Social participation, loneliness and cognitive function in the elderly in China: a cross- lagging longitudinal study based on CLHLS

Background With the acceleration of the aging process of the Chinese population, Cognitive dysfunction in the elderly has emerged as a significant challenge for healthy aging. The dynamic relationship and causal pathways between social participation, loneliness, and cognitive function remain unclear. Methods This study utilized longitudinal data from the China Longitudinal Health and Longevity Survey (CLHLS) from 2011 to 2018, including 2800 older adults ≥ 65 years or older. Cognitive function was assessed using the Chinese Mini-Mental State Examination (CMMSE). Social participation and loneliness were assessed through validated questionnaires. Unconditional latent growth curve model (ULGCM) and cross-lag panel model (CLPM) were employed to examine developmental trajectories and bidirectional causality. Results Men showed significantly higher cognitive function and lower levels of loneliness, while women showed higher levels of social participation ( P < 0.05). ULGCM showed a downward trend in social participation and cognitive functioning, with loneliness increasing over time. CLPM showed a significant two-way predictive relationship between social participation and cognitive functioning (T1-T2: β =-0.073, P < 0.01; T2-T3: β =-0.118, P < 0.01). Social participation was a negative predictor of loneliness at all time points, while loneliness was significantly negatively predicted by social participation only later (T2-T3: β =-0.037, P = 0.039). Cognitive function positively predicted decreased loneliness, but loneliness did not significantly predict cognitive function. Conclusion This study reveals the complex dynamic relationship between social participation, loneliness, and cognitive function in older Chinese adults, providing scientific evidence for targeted interventions to improve cognitive health and reduce loneliness in this population.