Association between Marital Status, Social Support and Lifestyle with Cognitive Impairment among Community-dwelling Older Adults: Based on the Baseline Survey of Hubei Memory and Aging Cohort Study
摘要
Background The accelerated aging process, combined with the increase in widowhood and social isolation, has led to a rise in chronic diseases, further increasing the social burden. Objective To explore the association between the marital status of older adults and the prevalence of cognitive impairment, as well as the impact of social support and lifestyle on this association. Methods A total of 9 466 older adults aged 65 years and above from Wuhan and Xiaogan, Hubei Province, were included in this study from 2018 to 2023. Participants were categorized into a married group (n=7 055) and an unmarried group (n=2 411) based on their marital status. Baseline information was collected through structured questionnaires, and cognitive function was assessed using the Mini-mental State Examnation and the Montreal Cognitive Assessment-basic China (MoCA-BC). A multivariable Logistic regression model was employed to analyze the association between marital status and cognitive impairment in the overall population as well as in subgroups stratified by age and sex. Further analyses explored the independent and combined effects of marital status, social support, and lifestyle habits on cognitive impairment risk. Results Compared with the elderly with spouses, no spouse was an independent risk factor for cognitive impairment (OR=1.299, 95%CI=1.227-1.376, P<0.001). Further subgroup analysis showed that never married (OR=1.679, 95%CI=1.448-1.947, P<0.001) and widowed (OR=1.282, 95%CI=1.206-1.362, P<0.001) were independent risk factors for cognitive impairment in the elderly. Gender and age stratified analysis showed that never married (OR=2.316, 95%CI=1.680-3.193, P<0.001) and widowed (OR=1.731, 95%CI=1.405-2.131, P<0.001) were independent risk factors for cognitive impairment in elderly men. Widowed was an independent risk factor for cognitive impairment in elderly women (OR=1.163, 95%CI=1.002-1.351, P=0.047). In the 65-74 years old group, never married (OR=1.953, 95%C