Does Social Participation Modify the Association Between Depression and Cognitive Functioning among Older Adults in China? A Secondary Analysis Based on CHARLS

Abstract Background Cognitive impairment and depression significantly affect the mental health of older Chinese adults. While previous studies highlighted the positive impact of social participation on cognitive functioning and depression, research on its specific types and their influence on the depression-cognitive relationship is limited. This study investigated which social activities mitigate cognitive impairment and if they moderate depression's effect on cognitive functioning in older Chinese adults. Methods The study conducted hierarchical regression analysis on the China Health and Retirement Longitudinal Study (CHARLS) dataset of 5,056 older adults. The Mini-Mental State Examination (MMSE) was employed to measure the cognitive performance of the subjects, and the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was utilized to evaluate depressive symptoms. Hierarchical regression analysis tested the fit of step-wise models: Model 1 examined the main effect of depression on cognitive functioning; Model 2 & 3 assessed the main and interactive effects of formal and informal social participation; and Model 4 & 5 evaluated the effects of specific social participation categories and their interactions with depression on cognitive functioning. Results Regression results indicated that depression significantly impacted older Chinese adults' cognitive functioning in all models. Engaging in both formal and informal social activities reduced cognitive decline among these adults. Specific activities like "playing mahjong, chess, or cards," "attending clubs or community organizations," and "stock investing" positively correlated with the MMSE scores. No interaction was observed between any form of social participation and depression. Conclusion The study highlighted the positive impact of social participation, especially informal activities, on the mental health of older Chinese adults. Its findings have implications for public policy and health, suggesting the need for social venues and activities for older adults. This could enhance their life satisfaction and ease the load on China's health system.