A change in social participation affects cognitive function in middle-aged and older Chinese adults: analysis of a Chinese longitudinal study on aging (2011-2018).

Background: One of the biggest challenges facing older adults is cognitive decline and social participation has always been considered a protective factor. However, it is not clear whether social participation predicts cognitive function in this population, rather than depressive symptoms, self-reported health, and activities of daily life, with sufficient capacity to detect unique effects. Methods: This study included adults aged 45 and above in China (N = 5,258) who participated in a large national older adult health survey and provided data from 2011, 2013, 2015, and 2018. The unique associations between the predictors of social participation and cognitive function over time and context were evaluated in the Latent Growth Model (LGM). Results: Among the 5,258 participants in our study, an overall cognitive decline was observed. Social participation predicts two dimensions of cognitive function, with a degree of impact comparable to depressive symptoms, self-reported health, and activities of daily life. Among them, social participation exhibits a noteworthy prognostic impact on episodic memory during the same period. The regression coefficient is approximately 0.1 (p < 0.05) after controlling other mixed variables (depressive symptoms, self-reported health, and activities of daily life). In contrast, social participation is also a significant predictor of mental intactness in the same period, with a regression coefficient of 0.06 (p < 0.05), even if all mixed variables are controlled. Conclusion: Over time, the correlation strength of social participation is comparable to other recognized cognitive function prediction indicators, indicating that promoting social participation among middle-aged and older Chinese adults is a meaningful way to improve cognitive function degradation, which has important policy and practical significance.

Connecting through clicks: A longitudinal examination of internet use and depressive symptoms among middle- and old-aged Chinese.

AIM: While prior investigations into the influence of internet engagement on depressive symptoms in middle-aged and older individuals have largely been favorable, concerns persist. Some research posits that internet use may detract from direct interpersonal interactions, elevating depression risks. Here, we scrutinize these contrasting views, endeavoring to delineate the relationship between internet use, social participation, and the ensuing depressive manifestations. METHODS: We analyzed nationally representative data from three consecutive waves (2013-T1, 2015-T2, 2018-T3) of the China Health and Retirement Longitudinal Study survey. Measures of social participation encompassed formal social participation (i.e., attending clubs for mahjong, chess, sports, or other activities; participation in community organizations, volunteering, or enrolling in training courses) and informal social participation (i.e., interactions with friends or extending assistance to relatives, friends, or neighbors). Structural equation modeling was used to evaluate a focused longitudinal mediation model. RESULTS: Our dataset comprised 13 671 individuals aged 45 years or older. Baseline internet use was associated with a decrease in depressive symptoms by T3 ( c ' = -0.143, SE = 0.055). The longitudinal association between internet use and the alleviation of depressive symptoms was partially mediated by enhanced formal social participation (indirect effect a 1 × b 1 = -0.023, SE = 0.011). CONCLUSIONS: For developing nations such as China, grappling with a rapidly aging demographic and scarce mental health infrastructure, pioneering initiatives that merge digital and formal social participation might be a valuable component in a multifaceted approach to alleviate late-life depression. Geriatr Gerontol Int 2024; 24: 218-224.

Predictors of the Social Participation of Adults with Down Syndrome: An Analysis Based on the Biopsychosocial Model of the International Classification of Functioning, Disability, and Health.

OBJECTIVE: The aim of the study is to identify the predictors of social participation in Down syndrome adults from the biopsychosocial model of the International Classification of Functioning, Disability, and Health. METHODS: An exploratory, analytical, cross-sectional study was conducted with Down syndrome adults. The social participation was assessed using the Life Habits Assessment. The independent variables were determined using the International Classification of Functioning, Disability, and Health biopsychosocial model: body functions were assessed by body mass index, cognition function (Mini-Mental State Examination), and lower limbs muscle strength (Sit-to-Stand Test). Activities were assessed by the 8-Foot Up and Go Test. Environmental factors were assessed by the measure of the quality of the environment, and personal factors were assessed by age, sex, and education level. RESULTS: The total Life Habits Assessment score indicates that individuals show moderate restriction in social participation, with major restriction in the education, employment, and responsibilities domains. The 8-Foot Up and Go Test was the best social participation predictor variable, followed by Mini-Mental State Examination, and the Sit-to-Stand Test. Contextual factors were not predictors of participation. CONCLUSIONS: It was concluded that individuals with Down syndrome present the most restrictions to social participation in activities that involve social roles. The predictors influencing social participation are functional mobility, cognition, and lower limb muscle strength.

