Longitudinal Relationship between Cognitive Decline and Subjective Well-Being in Older Adults Based on the Random-Intercept Cross-Lagged Panel Model

Objective. This study used a random-intercept cross-lagged panel model (RI-CLPM) to explore the longitudinal relationship between cognitive function (CF) and subjective well-being (SWB) for older adults and investigate if older adults with cognitive decline can be happy. Older adults were divided into two groups according to gender, and the effect of gender with different groups on CF and SWB was discussed. The effects of age, marital status, self-rated health, exercise, and education level on the CF and SWB were investigated. Methods. This study adopted a longitudinal design and selected 4,672 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which spanned 3 time points from 2008 to 2014 (N = 4,672). The mean age was 78.18 years (SD = 9.75, range = 61-111) and 2,238 (47.9%) were males. The CF was measured using the cognitive function scale, and the SWB was measured using 6 questions related to positive and negative emotions from CLHLS. Results. (1) The chi-square difference test between the two models further showed that the RI-CLPM fitted data significantly better than traditional CLPM (triangle chi(2) (3) = 203.656, p<0.001). The RI-CLPM was more suitable for this study than the CLPM. (2) This study examined whether the relationship between CF and SWB for older adults was bidirectional or unidirectional. The article only partially supported them, which indicates that including the gender role was successful. (3) Self-rated health, exercise, and education level had a significant positive impact on both CF and SWB. The only distinguishable factor that affects CF between males and females is the marital status. The effect for female CF is not significant (beta = -0.001, p=0.961), but the effect for male CF is significant (beta = -0.146, p<0.001). Conclusion. Gender discrimination is necessary to better understand the impact of cognitive decline on SWB. Female older adults with cognitive decline could be happy, but male older adults could not. Male CF is more affected by marital status than females. It is more important to care about the cognitive decline of unmarried male older adults. Older age and unmarried males are risk factors for older adults, but better self-rated health, more regular exercise, and continuous learning are the protective factors for older adults. These risk factors need to be prevented and these protective factors should be strengthened.