{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:33:10Z","timestamp":1783909990476,"version":"3.55.0"},"reference-count":50,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Discipline construction project of Guangdong Medical University","award":["4SG22001G"],"award-info":[{"award-number":["4SG22001G"]}]},{"name":"Doctoral Research Start-up Foundation of Guangdong Medical University","award":["B2019033"],"award-info":[{"award-number":["B2019033"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71804029"],"award-info":[{"award-number":["71804029"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013314","name":"111 Project","doi-asserted-by":"crossref","award":["B16031"],"award-info":[{"award-number":["B16031"]}],"id":[{"id":"10.13039\/501100013314","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Guangdong Medical Research Fund","award":["C2018081"],"award-info":[{"award-number":["C2018081"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,1]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine how living arrangement as a social contextual factor can affect Chinese elders\u2019 cognitive function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and participants<\/jats:title>\n                  <jats:p>Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China\u2019s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80\u2013112 in China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (\u00b18.31) years. The mean years of schooling were 2.86 (\u00b13.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Chinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050410","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T04:29:34Z","timestamp":1666585774000},"page":"e050410","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of living arrangements on cognitive function in Chinese elders: a longitudinal observational study"],"prefix":"10.1136","volume":"12","author":[{"given":"Yanwei","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Health Sociology, School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong, China"},{"name":"Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4546-0620","authenticated-orcid":false,"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingxian","family":"Wang","sequence":"additional","affiliation":[{"name":"School of public health, Guangdong Medical University, Dongguan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhirong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"2025101810132947000_12.10.e050410.1","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1016\/S0140-6736(20)32136-X","article-title":"Long-Term care system for older adults in China: policy landscape, challenges, and future prospects","volume":"396","author":"Feng","year":"2020","journal-title":"Lancet"},{"key":"2025101810132947000_12.10.e050410.2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001170"},{"key":"2025101810132947000_12.10.e050410.3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.jalz.2013.09.008","article-title":"The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese","volume":"10","author":"Jia","year":"2014","journal-title":"Alzheimers Dement"},{"key":"2025101810132947000_12.10.e050410.4","doi-asserted-by":"publisher","DOI":"10.1002\/1099-1166(200006)15:6<521::AID-GPS182>3.0.CO;2-F"},{"key":"2025101810132947000_12.10.e050410.5","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700033377"},{"key":"2025101810132947000_12.10.e050410.6","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1017\/S1744133118000221","article-title":"Projecting future demand for informal care among older people in China: the road towards a sustainable long-term care system","volume":"14","author":"Hu","year":"2019","journal-title":"Health Econ Policy Law"},{"key":"2025101810132947000_12.10.e050410.7","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610214001240"},{"key":"2025101810132947000_12.10.e050410.8","doi-asserted-by":"publisher","DOI":"10.1037\/a0013421"},{"key":"2025101810132947000_12.10.e050410.9","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.gerinurse.2020.06.014","article-title":"The association between nutritional status, advanced activities of daily living, and cognitive function among Brazilian older adults living in care homes","volume":"41","author":"Assis","year":"2020","journal-title":"Geriatr Nurs"},{"key":"2025101810132947000_12.10.e050410.10","first-page":"735","article-title":"Spousal care-giving arrangements in Europe. 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