Relationship between social participation and life satisfaction in community-dwelling older adults: Multiple mediating roles of depression and cognitive function.

BACKGROUND: Numerous studies have explored the relationship between social participation, depression, cognitive function, and life satisfaction in community-dwelling older adults. However, the results of these studies were not consistent. Therefore, the in-depth excavation of the complex relationship mechanism between these four variables is limited. This study aims to explore whether depression and cognitive function act as the multiple mediators between social participation and life satisfaction in community-dwelling older adults. METHODS: This study used the meta-analytic structural equation modeling (MASEM) approach. Six databases were comprehensively searched to investigate the relationship between social participation, depression, cognitive function, and life satisfaction in community-dwelling older adults from inception to March 1, 2023. RESULTS: The analysis included 50 articles that reported 66 effect sizes (N = 161,854). The MASEM found the relationship between social participation and life satisfaction was mediated by depression [ß = 0.085, 95 % CI (0.053, 0.126)] and by cognitive function [ß = 0.015, 95 % CI (0.002, 0.033)], respectively. Depression and cognitive function also played multiple mediating roles between social participation and life satisfaction in community-dwelling older adults [ß = 0.005, 95 % CI (0.001, 0.012)]. CONCLUSIONS: There was not only a direct association between social participation and life satisfaction, but also an association through multiple mediating roles of depression and cognitive function in community-dwelling older adults. In the process of using diverse interventions to promote social participation in community-dwelling older adults, more attention should be paid to their psychological status and cognitive function to eliminate intrinsic barriers so as to improve life satisfaction effectively.

Working hours, social engagement, and depressive symptoms: an extended work-life balance for older adults.

BACKGROUND: In recent years, researchers have been examining the impact of work-life balance (WLB) on mental health, considering it as a potential risk factor. However, it remains unclear whether the traditional understanding of WLB applies to older adults who worked for fewer hours before full retirement and whose children are likely to be independent adults. Therefore, this study aims to propose a modified form of WLB specifically for older adults. Within this context, we hypothesize that an optimum balance between working hours and social engagement protects against depressive symptoms among older adults. METHOD: We conducted an analysis using data on 5,751 Korean adults older than 55 years from the Korean Longitudinal Study of Aging 2016. Multivariate logistic regression analysis was used to evaluate the relationships among working hours, social engagement, and depressive symptoms. RESULTS: Older adults who worked fewer than 35 h per week were less likely to experience depressive symptoms than were non-working older adults and those working 35 h or more per week. Additionally, older adults with a high level of informal social participation, thus occurring almost every day or two to three times per week, were less likely to experience depressive symptoms than were those with a low level of such participation (once a month or less). Furthermore, depressive symptoms were less frequent among those who worked fewer than 35 h per week and engaged in a high level of informal social participation compared to non-working older individuals and those with a low level of informal social participation. CONCLUSIONS: Maintaining an optimal number of working hours and degree of social engagement are necessary to minimize the risk of depressive symptoms in older adults. Based on these findings, we suggest that fulfillment for work and life and their balance are important for older adults and propose work-life fulfillment balance.

Living arrangements, activity participation and depression among older Chinese adults.

OBJECTIVES: We examined the relationship among living arrangements, activity participation and depression and the mediating effects of activity participation on the relationship between living arrangements and depression. STUDY DESIGN: This was a cross-sectional study based on nationally representative data. METHODS: 9647 older adults aged 60 years and over were recruited from the 2018 Chinese Longitudinal Healthy Longevity Survey. Three-step regression and mediation analysis methods were used. RESULTS: Compared with older adults living with family members, those living in institutions attended fewer activities and experienced higher depression rates, and those living alone attended more activities and experienced higher depression rates. In the group living with family members, living with a spouse was an important way to increase activity participation and reduce depression. Mediation analysis suggested that activity participation mediated the impact of living arrangements on depression. Attending more activities could alleviate depression for older adults who are living alone, living in institutions and living without a spouse. CONCLUSION: Our findings suggest an emphasis on the role of spouses and activity participation during depression interventions among older adults.

