Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study
Abstract Background Associations between the frequency of social and intellectual activities and cognitive trajectories are understudied in Chinese middle-aged and older adults. We aimed to examine this association in a nationally representative longitudinal study.Methods The China Health and Retirement Longitudinal Study (CHARLS) is a prospective cohort study conducted from 2011 to 2016, with a nationally representative sample of Chinese middle-aged and older participants. The frequency of social and intellectual activities was measured in 2011-2012. Interview-based cognitive assessments of orientation and attention, episodic memory, and visuospatial skills and the calculation of combined global scores were conducted in three waves (2011-2012, 2013-2014 and 2015-2016). Cognitive trajectories over the study period were analyzed using group-based trajectory models (GBTMs), and the associations of the trajectory memberships with social and intellectual activities were analyzed using multinomial logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.Results After excluding respondents with missing data on cognitive function, we ultimately included 7243 participants aged 50 years or older in the analysis. Three trajectory groups for global cognitive performance over time were identified: low (20.34%), intermediate (34.39%) and high (45.27%). After adjustment for sociodemographic variables, lifestyles and health conditions, more frequent intellectual activities (OR: 0.43, 95% CI: 0.32 - 0.58) and social activities (OR: 0.66, 95% CI: 0.56 - 0.78) were both associated with a lower likelihood of being in the low global cognitive trajectory group than in the high trajectory group in separate analyses. These associations persisted after mutually exclusive adjustment for social and intellectual activities.Conclusions More frequent social and intellectual activities were associated with more favorable cognitive aging trajectories. Increasing the frequency of engagement in social and intellectual activities might help delay or prevent cognitive impairment in older people.