城乡老年人婚姻及居住状况与认知分域关联的差异性研究OA
Differences in the Association between Marital/Living Status and Cognitive Domains among Rural and Urban Older Adults
[目的]探讨老年人婚姻及居住状况与认知分域(记忆、语言、视空间、执行和注意功能)之间的关联性及其城乡差异影响因素.[方法]基于湖北老年记忆队列2016-2025年动态入组人群的基线数据,纳入符合研究要求的10 825名60岁以上老年人,其中农村居民3 788人,城市居民7 037人.湖北老年记忆队列通过问卷调查收集婚姻与居住状况信息,采用标准化神经心理学测验评估认知分域,得分进行z-score处理[(实际得分-纳入人群该分域均值)/纳入人群该分域标准差];采用多因素线性回归模型分析婚姻及居住状况与认知分域及总体认知之间的关联.[结果]农村老年人在社会经济地位、健康生活方式及多项认知域得分上均显著低于城市居民的对应项(均P＜0.001).未与家人同住与认知各分域得分较低显著关联[记忆:b=-0.217,95%CI(-0.276,-0.159);注意:b=-0.213,95%CI(-0.262,-0.163),均P＜0.001],且该关联在城市样本中更强、涉及更广泛的认知分域;此外,相较于在婚且与家人同住,在婚但未与家人同住与更差的认知表现相关,这一效应在城市样本中更为突出[记忆:b=-0.521,95%CI(-0.621,-0.422);注意:b=-0.443,95%CI(-0.533,-0.354),均P＜0.001].[结论]老年人非在婚状态和未与家人同住与较差认知分域表现分别显著关联;在婚但未与家人同住的联合状态也与老年人较差认知分域表现相关,上述关联效应在城市居住的老年人中更为突出.
[Objective]To explore the association between marital/living status and cognitive domains(memory,language,visuospatial,executive,and attention domains)in older adults,and to examine the influencing factors underlying urban-rural differences.[Methods]Based on baseline data from the dynamic enrollment cohort(2016-2025)of the Hubei Memory and Aging Cohort Study,10 825 older adults aged 60 years and above who met the study criteria were included,comprising 3 788 rural residents and 7 037 urban residents.The cohort collected information on marital and living status via questionnaires.Cognitive domains were assessed using standardized neuropsychological tests,with scores converted to z-scores[(raw score-mean score of the domain in the study population)/standard deviation of the domain in the study population].Multiple linear regression models were used to analyze the associations between marital/living status and cognitive domains,as well as global cognition.[Results]Rural older adults scored significantly lower than their urban counterparts in terms of socioeconomic status,healthy lifestyle indicators,and multiple cognitive domains(all P＜0.001).Living away from family was significantly associated with lower scores across cognitive domains[memory:b=-0.217,95%CI(-0.276,-0.159);attention:b=-0.213,95%CI(-0.262,-0.163),all P＜0.001],with this association being stronger and involving a broader range of cognitive domains in the urban sample.Moreover,compared to married and living with family,married but living away from family was associated with poorer cognitive performance,an effect that was more pronounced in the urban sample[memory:b=-0.521,95%CI(-0.621,-0.422);attention:b=-0.443,95%CI(-0.533,-0.354),all P＜0.001].[Conclusion]Unmarried status and living away from family were each significantly associated with poorer performance in cognitive domains among older adults.The combined status of being married but living away from family was also associated with poorer cognitive performance,with these associations being more pronounced among urban-dwelling older adults.
彭媛媛;曾燕;黄招兰
武汉科技大学附属老年病医院消化内科,湖北 武汉 430065||武汉科技大学脑科学先进技术研究院,湖北 武汉 430065||湖北省阿尔茨海默病临床医学研究中心,湖北 武汉 430065武汉科技大学附属老年病医院消化内科,湖北 武汉 430065||武汉科技大学脑科学先进技术研究院,湖北 武汉 430065||湖北省阿尔茨海默病临床医学研究中心,湖北 武汉 430065武汉科技大学附属老年病医院消化内科,湖北 武汉 430065||武汉科技大学脑科学先进技术研究院,湖北 武汉 430065||湖北省阿尔茨海默病临床医学研究中心,湖北 武汉 430065
医药卫生
社区老年人婚姻状况居住状况认知分域城乡差异
community-dwelling older adultsmarital statusliving statuscognitive domainsurban-rural differences
《中山大学学报（医学科学版）》 2026 (2)
293-305,13
脑科学与类脑研究国家科技重大专项(2022ZD0211600)武汉市卫健委科研项目资助项目(WX23B01)
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