The influence of widowhood and social engagement on cognitive impairment among Chinese older adults: mediation relations explored

Background: The transition from marriage to widowhood involves an unavoidable role adjustment, which is one of the most traumatic and difficult life experiences for older adults. Studies on the impact of widowhood on cognitive impairment in later life continue to be explored and assessed, however, most of these studies have taken place in the United States and Europe. Although there are several studies focusing on the Chinese population, the role of how lifestyle changes after widowhood in this relationship are less studied. The objective of this study was to explore the mediating role of social engagement, health behaviors, and subjective well-being underlying the association between widowhood and cognitive impairment. Method: This study was conducted with 7,796 older individuals from the Chinese Longitudinal Healthy and Longevity Study (2018). We employed logistic regression models to analyze the effect of widowhood situation effect on cognitive health among older adults, and designed a mediation analysis to determine this possible mediator role. Results: The results showed widows and widowers had a much higher risk of having cognitive impairment than married older adults (95%CI = 1.312,2.279). The results from SEM provided a good fit to the observed data (χ2 = 24.909, p = 0.003, CMIN/DF = 2.768, CFI = 0.996, TLI = 0.986, RMSEA = 0.015, RMR = 0.007 and SRMR = 0.010)and indicated the effect of widowhood on cognitive impairment was partially mediated by social engagement, lifestyle behaviors and subjective-wellbeing (β = 0.075,p < 0.01). Conclusions: This study contributes to the existing knowledge on the mechanisms underlying the association between widowhood and cognitive impairment among older individuals. Consequently, it is imperative to formulate policies that cater to the distinct requirements of this vulnerable population, encompassing the maintenance of social interaction, adoption of a healthy lifestyle, enhancement of subjective well-being, and provision of necessary support systems.