社会经济地位对老年人认知功能影响的多重中介效应分析  

Analysis of multiple mediating effects of social and economic status on cognitive status of the elderly

作　　者：孙琳 高强 张萌欣 李敏莹 陶睿嘉 张鹏俊[2] 王辰[3] Sun Lin;Gao Qiang;Zhang Mengxin;Li Minying;Tao Ruijia;Zhang Pengjun;Wang Chen(School of Management,Beijing University of Chinese Medicine,Beijing 102401,China;Research Office of Beijing Hospital,National Geriatrics Center,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China;Chinese Academy of Medical Sciences Peking Union Medical College,Beijing 100730,China)

机构地区：[1]北京中医药大学管理学院,北京102401 [2]北京医院科研处,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [3]中国医学科学院北京协和医学院,北京100730

出　　处：《中华老年医学杂志》2025年第3期359-365,共7页Chinese Journal of Geriatrics

摘　　要：目的旨在探讨社会经济地位对老年人认知功能的影响,分析健康社会决定因素在其中的中介作用,为实施积极的人口老龄化战略提供依据。方法本研究基于中国健康与养老追踪调查(CHARLS)2020年数据,采用多元线性回归分析社会经济地位与老年人认知功能之间的关系,同时采用多重中介效应模型评估健康社会决定因素在社会经济地位与认知功能关联中的中介效应,并通过Bootstrap检验中介效应。结果多元线性回归结果显示,社会经济地位对老年人认知功能有显著的正向影响,低龄、男性、汉族、城市的老年人认知得分相对较高。中介分析显示,在社会经济地位对认知功能的总影响中,健康状况介导了1.564%,个体生活方式介导了14.820%,社会支持网络介导了2.719%,居住条件介导了1.632%,其他社会结构因素介导了1.496%,在多重中介模型中,社会经济地位对老年人认知功能影响的17.945%由健康社会决定因素共同介导。结论老年人认知功能障碍受社会经济地位影响,应通过多维度综合干预,促进资源公平分配,缩小贫富差距,减轻健康不平等,从而提升弱势群体的认知水平。同时,预防和改善居民健康状况、引导居民采取积极的生活方式、加强社会支持网络建设、改善居住环境、优化社会结构因素等行动可以作为干预措施的切入点,帮助提升经济社会地位较低的老年人的认知功能。ObjectiveThis study aims to investigate the impact of socioeconomic status on cognitive function in older adults,while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.MethodsUtilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020,this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function,with these mediation effects assessed using the Bootstrap method.ResultsThe results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age,male gender,Han ethnicity,and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that,of the total effect of socioeconomic status on cognitive function,health status accounted for 1.564%,individual lifestyle for 14.820%,social support networks for 2.719%,living conditions for 1.632%,and other social structural factors for 1.496%.In the multiple mediation model,a total of 17.945%of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.ConclusionsSocioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue,comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources,reduce socioeconomic disparities,and mitigate health inequalities,thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status,encouraging healthy lifestyle choices,strengthening socia

关 键 词：认知功能 社会经济地位 健康社会决定因素 

分 类 号：R47[医药卫生—护理学]