Association of community-level social capital with dementia: A multilevel nine-year longitudinal study using data from the Japan Gerontological Evaluation Study.

BACKGROUND: Individual-level social capital prevents cognitive decline. However, a few studies have focused on the effects of community-level social capital on dementia. Therefore, we investigated the association between community-level social capital and dementia onset based on longitudinal study data on older adults in Japan. METHODS: We used longitudinal data from the Japan Gerontological Evaluation Study, obtained over nine years (2010-2019). In total, 35,921 physically and cognitively independent individuals (16,848 males and 19,073 females) aged ≥65 years and nested within 308 communities in seven municipalities participated in the study. Dementia onset was assessed using the public long-term care insurance registration. Social capital was assessed using three dimensions: civic participation, social cohesion, and reciprocity. We performed a two-level multilevel survival analysis stratified by sex, calculated hazard ratios (HRs), and 95% confidence intervals (CIs). RESULTS: During the follow-up, 6245 (17.4%) dementia onset cases were identified. The cumulative incidence of dementia was 16.2% in males and 18.4% in females. After adjusting for covariates, individual-level civic participation was associated with a lower incidence of dementia in both males and females (HR, 0.84; 95% CI, 0.77-0.92; HR, 0.78; 95% CI, 0.73-0.84). Community-level civic participation and social cohesion were associated with a lower incidence of dementia among females (HR, 0.96; 95% CI, 0.93-0.99; HR, 0.93; 95% CI, 0.88-0.98) and cross-level interaction on social cohesion among females (HR, 0.95; 95% CI, 0.90-0.99). CONCLUSIONS: Living in a community with high civic participation and social cohesion is associated with a lower incidence of dementia among older females. Therefore, promoting civic participation and social cohesion in the community may be a useful population-based strategy to delay or prevent the onset of dementia.

Association of home and community-based services and cognitive function of Chinese older adults: social participation as a mediator.

BACKGROUND: This study makes an effort to examine the impact of home and community-based services on maintaining cognitive function and understand the mediating effect of social participation on the relationship of community services and older adults' cognitive function in China. METHOD: The empirical data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 38,582 (person-time) respondents were gathered for this study. The two-way fixed effects regression model is used to estimate the associations between independent variables, mediating variables and cognitive ability after controlling for socio-demographic, family responsibility, and time variables. RESULT: This study has confirmed that participating in daily and social activities is associated with the cognitive functions of Chinese older adults. Social participation can stimulate cognition. Active participation in outdoor activities, doing housework or taking care of kids, daily playing cards or mah-jong, reading books and newspapers, watching TV, and listening to the radio can significantly promote the cognitive ability of older adults. In addition, the findings have indicated the importance of community services for older adults. This study shows personal daily care services, legal aid services, health education services, as well as dealing with family and neighborhood disputes have a positive effect on maintaining older adults' cognitive functions. Meanwhile, the provision of door-to-door medical services hurts their cognitive functions. This study also illustrates that community-based services can increase the level of older adults' social participation, and then enhance their level of cognitive function. CONCLUSION: This study can inform service provision agencies to develop targeted programs to support older adults' continued engagement.

Online communication and positive psychological capital of college students in China: the mediating role of online social support.

Online communication is one of the most significant factors that affect the growth and development of contemporary college students. The purpose of this study was to examine the mechanisms of online social support in the relationship between online communication and the positive psychological capital of college students in China. Drawing on social exchange theory, the research employed a sample of 1,212 Chinese college students and incorporated online social support as a mediating variable. The investigation constructed a research model using the College Students' Online Communication Questionnaire, Online Social Support Questionnaire, and Positive Psychological Capital Questionnaire to examine the intricate relationship among online communication, online social support, and positive psychological capital. The study found that both online self-expression and online extended relationship actions positively influenced students' positive psychological capital. However, online social participation did not demonstrate an impact on this measure. Furthermore, online social support was found to partially mediate the connection between online self-expression and positive psychological capital as well as between online extended relationships and positive psychological capital. Online social support fully mediated the relationship between online social participation and positive psychological capital.

