The association between family members’ migration and cognitive function among people left behind in China

Autoři: Yosuke Inoue aff001;  Annie Green Howard aff001;  Bo Qin aff003;  Aki Yazawa aff004;  Andrew Stickley aff005;  Penny Gordon-Larsen aff001
Působiště autorů: Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America aff001;  Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America aff002;  Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States of America aff003;  Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America aff004;  The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden aff005;  Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222867


While internal migration is widely occurring in countries across the world and older people are more likely to be left behind by family members who out-migrated to other locations, little attention has been paid to the cognitive health of those people who have been left behind (PLB). Understanding how these demographic patterns relate to older persons’ cognitive health may inform efforts to reduce the disease burden due to cognitive decline. Data came from the China Health and Nutrition Survey in 1997, 2000 and 2004. Participants aged 55 to 93 who participated in a cognitive function screening test (score range: 0–31) in two or more waves and provided information on family members’ migration (n = 1,267) were included in the analysis. A mixed linear model was used to investigate the association between being left behind by any members who had not resided in the household for at least 6 months at baseline and cognitive function. Approximately 10% of the participants had been left behind by family members who migrated out of their communities. A significant interaction was observed in relation to cognitive function between being left behind and the number of years from the first test. Specifically, there was a less steep decline in cognitive function of PLB compared to people not left behind. This longitudinal study showed that PLB tended to have a higher cognitive function compared to those not left behind due to their relatively stable transition in cognitive function during the study period.

Klíčová slova:

Cognitive impairment – Elderly – Geriatric depression – Geriatrics – Human families – China – Schools – Socioeconomic aspects of health


1. International Organization for Migration (2015) World Migration Report 2015: Migrants and Cities: New Partnerships to Manage Mobility. Geneva, Switzerland.

2. Thapa DK, Visentin D, Kornhaber R, Cleary M (2018) Migration of adult children and mental health of older parents 'left behind': An integrative review. PLS ONE 13: e0205665.

3. Burazeri G, Goda A, Tavanxhi N, Sulo G, Stefa J, Kark JD. (2007) The health effects of emigration on those who remain at home. Int J Epidemiol 36: 1265–1272. doi: 10.1093/ije/dym162 17768161

4. Lu Y (2012) Household migration, social support, and psychosocial health: the perspective from migrant-sending areas. Soc Sci Med 74: 135–142. doi: 10.1016/j.socscimed.2011.10.020 22169626

5. Taylor JE, Arango J, Hugo G, Kouaouci A, Massey DS, Pellegrino A. (1996) International migration and community development. Population Index: 397–418.

6. Lu Y, Hu P, Treiman DJ (2012) Migration and depressive symptoms in migrant-sending areas: findings from the survey of internal migration and health in China. Int J Public Health 57: 691–698. doi: 10.1007/s00038-011-0314-0 22015649

7. Abas M, Tangchonlatip K, Punpuing S, Jirapramukpitak T, Darawuttimaprakorn N, Prince M, et al. (2013) Migration of children and impact on depression in older parents in rural Thailand, Southeast Asia. JAMA Psychiatry 70: 226–233. doi: 10.1001/jamapsychiatry.2013.271 23403485

8. Li BQ (2006) Floating population or urban citizens? Status, social provision and circumstances of rural-urban migrants in China. Soc Policy Adm 40: 174–195.

9. Liang Z, Li Z, Ma Z (2014) Changing patterns of the floating population in China, 2000–2010. Population and Development Review 40: 695–716. doi: 10.1111/j.1728-4457.2014.00007.x 26213427

10. The National Health and Family Planning Commission C (2015) The Report on Chinese Family Development. Beijing, China.

11. Zhai Y, Yi H, Shen W, Xiao Y, Fan H, He F, et al. (2015) Association of empty nest with depressive symptom in a Chinese elderly population: A cross-sectional study. J Affect Disord 187: 218–223. doi: 10.1016/j.jad.2015.08.031 26342917

12. Wang Z, Shu D, Dong B, Luo L, Hao Q. (2013) Anxiety disorders and its risk factors among the Sichuan empty-nest older adults: A cross-sectional study. Arch Gerontol Geriatr 56: 298–302. doi: 10.1016/j.archger.2012.08.016 23022057

13. Guo YQ, Zhang CC, Huang H, Zheng X, Pan XJ, Zheng JZ. (2016) Mental health and related influencing factors among the empty-nest elderly and the non-empty-nest elderly in Taiyuan, China: a cross-sectional study. Public Health 141: 210–217. doi: 10.1016/j.puhe.2016.09.005 27932003

14. Gao M, Li Y, Zhang S, Gu L, Zhang J, Li Z, et al. (2017) Does an Empty Nest Affect Elders' Health? Empirical Evidence from China. Int J Environ Res Public Health 14.

