Social-behavioral and psychological resource advantage and favorable cognitive-domain transitions among older Chinese adults: a longitudinal CHARLS study.

OBJECTIVES

This study examined whether social-behavioral and psychological resource advantage, including lower depressive symptom burden, was associated with favorable observed cognitive-domain transitions among older Chinese adults.

METHOD: Using five waves of the China Health and Retirement Longitudinal Study from 2011 to 2020, we constructed four cognitive-domain states and adjacent-wave person-period intervals. The Social-Behavioral Resource Advantage Score-5 (SBRAS-5) was treated as an a priori formative resource-breadth count combining non-low educational attainment, non-agricultural hukou status, social participation, normal sleep duration, and absence of elevated depressive symptoms. Origin-state-restricted logistic models estimated apparent recovery from localized impairment and progression to multidomain impairment.

RESULTS

The descriptive transition sample comprised 15,611 intervals from 5,997 respondents; covariate-adjusted models used 15,607 intervals from 5,994 respondents. Each additional SBRAS-5 point was associated with higher odds of S1-to-S0 apparent recovery (OR = 1.40, 95% CI: 1.26-1.56) and S2-to-S0 apparent recovery (OR = 1.32, 95% CI: 1.24-1.41), and lower odds of S1-to-S3 progression (OR = 0.65, 95% CI: 0.55-0.76) and S2-to-S3 progression (OR = 0.85, 95% CI: 0.79-0.91). Threshold/score-change, depression-separated, weighted-index, selective-observation, stable-recovery, and continuous-time sensitivity analyses supported the principal directional pattern.

CONCLUSION

Resource advantage was associated with more favorable observed cognitive-domain transitions after localized impairment, but not clinically verified recovery.