Positive Psychological Assets and the Onset of Cognitive Impairment Among Chinese Older Adults

Background and Purpose: Dementia is one of the major causes of dependency among older adults worldwide. Efforts aiming to identify modifiable factors that may prevent or slow the progression of cognitive decline are necessary. Previous research has shown the beneficial effects of positive psychological assets on health, but more research is needed to confirm the prospective effects on cognitive function. The purpose of this study is to examine the relationship between positive psychological assets and the earliest onset of cognitive impairment among Chinese older adults.

Methods: Data came from 2000 to 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Study sample consisted of 6,225 older adults who were free from cognitive impairment in 2000. Positive psychological assets was measured based on seven items that assessed optimism, conscientiousness, self-determination, happiness, and self-esteem, with responses ranging from “never (1)” to always (5)”. Item values were summed up, with higher scores indicating higher levels of  positive psychological assets (Cronbach’s alpha at T1, T2, T3, T4, and at T5 =.89, .89, .90, .91, & .90, respectively). Cognitive impairment was measured by a Chinese version of the Mini-Mental State Examination. Respondents scored at or above 24 were regarded as having no cognitive impairment. A multi-category time-varying variable was used to capture four potential outcomes: (1) persistently free of cognitive impairment between waves, (2) onset of cognitive impairment, (3) death between waves, and (4) attrition. Socio-demographics, chronic diseases conditions, functional health status were served as controls. Multilevel multinomial logistic regression models that account for clustering of observations within a subject over time were employed for the study.

Results: The results show that higher level of positive psychological assets is significantly associated with reduced risk of cognitive impairment onset over time, controlling for individual socio-demographic characteristics, chronic diseases conditions, and functional health status.

Conclusions and Implications: Findings suggest that developing interventions that enhance older adults’ positive psychological assets may help them delay the onset of cognitive impairment.