{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:11:49Z","timestamp":1782306709458,"version":"3.54.5"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T00:00:00Z","timestamp":1583539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objective<\/jats:title>\n                  <jats:p>older adults have increased risk of social isolation, loneliness and cognitive functioning impairment, but the relationships among these factors are not conclusive. We investigated the potential mediation mechanism of loneliness on the association between social isolation and cognitive functioning among Chinese older adults within their cultural context.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>secondary analysis of the baseline wave (2011\u201312) of the harmonised China Health and Retirement Longitudinal Study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and Subjects<\/jats:title>\n                  <jats:p>community-dwelling older adults in China (N\u00a0=\u20097,410 participants aged 60\u2013101\u00a0years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>we applied a multiple indicator multiple cause approach to determine whether the construct of social isolation is well defined by four indicators (social activity engagement, weekly adult children contact, caregiving for grandchildren and living alone) and used structural equation modelling to examine the direct and indirect effects among variables of interest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>the results demonstrated that social activity engagement, weekly adult children contact and caregiving for grandchildren were significantly related to social isolation (\u03b2\u2009=\u2009\u22120.26 to \u22120.28) (Living alone was fixed to 1 for model identification.) The indirect effect of social isolation on cognitive functioning through loneliness was significant (\u03b2\u2009=\u2009\u22120.15), indicating loneliness was an important mediator. However, the direct effect of social isolation on cognitive functioning also remained significant (\u03b2\u2009=\u2009\u22120.83), suggesting a partial mediation effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>our study highlights the mediation role of loneliness in the relationship between social isolation and cognitive functioning among Chinese older adults. The findings support the beneficial effects of maintaining social relations and coping with feelings of loneliness on older adults\u2019 cognitive functioning.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaa020","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T12:08:32Z","timestamp":1581077312000},"page":"599-604","source":"Crossref","is-referenced-by-count":93,"title":["Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-2507","authenticated-orcid":false,"given":"Rumei","family":"Yang","sequence":"first","affiliation":[{"name":"School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haocen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Health and Kinesiology, College Station, Texas A and M University, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda S","family":"Edelman","sequence":"first","affiliation":[{"name":"Health Systems and Community Based Care Division, University of Utah College of Nursing, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjin L","family":"Tracy","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Demiris","sequence":"first","affiliation":[{"name":"University of Utah College of Nursing, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A","family":"Sward","sequence":"first","affiliation":[{"name":"University of Pennsylvania School of Nursing, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary W","family":"Donaldson","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Pain Research Center, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,7]]},"reference":[{"key":"2020070207442425900_ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1186\/s13643-017-0632-2","article-title":"The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review","volume":"1","author":"Kelly","year":"2017","journal-title":"Syst Rev"},{"key":"2020070207442425900_ref2","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1016\/s0140-6736(00)02113-9","article-title":"Influence of social network on occurrence of dementia: a community-based longitudinal study","volume":"9212","author":"Fratiglioni","year":"2000","journal-title":"Lancet"},{"key":"2020070207442425900_ref3","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1093\/geronb\/gbu007","article-title":"Loneliness and mortality among older adults in China","volume":"4","author":"Luo","year":"2014","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2020070207442425900_ref4","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1017\/s0714980817000101","article-title":"Social isolation in Chinese older adults: scoping review for age-friendly community planning","volume":"2","author":"Syed","year":"2017","journal-title":"Can J Aging"},{"key":"2020070207442425900_ref5","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1017\/s1041610214002749","article-title":"Loneliness and cognitive function in the older adult: a systematic review","volume":"4","author":"Boss","year":"2015","journal-title":"Int Psychogeriatr"},{"key":"2020070207442425900_ref6","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/PSY.0b013e31827f09cd","article-title":"Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English longitudinal study of ageing","volume":"2","author":"Shankar","year":"2013","journal-title":"Psychosom Med"},{"key":"2020070207442425900_ref7","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1159\/000351265","article-title":"Which social network or support factors are associated with cognitive abilities in old age?","volume":"5","author":"Gow","year":"2013","journal-title":"Gerontology"},{"key":"2020070207442425900_ref8","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1097\/PSY.0b013e3181f5e121","article-title":"What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later","volume":"9","author":"Amieva","year":"2010","journal-title":"Psychosom Med"},{"key":"2020070207442425900_ref9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/00223980.2010.548414","article-title":"Loneliness, optimism, and well-being among married, divorced, and widowed