Differences in the Association between Marital/Living Status and Cognitive Domains among Rural and Urban Older Adults
10.11714/jsysu.med.YX20260003
- VernacularTitle:城乡老年人婚姻及居住状况与认知分域关联的差异性研究
- Author:
Yuanyuan PENG
1
;
Yan ZENG
1
;
Zhaolan HUANG
1
Author Information
1. Department of Gastroenterology， Geriatric Hospital Affiliated to Wuhan University of Science and Technology， Wuhan 430065， China
- Publication Type:Journal Article
- Keywords:
community-dwelling older adults;
marital status;
living status;
cognitive domains;
urban-rural differences
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(2):293-305
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the association between marital/living status and cognitive domains （memory， language， visuospatial， executive， and attention domains） in older adults， and to examine the influencing factors underlying urban-rural differences. MethodsBased on baseline data from the dynamic enrollment cohort （2016—2025） of the Hubei Memory and Aging Cohort Study， 10 825 older adults aged 60 years and above who met the study criteria were included， comprising 3 788 rural residents and 7 037 urban residents. The cohort collected information on marital and living status via questionnaires. Cognitive domains were assessed using standardized neuropsychological tests， with scores converted to z-scores ［（raw score - mean score of the domain in the study population）/standard deviation of the domain in the study population］. Multiple linear regression models were used to analyze the associations between marital/living status and cognitive domains， as well as global cognition. ResultsRural older adults scored significantly lower than their urban counterparts in terms of socioeconomic status， healthy lifestyle indicators， and multiple cognitive domains （all P＜0.001）. Living away from family was significantly associated with lower scores across cognitive domains ［memory： b =-0.217， 95%CI （-0.276， -0.159）； attention： b =-0.213， 95%CI （-0.262， -0.163）， all P＜0.001］， with this association being stronger and involving a broader range of cognitive domains in the urban sample. Moreover， compared to married and living with family， married but living away from family was associated with poorer cognitive performance， an effect that was more pronounced in the urban sample ［memory： b =-0.521， 95%CI （-0.621， -0.422）； attention： b =-0.443， 95%CI （-0.533， -0.354）， all P＜0.001］. ConclusionUnmarried status and living away from family were each significantly associated with poorer performance in cognitive domains among older adults. The combined status of being married but living away from family was also associated with poorer cognitive performance， with these associations being more pronounced among urban-dwelling older adults.
