Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurements
2.2.1. Cognitive Function
2.2.2. Instrumental Activities of Daily Living (IADL) Disability
2.2.3. Social Interaction
2.2.4. Lifestyle
2.2.5. Depressive Status
2.2.6. Covariates
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Total | Without IADL Disability | With IADL Disability | Statistics | |
---|---|---|---|---|---|
(n = 1976) | (n = 1400) | (n = 576) | t/χ2 | p-Value | |
Sociodemographic Variables | |||||
Age, year (SD) | 74.3 (7.4) | 72.4 (6.2) | 79.0 (7.9) | −17.896 | <0.001 |
Gender, n (%) | 20.212 | <0.001 | |||
Male | 1225 (62.0) | 912 (46.2) | 313 (15.8) | ||
Female | 751 (38.2) | 488 (24.7) | 263 (13.3) | ||
Education, year (SD) | 4.0 (4.0) | 4.5 (4.1) | 2.9 (3.5) | 8.630 | <0.001 |
Region of residence, n (%) | 0.039 | 0.844 | |||
Urban | 255 (12.9) | 182 (9.2) | 73 (3.7) | ||
Rural | 1721 (87.1) | 1218 (61.6) | 503 (25.5) | ||
Marital status, n (%) | 49.416 | <0.001 | |||
Married and living with a spouse | 1295 (65.5) | 985 (49.8) | 310 (15.7) | ||
Others | 681 (34.5) | 415 (21.0) | 266 (13.5) | ||
Occupation, n (%) | 9.346 | 0.009 | |||
Manual worker | 1633 (82.6) | 1136 (57.5) | 497 (25.2) | ||
Nonmanual worker | 295 (14.9) | 231 (11.7) | 64 (3.2) | ||
Others | 48 (2.4) | 33 (1.7) | 15 (0.8) | ||
HI/year, thousand yuan (SD) | 19.5 (22.2) | 19.4 (21.7) | 19.6 (23.5) | −0.169 | 0.866 |
MC/year, thousand yuan (SD) | 3.4 (13.5) | 3.4 (13.8) | 3.2 (12.7) | 0.341 | 0.733 |
Social interaction (SD) | 3.3 (1.9) | 3.6 (2.0) | 2.6 (1.3) | 12.141 | <0.001 |
Play cards and/or mah-jong | 1.8 (1.4) | 2.0 (1.5) | 1.4 (1.0) | 9.999 | <0.001 |
Organized social activities | 1.5 (1.1) | 1.6 (1.2) | 1.3 (0.8) | 7.595 | <0.001 |
Health-Related Variables | |||||
Drinking at present (2008), n (%) | 545 (27.6) | 417 (21.1) | 128 (6.5) | 11.688 | 0.001 |
Smoking at present (2008), n (%) | 572 (28.9) | 443 (22.4) | 129 (6.5) | 16.966 | <0.001 |
Exercise at present (2008), n (%) | 891 (45.1) | 628 (31.8) | 263 (13.3) | 0.106 | 0.745 |
Self-reported Health, n (%) | 0.171 | 0.918 | |||
Good | 1177 (59.6) | 838 (42.4) | 339 (17.2) | ||
Fair | 607 (30.7) | 427 (21.6) | 180 (9.1) | ||
Poor | 192 (9.7) | 135 (6.8) | 57 (2.9) | ||
Self-reported quality of life, n (%) | 5.545 | 0.063 | |||
Good | 1200 (60.7) | 831 (42.1) | 369 (18.7) | ||
Fair | 697 (35.3) | 506 (25.6) | 191 (9.7) | ||
Poor | 79 (4.0) | 63 (3.2) | 16 (0.8) | ||
Night sleep duration, hour (SD) | 7.6 (1.9) | 7.5 (1.8) | 7.7 (1.9) | −1.866 | 0.062 |
Self-reported sleep quality, n (%) | 0.665 | 0.717 | |||
Good | 1389 (70.3) | 978 (49.5) | 411 (20.8) | ||