individuals","volume":"1-2","author":"Ben-Zur","year":"2012","journal-title":"J Psychol"},{"key":"2020070207442425900_ref10","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/s0140-6736(00)02107-3","article-title":"Which influences cognitive function: living alone or being alone?","volume":"9212","author":"Berkman","year":"2000","journal-title":"Lancet"},{"key":"2020070207442425900_ref11","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1017\/CBO9780511606632.027","volume-title":"The Cambridge Handbook of Personal Relationships","author":"de Jong Gierveld","year":"2006"},{"key":"2020070207442425900_ref12","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1002\/gps.4509","article-title":"The discrepancy between social isolation and loneliness as a clinically meaningful metric: findings from the Irish and English longitudinal studies of ageing (TILDA and ELSA)","volume":"6","author":"McHugh","year":"2017","journal-title":"Int J Geriatr Psychiatry"},{"key":"2020070207442425900_ref13","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/j.socscimed.2011.11.028","article-title":"Loneliness, health, and mortality in old age: a national longitudinal study","volume":"6","author":"Luo","year":"2012","journal-title":"Soc Sci Med"},{"key":"2020070207442425900_ref14","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1093\/geronb\/gbt075","article-title":"Feeling lonely versus being alone: loneliness and social support among recently bereaved persons","volume":"1","author":"Utz","year":"2014","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2020070207442425900_ref15","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1007\/s11606-014-2977-8","article-title":"Living alone, socially isolated or lonely-what are we measuring?","volume":"11","author":"Perissinotto","year":"2014","journal-title":"J Gen Intern Med"},{"key":"2020070207442425900_ref16","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1159\/000091828","article-title":"Social contacts and their relationship to loneliness among aged people - a population-based study","volume":"3","author":"Routasalo","year":"2006","journal-title":"Gerontology"},{"key":"2020070207442425900_ref17","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1093\/sf\/sor012","article-title":"Intergenerational ties in context: grandparents caring for grandchildren in China","volume":"2","author":"Chen","year":"2011","journal-title":"Soc Forces"},{"key":"2020070207442425900_ref18","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/ageing\/afx032","article-title":"Continuity and changes in three types of caregiving and the risk of depression in later life: a 2-year prospective study","volume":"5","author":"Liu","year":"2017","journal-title":"Age Ageing"},{"key":"2020070207442425900_ref19","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/jomf.12096","article-title":"Does grandparenting pay off? The effect of child care on grandparents' cognitive functioning","volume":"2","author":"Arpino","year":"2014","journal-title":"J Marriage Fam"},{"key":"2020070207442425900_ref20","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.archger.2014.09.007","article-title":"Frequency of contact with non-cohabitating adult children and risk of depression in elderly: a community-based three-year longitudinal study in Korea","volume":"1","author":"Roh","year":"2015","journal-title":"Arch Gerontol Geriatr"},{"key":"2020070207442425900_ref21","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China health and retirement longitudinal study (CHARLS)","volume":"1","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol"},{"key":"2020070207442425900_ref22","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1002\/gps.4495","article-title":"Loneliness, depression and cognitive function in older U.S. adults","volume":"5","author":"Donovan","year":"2017","journal-title":"Int J Geriatr Psychiatry"},{"key":"2020070207442425900_ref23","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale)","volume":"2","author":"Andresen","year":"1994","journal-title":"Am J Prev Med"},{"key":"2020070207442425900_ref24","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1007\/s11136-005-3977-2","article-title":"Structural equation models for quality of life response shifts: promises and pitfalls","volume":"10","author":"Donaldson","year":"2005","journal-title":"Qual Life Res"},{"key":"2020070207442425900_ref25","first-page":"1","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives","volume":"1","author":"Lt","year":"1999","journal-title":"Struct Equ Model Multidiscip J"},{"key":"2020070207442425900_ref26","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1093\/geronb\/60.6.P320","article-title":"Trajectories of cognitive decline and social relations","volume":"6","author":"Beland","year":"2005","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2020070207442425900_ref27","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1080\/13607863.2012.692764","article-title":"Chinese older adults' resilience to the loneliness of living alone: a qualitative study","volume":"8","author":"Lou","year":"2012","journal-title":"Aging Ment Health"},{"key":"2020070207442425900_ref28","doi-asserted-by":"publisher","first-page":"i38","DOI":"10.1093\/geronb\/gbp037","article-title":"Measuring social isolation among older adults using multiple indicators from the NSHAP study","volume":"64B","author":"Cornwell","year":"2009","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2020070207442425900_ref29","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1037\/amp0000103","article-title":"Advancing social connection as a public health priority in the United States","volume":"6","author":"Holt-Lunstad","year":"2017","journal-title":"Am Psychol"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/4\/599\/33456230\/afaa020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/4\/599\/33456230\/afaa020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T11:46:41Z","timestamp":1593690401000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/49\/4\/599\/5799038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,7]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,3,7]]},"published-print":{"date-parts":[[2020,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afaa020","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,7]]},"published":{"date-parts":[[2020,3,7]]}}}