15. Lv XL, Jiang YH, Sun YH, Ren CZ, Sun CY, Sun L, et al. (2013) Short form 36-Item Health Survey test result on the empty nest elderly in China: a meta-analysis. Arch Gerontol Geriatr 56: 291–297. doi: 10.1016/j.archger.2012.10.011 23182316

16. Chang Y, Guo X, Guo L, Li Z, Yang H, Yu S, et al. (2016) Comprehensive Comparison between Empty Nest and Non-Empty Nest Elderly: A Cross-Sectional Study among Rural Populations in Northeast China. Int J Environ Res Public Health 13.

17. Glisky EL (2007) Changes in Cognitive Function in Human Aging. In: Riddle DR, editor. Brain Aging: Models, Methods, and Mechanisms. Boca Raton (FL).

18. Duan D, Dong Y, Zhang H, Zhao Y, Diao Y, Cui Y, et al. (2017) Empty-nest-related psychological distress is associated with progression of brain white matter lesions and cognitive impairment in the elderly. Sci Rep 7: 43816. doi: 10.1038/srep43816 28256594

19. Ao X, Jiang DW, Zhao Z (2016) The impact of rural-urban migration on the health of the left-behind parents. China Economic Review 37: 126–139.

20. Huang BH, Lian YJ, Li WS (2016) How far is Chinese left-behind parents' health left behind? China Economic Review 37: 15–26.

21. He G, Xie JF, Zhou JD, Zhong ZQ, Qin CX, Ding SQ. (2016) Depression in left-behind elderly in rural China: Prevalence and associated factors. Geriatr Gerontol Int 16: 638–643. doi: 10.1111/ggi.12518 26017357

22. Adhikari R, Jampaklay A, Chamratrithirong A (2011) Impact of children's migration on health and health care-seeking behavior of elderly left behind. BMC Public Health 11: 143. doi: 10.1186/1471-2458-11-143 21366920

23. Giles J, Mu R (2007) Elderly parent health and the migration decisions of adult children: Evidence from rural China. Demography 44: 265–288. doi: 10.1353/dem.2007.0010 17583305

24. Popkin BM, Du S, Zhai F, Zhang B (2010) Cohort Profile: The China Health and Nutrition Survey—monitoring and understanding socio-economic and health change in China, 1989–2011. Int J Epidemiol 39: 1435–1440. doi: 10.1093/ije/dyp322 19887509

25. National Bureau of Statistics of China (2007) China Statistical Yearbook. Beijing: China Statistics Press.

26. Chen C (1996) Nutrition status of the Chinese people. Biomedical and Environmental Sciences: BES 9: 81–92.

27. Wang L (2005) Report of China nationwide nutrition and health survey 2002 (1): summary report. Beijing: People’s Medical Publishing House: 18–45.

28. Popkin BM (2010) The Implications of the Nutrition Transition for Obesity in the Developing World. In: Crawford D, Ball K, Brug J, editors. Obesity Epidemiology: from Aetiology to Public Health. Oxford: Oxford University Press. pp. 136–142.

29. Welsh KA, Breitner JCS, Magruderhabib KM (1993) Detection of Dementia in the Elderly Using Telephone Screening of Cognitive Status. Neuropsychiatry Neuropsychol Behav Neurol 6: 103–110.

30. Crimmins EM, Kim JK, Langa KM, Weir DR (2011) Assessment of Cognition Using Surveys and Neuropsychological Assessment: The Health and Retirement Study and the Aging, Demographics, and Memory Study. J Gerontology B-Psychol 66: 162–171.

31. Qin B, Plassman BL, Edwards LJ, Popkin BM, Adair LS, Mendez MA. (2014) Fish Intake Is Associated with Slower Cognitive Decline in Chinese Older Adults. J Nutr 144: 1579–1585. doi: 10.3945/jn.114.193854 25080536

32. Qin B, Viera AJ, Muntner P, Plassman BL, Edwards LJ, Adair LS, et al. (2016) Visit-to-Visit Variability in Blood Pressure Is Related to Late-Life Cognitive Decline. Hypertension 68: 106–113. doi: 10.1161/HYPERTENSIONAHA.116.07494 27217401

33. Strauss J, Lei X, Park A, Shen Y, Smith JP, Yang Z, et al. (2010) Health Outcomes and Socio-Economic Status Among the Elderly in Gansu and Zhejiang Provinces, China: Evidence from the CHARLS Pilot. J Popul Ageing 3: 111–142. doi: 10.1007/s12062-011-9033-9 23539329

34. Jones-Smith JC, Popkin BM (2010) Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med 71: 1436–1446. doi: 10.1016/j.socscimed.2010.07.027 20810197

35. Du Y, Park A, Wang SG (2005) Migration and rural poverty in China. J Comp Econ 33: 688–709.

36. De Brauw A, Rozelle S (2008) Migration and household investment in rural China. China Econ Rev 19: 320–335.

37. Mani A, Mullainathan S, Shafir E, Zhao JY (2013) Poverty Impedes Cognitive Function. Science 341: 976–980. doi: 10.1126/science.1238041 23990553

38. Yang L, Martikainen P, Silventoinen K, Konttinen H (2016) Association of socioeconomic status and cognitive functioning change among elderly Chinese people. Age Ageing 45: 673–679.

