Mediation analysis of leisure activities on the association between cognitive function and mortality: a longitudinal study of 42,942 Chinese adults 65 years and older

• 발행기관: 한국역학회
• 저자명: Xingxing Chen Wenfan Wu Xian Zhang Tingxi Long Wenyu Zhu Rundong Hu Xurui Jin Lijing L. Yan Yao Yao
• 간행물 정보: 『Epidemiology and Health』44, 1~10쪽, 전체 10쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2022.01.01

영문 초록

study aimed to evaluate whether leisure activities causally mediate these associations. METHODS This longitudinal study included 42,246 participants aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey. The Mini-Mental State Examination and a self-reported scale were used to measure cognitive status and leisure activities, respectively. We examined the associations of cognitive function and leisure activities with mortality using Cox proportional hazards models. Causal mediation analysis was used to assess whether leisure activities mediated the association between cognitive function and mortality. RESULTS Cognitive function and leisure activities were inversely associated with mortality. Leisure activities accounted for 28.3% (95% confidence interval [CI], 25.6 to 31.1) of the total effect of cognitive function and mortality. A higher mediated proportion (PM) was observed for physical leisure activities (PM, 20.1%; 95% CI, 18.0 to 22.3) than for social leisure activities (PM, 17.7%; 95% CI, 15.7 to 19.7). The mediating effect was higher among participants at younger ages (PM, 41.5%; 95% CI, 21.3 to 65.4), those with higher education levels (PM, 30.5%; 95% CI, 25.3 to 36.2), and residents of rural China (PM, 42.5%; 95% CI, 25.4 to 62.5). CONCLUSIONS Cognitive function was associated with inverse mortality. Leisure activities significantly mediated this association. Participation in leisure activities at the early stages of mild cognitive impairment could reduce the risk of mortality, which has a major impact on interventional strategies for healthy aging.

키워드

Causal mediation analysis Older people Cognitive function All-cause mortality Leisure activities