Independent and joint associations of psychological resilience and social support with cognitive impairment among middle-aged and older Chinese adults

The overall prevalence of cognitive impairment in the study sample was 18.4%, with higher rates in women than men.

• Total sample included 3,058 Chinese adults aged ≥ 50 years from urban and rural communities
• 18.4% of all participants had cognitive impairment
• Women had a higher prevalence at 20.1% compared to men at 16.3%
• Cognitive function was assessed using the Mini-Mental State Examination (MMSE)

Higher psychological resilience was independently associated with lower odds of cognitive impairment.

• Resilience was measured using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10)
• The association showed some variation in effect strength across sex, age group, and educational attainment in sensitivity and stratified analyses
• Logistic regression models were stratified by gender and adjusted for demographic, behavioral, and health-related variables
• Generalized additive models revealed curvilinear (non-linear) associations between resilience and cognitive impairment

Higher social support was independently associated with lower odds of cognitive impairment.

• Social support was measured using the 6-item Lubben Social Network Scale (LSNS-6)
• The association showed some variation in effect strength across sex, age group, and educational attainment
• Generalized additive models revealed curvilinear (non-linear) associations between social support and cognitive impairment
• Both resilience and social support associations were examined with adjustment for demographic, behavioral, and health-related variables

The joint combination of moderate resilience and high social support was associated with the lowest risk of cognitive impairment compared to low resilience and low social support.

• Participants with moderate resilience and high support had OR = 0.25 (95% CI: 0.11–0.51) compared to those with low resilience and low support
• Joint effects were examined using combined categories of resilience and social support levels
• This represented a 75% reduction in odds of cognitive impairment for the moderate resilience/high support group
• Joint association analyses suggested potential synergistic benefit of combined psychosocial resources

The associations between psychosocial resources and cognitive impairment appeared to be stronger in women than in men.

• Logistic regression models were stratified by gender to explore sex-specific differences
• The abstract notes associations 'appeared to be stronger in women, although variation by sex was observed'
• Gender-specific stratified analyses were applied with adjustment for demographic, behavioral, and health-related variables
• Women had a higher baseline prevalence of cognitive impairment (20.1%) compared to men (16.3%)

Non-linear (curvilinear) associations were observed between both resilience and social support and cognitive impairment.

• Generalized additive models (GAMs) were used specifically to test for non-linear associations
• Curvilinear associations were observed for both resilience and social support measures
• This finding suggests that the relationship between psychosocial resources and cognitive function is not simply linear across the full range of scores
• Standard logistic regression was supplemented by GAMs to capture these non-linear patterns

The study design was cross-sectional, limiting causal interpretation of the findings.

• The authors explicitly state findings 'should be interpreted as exploratory' given the cross-sectional design
• The authors call for 'further longitudinal and interventional studies to clarify the role of psychosocial resources in cognitive ageing'
• The sample included 3,058 community-dwelling adults from both urban and rural Chinese communities aged ≥ 50 years
• Sensitivity and stratified analyses were conducted to examine variation by sex, age group, and educational attainment