Relationship between Social Participation and Cognitive Impairment in Low-Educated Older Adults Based on Indonesian Family Life Survey-5

Background: The increasing older adult population requires attention in terms of education and health, as higher education levels contribute to cognitive reserve and may protect against age-related cognitive impairment.Cognitive reserve is an individual's cognitive flexibility in using cognitive functions affected by brain aging, neurological diseases, and injury.Indonesia has a high prevalence of low-educated older adults, which strongly correlates with progressive cognitive impairment.Identifying risk factors for cognitive decline in this population is crucial.This study determines the factors affecting cognitive impairment in low-educated older adults using cross-sectional data from the Indonesian Family Life Survey-5.Methods: This descriptive study analyzed 2,313 low-educated older adults ≥60 years old.Univariate and bivariate analyses were used to describe the sample and identify the relationships between categorical variables.Logistic regression identified the most significant factor affecting cognitive impairment.Results: The prevalence of cognitive impairment in low-educated older adults is 22.6%.The chi-square test revealed significant relationships between those who are aged 75 years, a status other than married, female, living in rural areas, and not participating in social activities.Age is the most prominent factor affecting cognitive impairment in such adults (P<0.001;adjusted odds ratio, 3.232; 95% confidence interval, 2.500-4.180). Conclusion:Cognitive impairment in the aforementioned adults is associated with being ≥75 years old, being a status other than married, being female, living in rural areas, and not participating in social activities.After controlling other variables, low-educated older adults who participated in at least ≥1 social activity in the last 12 months experienced cognitive impairment 0.64 times compared to those who did not participate in social activities.