Association between social capital and cognitive function in older rural Chinese adults: A moderated mediation of depression, education, and ADL.

OBJECTIVE: To determine the moderating mediation of depression, education, and activities of daily living (ADL) between the variables of social capital and cognitive function among older adults in rural China. METHOD: A moderated mediation analysis was performed using the 2018 CHARLS data (N = 7,352, age ≥ 60) through the PROCESS macro. RESULT: The association was partly mediated by depression (indirect effect: B = 0.0211, 95% CI[0.1110,0.3190]; proportion mediated: 4.45%). ADL dampened the depression-cognition relationship (B = 0.030, 95% CI[0.0030,0.0565]), which neutralized the adverse impact of depression. Education also had a mediating influence on the direct social capital-cognition relationship (B = -0.0206, 95% CI[-0.039,-0.0022]), although with a significant effect in less-educated cohorts. CONCLUSIONS: Combinational nurse interventions with the strategy of promoting social capital, screening and managing depression, and assisting with the activities of daily living could be particularly effective at sustaining cognitive ability in rural older adults, and particularly among less educated individuals.