Background and Objectives: Living arrangement is a crucial factor for older adults’ health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China’s population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults.

Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008–2009, 2011–2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function.

Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment.

Conclusions: With older adults’ transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.


Public Health and Sports Medicine

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© 2021 The authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).


China, cognitive function, living arrangement, multistate survival analysis, older adults

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