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Review
. 2024 Mar 22;14(4):262.
doi: 10.3390/bs14040262.

Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies

Cláudia Cunha  1 , Gina Voss  2 , Renato Andrade  3   4   5 , Alice Delerue-Matos  1   6
Affiliations
Review

Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies

Cláudia Cunha et al. Behav Sci (Basel). .

Abstract

This systematic review with meta-analysis aimed to explore the association between formal social participation and cognitive function in middle-aged and older adults using data from longitudinal studies. A comprehensive search was conducted in Scopus, PubMed, and Web of Science for longitudinal studies that assessed the association between formal social participation and cognitive function in middle-aged and older adults published between January 2010 to 19 August 2022. Risk of bias was judged using the RoBANS tool. Meta-analysis using a random-effects model was computed with odds ratio (OR) and 95% confidence interval (CI) for cognitive decline probability. Sensitivity analyses were made to explore any changes to the pooled statistical heterogeneity and pooled effect size. Certainty of evidence was judged using the GRADE framework. We included 15 studies comprising 136,397 participants from 5 countries. Meta-analyses showed that formal social participation was associated with reduced cognitive decline (OR = 0.78, 95% CI 0.75-0.82, p < 0.001), with very low certainty of evidence. Formal social participation appears to enhance cognition in middle-aged and older adults, but further high-quality research is needed given the very low certainty of evidence.

Keywords: cognitive function; formal social participation; middle-aged; older adults.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the study selection process.
Figure 2
Figure 2
Risk of bias judgment: (a) study level; (b) overall summary of all included studies; [18,20,21,22,23,24,25,32,33,34,42,43,44,45,46].
Figure 3
Figure 3
Quantitative synthesis on the dichotomous measurement of cognitive function. Notes: ** = Downgraded two levels due to very serious study limitations (high risk of bias in at least three domains); § = Downgraded one level due to serious indirectness (different methods for assessing formal social participation and cognitive function); [24,25,33,34,43,44].
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