Association between hearing status and social participation in Japanese older adults: A cross-sectional study from the Japan gerontological evaluation study.

PURPOSE: Hearing is known to decline with age. As sensitivity to speech declines, conversation becomes more difficult and social interactions are affected, resulting in increased risk of cognitive decline. This study aimed to examine the relationship between hearing status and social participation. MATERIALS AND METHODS: The study included 21,117 adults aged 65 years or older who responded to a survey in 2019. The survey asked participants about their hearing status and how frequently they participated in certain social activities. RESULTS: The analysis of the relationship between degree of hearing and social activity showed lower hearing status odds ratios for those who participated more frequently in social activities compared to those who participated less frequently. The odds ratios were as follows, hobby clubs (OR 0.81, 95%CI 0.78-0.84), activities such as teaching skills or passing on experiences to others (OR 0.69, 95%CI 0.65-0.75), and meeting with friends (OR 0.77, 95%CI 0.74-0.79). Compared to those who did not participate in social activities, those who participated in three or more types of groups had significantly lower hearing impairment (OR 0.75, 95% CI 0.72-0.79). CONCLUSION: Hearing impairment was shown to inhibit participation in activities, including those that require communication with multiple people or smooth communication, those that involve a wide range of ages, and those that involve work and movement. Hearing impairment should be identified and addressed in its early stages to prevent its negative impact on social participation.

Crisis response during the COVID-19 pandemic: Changes in social contact and social participation of older Americans.

OBJECTIVE: This study aimed to assess changes in social contact with family, friends and healthcare providers, as well as social participation in working, volunteering, religious services and other organized activities, among older adults during the COVID-19 pandemic while examining the role of pre-COVID sociodemographic characteristics or cognitive and physical limitations in changes in social contact and participation. METHODS: We conducted secondary data analyses in the National Health and Aging Trends Study (NHATS) COVID-19 questionnaire, collected in 2020 during a period of workplace closures and social distancing guidelines. We linked data to pre-COVID sociodemographic and medical information collected in 2019 before COVID interrupted social life. The frequency of participants' social contact and social participation prior to and during the COVID-19 pandemic, were compared using paired t-tests for summed scores. Multivariate linear regression was used to relate participants' socio-demographic, prior physical and cognitive performance with levels of social contact and participation and with changes reported during the COVID-19 pandemic. RESULTS: In total, results from 2,486 eligible participants revealed that COVID-19 was associated with decreased social contact among family and friends (change: -0.62; SE: 0.06; p<0.0001), and social participation among older adults (change: -0.58; SE: 0.02; p<0.0001). Pre-COVID characteristics including older age, lower educational attainment, poorer physical performance, and more chronic conditions were associated with lower social contact and social participation and with how older adults adapted their social lives during the COVID-19 pandemic. DISCUSSION: These results emphasize the importance of increasing digital inclusion for older adults in a major crisis.

Association between chronic disease and depression among older adults in China: the moderating role of social participation.

OBJECTIVES: Depression is an increasingly serious mental health problem worldwide. Therefore, this study aimed to explore the association between chronic disease and depression and to further test the moderating role of social participation in this association. STUDY DESIGN: This is a cross-sectional study. METHODS: We screened 6421 subjects from the 2018 wave of the China Health and Retirement Longitudinal Study database. Social participation and depressive symptoms were assessed using the 12-item self-made scale and 10-item Center for Epidemiological Studies Depression Scale, respectively. Hierarchical regression was used to determine the main effect of chronic disease and depression and the moderating effect of social participation on the relationship between chronic disease and depression. RESULTS: In this study, 3172 (49.40%) eligible participants were male, 4680 (72.90%) older adults were concentrated in the 65-74 years group, and 68.20% reported good health status. In addition, gender, area, education level, marital status, health status, health insurance, health service utilization, and physical activity intensity were significant factors associated with participants' depression status (P < 0.05). The results also showed that a higher number of chronic diseases were associated with a higher depression score after adjusting for confounders (single disease: ß = 0.074, P < 0.001; multimorbidity: ß = 0.171, P < 0.001) and that social participation played a moderating role in this association (ß = -0.030, P < 0.05). CONCLUSIONS: This study tentatively suggests that a higher number of chronic diseases are associated with rising depression scores in the older Chinese population. In addition, the moderating effect of social participation suggests that more active social engagement should be promoted in this population to alleviate the depressive mood.

