Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated?

Abstract

Background and Objectives: Living arrangement is a crucial factor for older adults’ health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China’s population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults. Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008–2009, 2011–2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function. Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment. Conclusions: With older adults’ transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.

A Scoping Review on the Opportunities for Social Engagement and Cognitive Frailty in Older Adults

“…Living alone was not associated with poorer cognitive function at baseline and follow-up [ 38 ]. In line with this, older adults who transitioned to living alone (due to death of or divorce from spouse) had a lower risk of cognitive impairment, compared to those who continued to live with others [ 59 ]. However, men who lived alone in old age were twice as likely to experience cognitive decline compared to those married or living with someone [ 74 ], (see detail on gender influence below).…”

“…Living arrangements were found to be one of the factors more strongly associated with cognitive ability in older people [ 45 ]. Older people living in multigenerational family household often had poorer cognitive function than those living with a spouse or non-relatives [ 59 ]. Data collected in Taiwan found that social participation outside the family may have a larger effect on cognition than the social contracts within the family [ 44 , 68 ].…”

“…Living arrangements were found to be one of the factors more strongly associated with cognitive ability in older people [45]. Older people living in multigenerational family household often had poorer cognitive function than those living with a spouse or non-relatives [59] the family may have a larger effect on cognition than the social contracts within the family [44,68]. While individuals did experience more isolation from family and more loneliness than those living with others, they were often more engaged in social activities.…”

Case Report: Supernormal Vascular Aging in Leningrad Siege Survivors

“…Both patients were widows and lived alone. While the death of a husband is clearly a stressful factor, there are paradoxical studies demonstrating the benefits of living alone for the cognitive function of older adults ( 32 ).…”

Can leisure and entertainment lifestyle promote health among older people living alone in China?—A simultaneous equation approach

“…This is related to multiple factors, including objective and subjective indicators, respectively (17). Although objective functional health is the main predictor of perceived health, empirical results on the associations between functional health and subjective health are often inconsistent, ranging from low and non-significant associations to highly significant associations (16,(18)(19)(20)(21)(22). Part of this heterogeneity may be based on the assessment of the expanded function in functional health, mainly leisure activities (23).…”