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Cognitive function among older adults has a crucial effect on successful aging. Several studies suggest that self-rated health affects cognitive function. A previous study reported that a group of older people with poorer perceived health had a higher incidence of dementia compared to their counterparts. Depression is a common negative emotion experienced by older adults. There is substantial empirical evidence that it contributes to the deterioration of cognition in older people. Particularly, a longitudinal study identified that depression symptoms among older adults predicted an increased possibility of a decline in cognitive functioning. Finally, prior studies suggest that social engagement is also strongly associated with cognitive function in later life. Previous research mostly examined the relationships between perceived health, depression, social engagement, and cognitive function among adults separately or cross-sectionally. Therefore, this study aims to take a holistic approach by examining the links between health status, depression, social engagement, and cognitive function among older adults over time.
Methods
The study sample of 2,956 older adults (65 and older at the 5th wave) was drawn from the 5th wave (2014) to 8th wave (2020) of the Korean Longitudinal Study of Ageing (KLoSA) conducted by the Korea Labor Institute. To investigate the longitudinal relationships among factors, the analysis included four parallel latent growth curves and a parallel latent growth curve model (LGCM) was fitted to the cognitive function with self-rated health, depression, and social engagement. Control variables included age, sex, and education. All analyses were conducted via Mplus.
Results
The study sample, on average, was 73.3 years old (65-95), 58.8% were women, and about 40% of sample received at least a middle school education. The model fit was acceptable (χ2 (df = 145) = 918.56, < .001; RMSEA = .042 (.040, .045); CFI = .965; and SRMR = .029). Results of the LGCM indicated that initial health status (ß = -.85. p < .001), social engagement (ß = 1.40. p < .001), depression (ß = -.40. p < .001) were significantly associated with initial cognitive function. Initial social engagement was significantly associated with change of cognitive function (ß = .488. p < .001). The results also revealed parallel relationships between depression change and cognitive function change (ß = -.32. p < .001), self-rated health change and cognitive function change (ß = -5.51. p < .001), and social engagement change and cognitive function change (ß = 1.92. p < .001).
Conclusion and Implications
The examination of the longitudinal relationships between the four latent growth curves indicates that initial physical health, mental health, and social engagement have strong associations with initial cognitive function. Furthermore, older adults who experience a slow decrease in participation in social activities exhibit a gradual decline in cognitive function over time, while those who experience a rapid deterioration in physical and mental health show a faster decline in cognitive function. As a result, policy and practice measures should prioritize the fostering social engagement among older adults to prevent a rapid decline in cognitive function.