Education, Social Engagement, and Cognitive Function: A Cross-Lagged Panel Analysis.

OBJECTIVES: Although education and social engagement are considered cognitive reserves, the pathway of both reserves on cognitive function has been rarely studied. This study aimed to examine the underlying mechanism between education, social engagement, and cognitive function. METHODS: This study used 2-wave data (2010 and 2014) from Health and Retirement Study in the United States (N = 3,201). Education was measured by years of schooling. Social engagement was evaluated by 20 items including volunteering, physical activities, social activities, and cognitive activities. Cognitive function was assessed by a modified Telephone Interview for Cognitive Status. A cross-lagged panel model was fitted to test the mediating mechanism between education, social engagement, and cognitive function. RESULTS: Controlling for covariates, higher education in early life was associated with better cognitive function in old age (b = 0.211, 95% confidence interval [CI] = [0.163, 0.259], p < .01). Late-life social engagement partially mediated the association between education and cognitive function (indirect effect = 0.021, 95% CI = [0.010, 0.033], p < .01). The indirect path between education and social engagement via cognition also existed (b = 0.009, 95% CI = [0.005, 0.012], p < .001). DISCUSSION: Education in earlier life stage may exert a lifelong effect on cognitive function as well as an indirect effect via enhancing late-life cognitive reserve such as social engagement. The cross-lagged effect of social engagement on cognitive function is significant and vice versa. Future research may explore other cognitive reserves over the life course and its underlying mechanism to achieve healthy cognitive aging.

Percepção de familiares e autopercepção de idosos usuários de dispositivos de amplificação quanto à restrição de participação causada pela deficiência auditiva / Perception of family members and self -perception of the elderly users of amplification devices regarding the restriction of participation caused by hearing impairment / Percepción de los miembros de la familia y la autopercepción de los ancianos usuarios de dispositivos de amplificación sobre la restricción de la participación causada por la discapacidad auditiva

Introdução: A deficiência auditiva tem um efeito profundo na vida dos idosos. O apoio dos familiares no processo de reabilitação cria meios para facilitar a aceitação da deficiência e o uso dos dispositivos auditivos. Objetivo: Analisar a percepção dos familiares quanto à restrição da participação causada pela deficiência auditiva em indivíduos idosos usuários de aparelho de amplificação sonora individual (AASI) e compará-la com a autopercepção do próprio idoso quando a este aspecto. Métodos: A amostra foi composta por 48 indivíduos, que foram divididos em dois grupos, sendo GI o grupo de idosos, composto por 24 idosos com perda auditiva sensorioneural bilateral usuários de AASI; e GF o grupo de familiares, composto por 24 familiares, que acompanhavam esses idosos. Os participantes do GI responderam ao questionário de autoavaliação Hearing Handicap Inventory for the Elderly (HHIE) e os participantes do GF responderam ao questionário Hearing Handicap Inventory for the Elderly for Spouses (HHIE-SP). Resultados: Não houve correlação entre o tempo de uso do AASI e o escore obtido no questionário. Observou-se que, quanto maior a idade do idoso, piores foram os resultados encontrados no domínio "emocional" do HHIE para o grupo GI e para os domínios "social" e "emocional" para o grupo GF. Além disso, houve correlação entre os dois grupos, indicando que, quanto piores os resultados no HHIE para o GI, também foram piores os resultados no HHIE-SP respondido pelo GF. Conclusão: Arestrição de participação social e os aspectos emocionais influenciados pela perda auditiva em indivíduos idosos usuários de AASI são fatores percebidos pelos familiares que os acompanham nas consultas fonoaudiológicas. (AU)

