Association Between Social Participation and Cognitive Decline Among Middle-Aged and Older Chinese Community-Dwelling Adults: Insights from the China Health and Retirement Longitudinal Study (CHARLS)

Background Cognitive impairment is a growing public health concern globally. Early identification of risk factors for cognitive decline is critical for delaying and preventing its onset. Alongside physical activity, social engagement represents a key component of healthy aging among middle-aged and older adults. Methods This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), including 12,171 participants. Baseline social participation was recorded, and cognitive function was assessed using z-scores calculated at baseline and follow-up. Cognitive decline was defined as a negative change in z-scores between the two time points. Statistical analyses were conducted using SPSS, with significance set at p < 0.05. Results Baseline cognition z-scores were significantly positively associated with social participation (β = 0.119, p < 0.001), and follow-up z-scores showed a similar positive association (β = 0.060, p < 0.001). Conversely, a decline in delta z-scores was negatively associated with social participation (β=-0.067, p < 0.001). Besides, a significant association was observed between overall social participation and cognitive decline (OR = 0.795, 95% CI: 0.728–0.869, p < 0.001). Additionally, interacting with friends also showed a significant relationship with cognitive decline (OR = 0.809, 95% CI: 0.739–0.886, p < 0.001). Conclusion This study highlights a significant relationship between social participation and cognitive decline among Chinese adults. Social participation appears to play a protective role in maintaining cognitive function and mitigating decline. Further research is warranted to confirm these findings and explore the mechanisms.