Demographic and socioeconomic factors associated with cognitive deficiency in patients with chronic diseases: A cross-sectional analysis from the CHARLS study

This study aimed to investigate the associations between cognitive deficiency and various demographic and socioeconomic factors among individuals with chronic internal medicine diseases using data from the China Health and Retirement Longitudinal Study. A cross-sectional analysis was conducted using data from the 2020 wave of the China Health and Retirement Longitudinal Study, following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Cognitive deficiency was assessed using a standardized composite cognitive Z-score, with participants scoring ≤-1.0 classified as having cognitive deficiency. To ensure robust estimates, multivariable logistic regression models were established for each sex, adjusting for standardized age and key socioeconomic covariates. A total of 4300 participants (2425 males and 1875 females) were included. Using the standardized threshold, the prevalence of cognitive deficiency was 11.4% in males and 6.9% in females. In multivariable models, nonurban residence was a significant risk factor for cognitive deficiency in both males (odds ratio [OR]: 3.37; 95% confidence interval [CI]: 2.22-5.13; P < .001) and females (OR: 1.93; 95% CI: 1.23-3.02; P = .004). Income strain was also significantly associated with cognitive deficiency in both males (OR: 1.96; 95% CI: 1.47-2.61; P < .001) and females (OR: 1.52; 95% CI: 1.02-2.26; P = .039). Marital status remained significant for males (OR: 1.43; 95% CI: 1.05-1.94; P = .023). Nonurban residence and financial strain are universal socioeconomic determinants of cognitive health in both male and female patients with chronic internal medicine diseases. Marital separation further increases cognitive risk in males. Targeted interventions should prioritize rural populations and economically vulnerable patients to mitigate cognitive decline.