Introduction: Hearing loss has a profound effect on the lives of the elderly. The support of family members in the rehabilitation process creates ways to facilitate the acceptance of the disability and the use of hearing devices. Objective: To analyze the perception of family members regarding the restriction of participation caused by hearing impairment in elderly individuals users of hearing aids and compare it with the self-perception of the elderly in this regard. Methods: The sample consisted of 48 individuals, who were divided into two groups, EG being the elderly group, composed of 24 elderly people with bilateral sensorineural hearing loss, who use HA; and FG the group of family members, composed of 24 family members, who accompanied these elderly people. EG participants answered the Hearing Handicap Inventory for the Elderly (HHIE) self-assessment questionnaire and FG participants answered the Hearing Handicap Inventory for the Elderly for Spouses (HHIE-SP). Results: There was no correlation between the time of HA use and the score obtained in the questionnaire. It was observed that the older the person, the worse the results found in the "emotional" domain of the HHIE for the EG group, and the "social" and "emotional" domains for the FG group. In addition, there was a correlation between the two groups, indicating that the worse the results in the HHIE for the EG, the worse the results in the HHIE-SP answered by the GF. Conclusion: The restriction of social participation and the emotional aspects influenced by hearing loss in the elderly who use HA are factors perceived by family members who accompany them in audiology appointments. (AU)

Introducción: La discapacidad auditiva tiene un profundo efecto en la vida de los adultos mayores. El apoyo de los familiares en el proceso de rehabilitación crea vías para facilitar la aceptación de la discapacidad y el uso de audífonos. Objetivo: Analizar la percepción de los familiares sobre la restricción de la participación causada por la deficiencia auditiva en ancianos usuarios de audífonos y compararla con la autopercepción de los ancianos al respecto. Métodos: La muestra estuvo conformada por 48 individuos, quienes fueron divididos en dos grupos, siendo GI el grupo de adultos mayores, compuesto por 24 adultos mayores con hipoacusia neurosensorial bilateral, que utilizan audífonos; y GF el grupo de familiares, compuesto por 24 familiares, que acompañaban a estos individuos. Los participantes del GI respondieron el cuestionario Hearing Handicap Inventory for the Elderly (HHIE) y los participantes del GF respondieron el cuestionario Hearing Handicap Inventory for the Elderly for Spouses (HHIE-SP). Resultados: No hubo correlación entre el tiempo de uso del audífono y la puntuación obtenida en el cuestionario. Se observó que a mayor edad del adulto mayor, peores resultados encontrados en el dominio "emocional" del HHIE para el grupo GI y para los dominios "social" y "emocional" para el grupo GF. Además, hubo correlación entre los dos grupos, indicando que a peores resultados en el HHIE para el GI, peores resultados en el HHIE-SP contestado por el GF. Conclusión: La restricción de la participación social y los aspectos emocionales influenciados por la hipoacusia en adultos mayores usuarios de audífonos son factores percibidos por los familiares que los acompañan en las consultas de audiología.(AU)

Activity engagement and cognitive function among chinese older adults: moderating roles of gender and age.

BACKGROUND: Many studies have found that engaging in activities, including physical exercise, social interaction, and cognitive training, is beneficial for preventing cognitive decline among older adults; however, the demographic differences in the association between activity engagement and cognitive functions remain understudied. This study investigates: (a) the influence of activity engagement on cognitive functions among Chinese older adults, and (b) the moderating roles of age and gender in these associations . METHODS: The data were derived from the China Health and Retirement Longitudinal Study in 2018, which included 9803 participants aged 60 or older. A multiple regression model was used to test the study hypotheses. RESULTS: Engaging in physical activity (b = 1.578, p < .001), social interaction (b = 1.199, p < .001), and cognitive activity (b = 1.468, p < .001) was positively associated with cognitive functions, whereas the effect of volunteer activities on cognitive functions was not significant (b = -.167, p = .390). Light- and moderate-intensity activities were beneficial for cognition (light: b = .847, p < .001; moderate: b = 1.189, p < .001), but vigorous-intensity activity was negatively related to cognition (b = -.767, p < .001). In addition, women and participants with advanced age appeared to benefit more from cognitive activities than their male and younger counterparts, respectively (gender: b = 1.217, p = .002; age: b = .086, p = .004). The adverse effects of vigorous-intensity activities (including agricultural work) on cognitive health were stronger for women and younger participants (gender: b = -1.472, p < .001; age: b = .115, p < .001). The protective effects of moderate-intensity activities on people's cognition increased with increasing age (b = .055, p = .012). CONCLUSIONS: The findings indicate that participating in physical, social, and cognitive activities can help older adults to maintain cognitive health. They suggest that older adults should select activities while considering activity intensity and their individual characteristics.

