社区老年人婚姻状况、社会支持和生活习惯与认知障碍的关联：基于湖北老年记忆队列基线调查

Background  The accelerated aging processcombined with the increase in widowhood and social isolationhas led to a rise in chronic diseasesfurther increasing the social burden. Objective  To explore the association between the marital status of older adults and the prevalence of cognitive impairmentas 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 XiaoganHubei Provincewere included in this study from 2018 to 2023. Participants were categorized into a married groupn=7 055 and an unmarried groupn=2 411 based on their marital status. Baseline information was collected through structured questionnairesand cognitive function was assessed using the Montreal Cognitive AssessmentMoCA and multidomain cognitive function tests. 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 statussocial supportand lifestyle habits on cognitive impairment risk. Results  Compared with the elderly with spousesno spouse was an independent risk factor for cognitive impairmentOR=1.29995%CI=1.227-1.376P<0.001. Further subgroup analysis showed that never marriedOR=1.67995%CI=1.448-1.947P<0.001 and widowedOR=1.28295%CI=1.206-1.362P<0.001 were independent risk factors for cognitive impairment in the elderly.Gender and age stratified analysis showed that never marriedOR=2.31695%CI=1.680-3.193P<0.001 and widowedOR=1.73195%CI=1.405-2.131P<0.001 were independent risk factors for cognitive impairment in elderly men. Widowed was an independent risk factor for cognitive impairment in elderly womenOR=1.16395%CI=1.002-1.351P=0.047. In the 65-74 years old groupnever marriedOR=1.95395%CI=1.390-2.746P<0.001 and widowedOR=1.31595%CI=1.120-1.545P=0.001 were independent risk factors for cognitive impairment. In the 75 years old groupwidowed was an independent risk factor for cognitive impairmentOR=1.47095%CI=1.238-1.747P<0.001. Multivariate Logistic regression analysis showed that marital statussocial support and living habits were associated with cognitive impairment. Compared with the elderly with spouse and social support and healthy living habitsthe elderly with spouse and social support but unhealthy living habitsOR=1.26295%CI=1.169-1.363P=0.002spouse and no social support but healthy lifestyleOR=1.65095%CI=1.479-1.841P<0.001spouse and no social support but unhealthy lifestyleOR=1.77795%CI=1.575-2.005P<0.001no spouse and social support with healthy lifestyleOR=1.28495%CI=1.189-1.397P<0.001no spouse and social support with unhealthy lifestyleOR=1.99995%CI=1.768-2.260P<0.001no spouse and social support with unhealthy lifestyleOR=1.99995%CI=1.768-2.260P<0.001no spouse and no social support but healthy lifestyleOR=1.68095%CI=1.50-1.882P<0.001no spouse and no social support but unhealthy lifestyleOR=2.42295%CI=2.141-2.740P<0.001no spouse and no social support but healthy lifestyleOR=2.42295%CI=2.141-2.740P<0.001were at increased risk for cognitive impairment. Conclusion  The prevalence of cognitive impairmentespecially among older adults without spousesnotably increasesparticularly for those who have never married or are widowed. Regardless of marital statusthe lack of social support and unhealthy lifestyle are risk factors for cognitive impairment. This study highlights the importance of paying attention to marital statussocial supportand lifestyle in the health management of older adults.