39. Chang H, Dong X, Macphail F (2011) Labor Migration and Time Use Patterns of the Left-behind Children and Elderly in Rural China. World Dev 39: 2199–2210.

40. Wang LM, Mesman J (2015) Child Development in the Face of Rural-to-Urban Migration in China: A Meta-Analytic Review. Perspectives on Psychological Science 10: 813–831. doi: 10.1177/1745691615600145 26581737

41. Bassuk SS, Glass TA, Berkman LF (1999) Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med 131: 165–+. doi: 10.7326/0003-4819-131-3-199908030-00002 10428732

42. Weuve J, Kang JH, Manson JE, Breteler MMB, Ware JH, Grodstein F. (2004) Physical activity, including walking, and cognitive function in older women. JAMA 292: 1454–1461. doi: 10.1001/jama.292.12.1454 15383516

43. Liang Y, Wu W (2014) Exploratory analysis of health-related quality of life among the empty-nest elderly in rural China: an empirical study in three economically developed cities in eastern China. Health Qual Life Outcomes 12: 59. doi: 10.1186/1477-7525-12-59 24766880

44. Xie LQ, Zhang JP, Peng F, Jiao NN (2010) Prevalence and related influencing factors of depressive symptoms for empty-nest elderly living in the rural area of YongZhou, China. Arch Gerontol Geriatr 50: 24–29. doi: 10.1016/j.archger.2009.01.003 19217674

45. Liu LJ, Guo Q (2007) Loneliness and health-related quality of life for the empty nest elderly in the rural area of a mountainous county in China. Qual Life Res 16: 1275–1280. doi: 10.1007/s11136-007-9250-0 17703375

46. Liu LJ, Guo Q (2008) Life satisfaction in a sample of empty-nest elderly: a survey in the rural area of a mountainous county in China. Qual Life Res 17: 823–830. doi: 10.1007/s11136-008-9370-1 18595006

47. Jia J, Wang F, Wei C, Zhou A, Jia X, Li F, et al. (2014) The prevalence of dementia in urban and rural areas of China. Alzheimer's & Dementia 10: 1–9.

48. Wang ZH, Zhai FY, Wang HJ, Zhang JG, Du WW, Su C, et al. (2015) Secular trends in meat and seafood consumption patterns among Chinese adults, 1991–2011. Eur J Clin Nutr. 69: 227–233. doi: 10.1038/ejcn.2014.225 25351649

49. Sabia S, Elbaz A, Dugravot A, Head J, Shipley M, Hagger-Johnson G, et al. (2012) Impact of Smoking on Cognitive Decline in Early Old Age The Whitehall II Cohort Study. Arch Gen Psychiat. 69: 627–635. doi: 10.1001/archgenpsychiatry.2011.2016 22309970

50. Liu S, Zhang M, Yang L, Li Y, Wang L, Huang Z, et al. (2016) Prevalence and patterns of tobacco smoking among Chinese adult men and women: findings of the 2010 national smoking survey. J Epidemiol Community Health: jech-2016-207805.

51. Kawachi I (2006) Commentary: Social capital and health: making the connections one step at a time. Int J Epidemiol 35: 989–993. doi: 10.1093/ije/dyl117 16870679

Článek vyšel v časopise


2019 Číslo 9

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Zvyšte si kvalifikaci online z pohodlí domova

Ulcerative colitis_muž_břicho_střeva
Ulcerózní kolitida
nový kurz

Blokátory angiotenzinových receptorů (sartany)
Autoři: MUDr. Jiří Krupička, Ph.D.

Antiseptika a prevence ve stomatologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Citikolin v neuroprotekci a neuroregeneraci: od výzkumu do klinické praxe nejen očních lékařů
Autoři: MUDr. Petr Výborný, CSc., FEBO

Zánětlivá bolest zad a axiální spondylartritida – Diagnostika a referenční strategie
Autoři: MUDr. Monika Gregová, Ph.D., MUDr. Kristýna Bubová

Všechny kurzy
Kurzy Doporučená témata