School connectedness and psychological resilience as mediators in the relationship between childhood abuse and suicidal ideation among Chinese adolescents.

Background: Suicide among adolescents is a huge public health concern around the world. Although childhood abuse has been established as a substantial risk factor for suicide behaviours, potential mediators in this relationship remain unclear.Objective: This study aimed to examine the mediating roles of school connectedness and psychological resilience in the association between childhood abuse and suicidal ideation among Chinese high school students.Methods: The sample involved 1607 adolescents from four high schools in Central China. Structural equation modelling (SEM) was conducted to investigate the mediation effects of school connectedness and psychological resilience on the relationship between childhood abuse and suicidal ideation.Results: The prevalence of suicidal ideation during the past week was 21.9%. Childhood abuse was positively related to the development of suicidal ideation directly and indirectly through school connectedness and psychological resilience. School connectedness and psychological resilience were also partial mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately.Conclusions: Suicidal ideation was widespread among Chinese high school students. Psychological resilience and school connectedness could attenuate the detrimental impact of childhood abuse on suicidal ideation. Findings underscore the improvement of psychological resilience and the connection to the school would be beneficial to suicide prevention among Chinese adolescents with childhood abuse.

Adolescent suicide is a major public health concern worldwide.Childhood abuse exerts a negative effect on suicide behaviours.School connectedness and psychological resilience mediated the relationship between childhood abuse and suicidal ideation.

The correlation analysis of WeChat usage and depression among the middle-aged and elderly in China: the mediating role of social participation.

BACKGROUND: We aimed to explore the association between WeChat usage and depression in the Chinese middle-aged and elderly and the role of social participation. METHODS: Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) of 2018. The dependent variable was depressive symptoms, measured with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). We used the propensity score matching (PSM) to match the WeChat users with the non-WeChat users. Correlations between WeChat usage and depressive symptoms were verified by using logistic regression and linear regression, and the mediating role of social participation was verified by using stepwise regression and KHB method. RESULTS: Four thousand five hundred forty-five samples were ultimately matched for analysis in this study. After including all control variables, results of logistic regression showed that WeChat usage was significantly associated with a lower prevalence of depression (aOR:0.701,95% CI: 0.605-0.812). And the results of linear regression showed that WeChat usage was associated with lower levels of depression which was significant (p < 0.001). The results of the stepwise regression and the KHB method showed a mediating role of social participation in WeChat usage and depressive symptoms. Among the four types of social participation, the mediating effect of recreational activities was significant, while the mediating effects of voluntary activities, cultural activities, and other activities were not significant. Meanwhile, the effect of WeChat usage on depression and the mediating effect of social participation were heterogeneous because of differences in age and gender. CONCLUSION: Social participation partly mediated the effect between WeChat usage and depression in middle-aged and older adults. Among the four types of social participation, only recreational activities had a mediating effect. Encouraging more active social participation and other types of social activities should be considered to improve the mental health of the middle-aged and older adults in China through social media usage.

Positive Self-perceptions of Aging Increase Physical Resilience to Facilitate Social Re-engagement of Older Adults Who Fall: Analysis Based on Health and Retirement Study Data.