Fair | 393 (19.9) | 285 (14.4) | 108 (5.5) | ||
Poor | 194 (9.8) | 137 (6.9) | 57 (2.9) | ||
Body mass index, kg/m2 (SD) | 21.8 (3.6) | 21.9 (3.6) | 21.5 (3.5) | 2.706 | 0.007 |
Chronic diseases, n (%) | |||||
Hypertension | 457 (23.1) | 308 (15.6) | 149 (7.5) | 3.434 | 0.064 |
Diabetes | 66 (3.3) | 50 (2.5) | 16 (0.8) | 0.796 | 0.372 |
Heart disease | 208 (10.5) | 144 (7.3) | 64 (3.2) | 0.295 | 0.587 |
Global cognitive function (SD) | 28.4 (2.3) | 28.6 (2.0) | 27.8 (2.7) | 6.553 | <0.001 |
Orientation | 11.6 (1.0) | 11.7 (0.9) | 11.5 (1.1) | 2.859 | 0.004 |
Memory | 5.5 (1.0) | 5.6 (0.9) | 5.4 (1.2) | 4.288 | <0.001 |
Attention and calculation | 5.4 (1.0) | 5.5 (0.9) | 5.1 (1.2) | 7.034 | <0.001 |
Language | 5.9 (0.4) | 5.9 (0.4) | 5.9 (0.4) | 2.306 | 0.021 |
Depressive status (SD) | 10.8 (3.4) | 10.3 (3.3) | 11.9 (3.5) | −9.690 | <0.001 |
Lifestyle, score (SD) | 1.8 (0.8) | 1.9 (0.8) | 1.7 (0.8) | 6.041 | <0.001 |
Fruit, n (%) | 902 (45.6) | 655 (33.1) | 247 (12.5) | 2.507 | 0.113 |
Vegetable, n (%) | 1838 (93.0) | 1221 (67.4) | 507 (25.7) | 31.229 | <0.001 |
Exercise, n (%) | 880 (44.5) | 680 (34.4) | 200 (10.1) | 31.688 | <0.001 |
Variables | Standardized Estimate | Standard Errors | LLCI | ULCI | p | Ratio |
---|---|---|---|---|---|---|
Direct effect on IADL | ||||||
Cognitive function | −0.007 | 0.072 | −0.124 | 0.147 | 0.885 | - |
Indirect effect | ||||||
Social interaction (a1 × b1) | −0.095 | 0.045 | −0.183 | −0.007 | <0.001 | 46.34% |
Lifestyle (a2 × b2) | −0.086 | 0.042 | −0.168 | −0.004 | <0.001 | 41.95% |
Depressive status (a3 × b3) | −0.017 | 0.007 | −0.032 | −0.003 | 0.003 | 8.29% |
Total effect | −0.205 | 0.039 | −0.282 | −0.128 | <0.001 | - |
Difference of indirect effects | ||||||
a1 × b1 − 2 × b2 | −0.008 | 0.055 | −0.115 | 0.098 | 0.875 | - |
a1 × b1 − a3 × b3 | −0.077 | 0.043 | −0.162 | 0.007 | <0.001 | - |
a2 × b2 − a3 ×b3 | −0.069 | 0.041 | −0.149 | 0.011 | 0.013 | - |
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Li, Q.; Wu, C. Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults. Int. J. Environ. Res. Public Health 2022, 19, 4235. https://doi.org/10.3390/ijerph19074235
Li Q, Wu C. Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults. International Journal of Environmental Research and Public Health. 2022; 19(7):4235. https://doi.org/10.3390/ijerph19074235
Chicago/Turabian StyleLi, Qiuhong, and Chao Wu. 2022. "Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults" International Journal of Environmental Research and Public Health 19, no. 7: 4235. https://doi.org/10.3390/ijerph19074235