Zhongguo quanke yixue (Jan 2024)
A Path Analysis of the Effect of Childhood Socioeconomic Status on Cognitive Function in Middle-aged and Older Adults
Abstract
Background The effects of childhood experiences on the health of middle-aged and older adults has become a research hotspot. However, the effects and pathways of childhood experiences on cognitive function in middle-aged and older adults still remain unclear. Objective To analyze the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults from a whole life cycle perspective, and explore promotion strategies for cognitive function in middle-aged and older adults. Methods The China Family Panel Studies (CFPS) for 2010, 2012, and 2020 was used to construct a multiple mediated-effects model to investigate the mediating pathways of the effect of childhood socioeconomic status on cognitive function in middle-aged and older adults. Pearson correlation analysis was used to analyze the relationship between various indicators. Results A total of 1 034 middle-aged and older adults with an average age of (62.33±9.89) years were included in this study. The childhood socioeconomic status score was (0.000±0.797), education level score was (1.970±1.111), social participation score was (1.150±0.967), depression status score was (5.960±4.681), and cognitive score was (0.000±1.000). Childhood socioeconomic status was positively correlated with education level, social participation, and cognitive function in middle-aged and older adults (P<0.05), and negatively correlated with depressive status (P<0.05). The results of Multiple mediation model regression analysis showed that childhood socioeconomic status had no significant direct effects on cognitive function of middle-aged and older adults (β=0.054, t=1.400, P=0.162), education level, social participation, and depression status significantly affected cognitive function in middle-aged and older adults (β=0.335, t=11.622, P<0.05; β=0.064, t=2.166, P<0.05; β=-0.019, t=-3.154, P<0.05) when controlled for age, gender, urban/rural, chronic disease prevalence, and medical service utilization. The results of the mediation effect test showed that education level and social participation significantly affected cognitive function in the middle-aged and older adults (95%CI=0.141-0.223; 95%CI=0.001-0.019). There was a statistically significant chain mediated effect of education level and social participation (95%CI=0.001-0.017), as well as education level and depression status (95%CI=0.001-0.008) . Conclusion Education level is the resource pathway through which childhood socioeconomic status affects cognitive function in middle-aged and older adults; social participation is a conditional path through which childhood socioeconomic status affects cognitive function in the middle-aged and older adults; depression is a risk factor affecting cognitive function in middle-aged and older adults. Based on the life course theory, attention should be paid to the effect of childhood socioeconomic status from multiple levels of individual, family, and society, to develop cognitive function promotion strategies for the middle-aged and older adults.
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