The Impact of Socioeconomic Factors on Cognitive Ability in Community-Dwelling Older Adults: Mediating Effect of Social Participation and Social Support

Background and Purpose: Previous studies have demonstrated the effect of socioeconomic status on the mental or cognitive health in adults. Nevertheless, the effect of specific socioeconomic factors on cognitive function in older people and the mechanism remain to be further investigated. In this study, three specific socioeconomic factors (i.e., income, occupation and education) were used as independent variables, and social support and social participation were used as the parallel or serial mediating variables to investigate the effect on cognitive function in community-dwelling older adults and the specific pathway of influence. Methods: A cross-sectional study was conducted in the Pudong New District of Shanghai, China. A total of 970 community-dwelling older adults aged over 60 years old were enrolled. Socioeconomic factors in older adults, including income, education level, and occupation before retirement, were investigated, and their cognitive function, social support and social participation levels were measured using the MoCA, MSPSS and the quantity of participation in social activities, respectively. Covariates, including lifestyle, health status, sleep quality, and nutritional status, were assessed using a self-designed questionnaire, the PSQI, and the MNA-SF scale. Omnibus mediation effect analysis was adopted to examine the mediation effect, and the mediation analysis was performed using the SPSS PROCESS program. Results: The results showed that the higher levels of socioeconomic conditions (income, occupational experience and education) were linked with better cognitive function in community-dwelling older adults; social participation mediated the aforementioned relationship, with the relative indirect effect of income, occupation and education accounting for 18.36%-20.15%, 28.36%-35.64% and 17.14%-39.19% of their total effects, respectively, compared to their low levels; social support only mediated the relationship of income and education with cognitive function, with the indirect effect accounting for 4.21%-6.77% and 5.29%-10.32%, respectively, compared to their low levels. Serial mediation showed that income and education affected social participation through social support and subsequently cognitive function, with the relative indirect effects accounting for 2.0%-3.3% and 2.4%-4.6% of their total effects, respectively, compared to their low levels. Conclusion: This study demonstrates that social support and social participation independently and cumulatively mediate the relationship between socioeconomic conditions and cognitive function in community-dwelling older adults. The findings provide new insights for the future improvement of cognitive function in community-dwelling older adults in the future.