166,P<0.05;β=-0.019,t=-3.154,P<0.05)。中介效应检验结果显示,受教育水平、社会参与在童年社会经济地位与中老年认知之间的简单中介作用有统计学意义(95%CI=0.141~0.223;95%CI=0.001~0.019),受教育水平、社会参与的链式中介效应有统计学意义(95%CI=0.001~0.017),受教育水平、抑郁状况的链式中介效应有统计学意义(95%CI=0.001~0.008)。结论受教育水平是童年社会经济地位影响中老年认知功能的资源路径;社会参与是童年社会经济地位影响中老年认知功能的条件路径;抑郁状况是影响中老年认知功能的风险因素。应基于生命历程理论,从个人、家庭、社会多个层面关注童年期社会经济地位的影响,制订中老年认知促进策略。

Background The effects of childhood experiences on the health of middle-aged and older adults has become a research hotspot.However,the effects and pathways of childhood experiences on cognitive function in middle-aged and older adults still remain unclear.Objective To analyze the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults from a whole life cycle perspective,and explore promotion strategies for cognitive function in middle-aged and older adults.Methods The China Family Panel Studies(CFPS)for 2010,2012,and 2020 was used to construct a multiple mediated-effects model to investigate the mediating pathways of the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults.Pearson correlation analysis was used to analyze the relationship between various indicators.Results A total of 1034 middle-aged and older adults with an average age of(62.33±9.89)years were included in this study.The childhood socioeconomic status score was(0.000±0.797),education level score was(1.970±1.111),social participation score was(1.150±0.967),depression status score was(5.960±4.681),and cognitive score was(0.000±1.000).Childhood socioeconomic status was positively correlated with education level,social participation,and cognitive function in middle-aged and older adults(P<0.05),and negatively correlated with depressive status(P<0.05).The results of Multiple mediation model regression analysis showed that childhood socioeconomic status had no significant direct effects on cognitive function of middle-aged and older adults(β=0.054,t=1.400,P=0.162),education level,social participation,and depression status significantly affected cognitive function in middle-aged and older adults(β=0.335,t=11.622,P<0.05;β=0.064,t=2.166,P<0.05;β=-0.019,t=-3.154,P<0.05)when controlled for age,gender,urban/rural,chronic disease prevalence,and medical service utilization.The results of the mediation effect test showed that education level and social participation significantly affected cognitive function in the middle-aged and older adults(95%CI=0.141-0.223;95%CI=0.001-0.019).There was a statistically significant chain mediated effect of education level and social participation(95%CI=0.001-0.017),as well as education level and depression status(95%CI=0.001-0.008).Conclusion Education level is the resource pathway through which childhood socioeconomic status affects cognitive function in middle-aged and older adults;social participation is a conditional path through which childhood socioeconomic status affects cognitive function in the middle-aged and older adults;depression is a risk factor affecting cognitive function in middle-aged and older adults.Based on the life course theory,attention should be paid to the effect of childhood socioeconomic status from multiple levels of individual,family,and society,to develop cognitive function promotion strategies for the middle-aged and older adults.