OBJECTIVE: To determine whether self-perceptions of aging (SPAs) predict physical resilience after a fall and whether SPA and physical resilience affect subsequent social engagement in older adults with a fall. DESIGN: Prospective cohort study. SETTING: General community. PARTICIPANTS: Older adults who reported a fall within 2 years after baseline data collection (N=1707, mean age 72.9 years, 60.9% women). MAIN OUTCOME MEASURE: Physical resilience indicates the ability to resist or recover from functional decline from a stressor. The change in frailty status from directly after the fall to up to 2 years of follow-up was used to generate 4 physical resilience phenotypes. Social engagement was dichotomized based on the presence at 1 of the 5 social activities at least once a month. The 8-item Attitudes Toward Own Aging Scale was used to assess SPA at baseline. Multinomial logistic regression and nonlinear mediation analysis were used. RESULTS: Positive prefall SPA predicted more resilient phenotypes after a fall. Both positive SPA and physical resilience affected subsequent social engagement. Physical resilience partially mediated the association between SPA and social re-engagement (mediated percentage of 14.5%, P=.004). This mediation effect was fully driven by those with previous falls. CONCLUSION: Positive SPA promotes physical resilience in older adults with a fall, both of which affect subsequent social engagement. Physical resilience partially mediated the effect of SPA on social engagement but only for previous fallers. Multidimensional recovery incorporating psychological, physiological, and social aspects should be stressed in the rehabilitation of older adults who fall.

Trajectories of Social Participation and Its Predictors in Older Adults: Based on the CLHLS Cohorts from 2002 to 2018.

Social participation is a key factor in achieving active aging. This study aimed to explore the trajectories and predictors of social participation changes among older adults in China. The data used in this study are from the ongoing national longitudinal study CLHLS. A total of 2492 older adults from the cohort study were included. Group-based trajectory models (GBTM) were used to identify potential heterogeneity in longitudinal changes over time and investigate associations between baseline predictors and trajectories for different cohort members using logistic regression. Four different trajectories of social participation were reported in older adults, namely, stable (8.9%), slow decline (15.7%), lower score with decline (42.2%), and higher score with decline (9.5%). On multivariate analyses, age, years of schooling, pension, mental health, cognitive function, instrumental activities of daily living, and initial social participation scores significantly impact the rate of change in social participation over time. Four trajectories of social participation were identified in the Chinese elderly population. Management of mental health, physical function, and cognitive function appear to be important in maintaining the long-term social participation of older people in the community. Early identification of factors influencing the rapid decline in social participation and timely interventions can maintain or improve social participation levels in older adults.

Association of social participation and psychological resilience with adverse cognitive outcomes among older Chinese adults: A national longitudinal study.

BACKGROUND: Limited epidemiological evidence exists regarding the association of social participation and psychological resilience with cognitive health. This study aimed to comprehensively investigate the effects of social participation and psychological resilience on adverse cognitive outcomes among older adults in China. METHODS: We used two waves (2011 and 2014) of data from the Chinese Longitudinal Survey of Health and Longevity (CLHLS), and 9765 respondents were eligible for the subsequent screening for the present prospective analysis. The Cox proportional hazards model was utilized to examine the association of social participation and psychological resilience with cognitive impairment, cognitive decline and greater cognitive decline. The restricted cubic spline plots were applied to clarify the dose-response relationships between them. RESULTS: Compared to those with low social participation, participants with high social participation had a lower hazard ratio (HR) of 0.72 (95 % confidence interval [CI]: 0.59-0.89) for cognitive impairment, 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.78 (95 % CI: 0.67-0.90) for greater cognitive decline. Participants with high psychological resilience had an HR of 0.77 (95 % CI: 0.63-0.95) for cognitive impairment 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.85 (95 % CI: 0.73-0.98) for greater cognitive decline compared with those with low psychological resilience. Similar effects were observed for social participation score and psychological resilience score. The dose-response analysis also showed that the risk of adverse cognitive outcomes decreased gradually with increasing social participation scores and psychological resilience scores. Additionally, the multiplicative interaction between social participation and psychological resilience was not significant. LIMITATION: All information was collected by self-report, which may lead to biases in the process of information collection. CONCLUSION: In this study, social participation and psychological resilience were independently associated with a lower risk of adverse cognitive outcomes, and therefore both need to be considered as broader measures to preserve cognitive health among older Chinese adults.