function could be anticipated through integrative activities that incor-porate physical, mental, and social elements. Synergies involving physical, cognitive, and social factors may result in significant out-comes, such as an improvement in cognitive function. In addition, the effects of social participation are also not limited to cognitive func-tion. A Chinese study demonstrated that in older people living alone, those who participated in more social activities had better physical function and lower risks of mortality (Gu, Feng, & Yeung, 2018).
Therefore, social participation may be an important modifiable factor for maintaining overall health and independence of older adults living alone.
For almost all variables, excluding face-to-face contact with fri-ends, the older adults living with others had more frequent social con-tact than those who lived alone. Multiple regression analyses showed no significant relationship between social contact (except for phone or letter contact with siblings and relatives) and cognitive function when controlling other factors. Several previous studies showed inconsistent association between levels of contact and cognition among older adults. Kim and Chon (2018) reported that cognitive decline was not associated with the frequency of face-to-face contact with a first-born child; however, it was associated with contact through phone calls, letters, and emails. Another community-based longitudinal study reported that frequent phone or letter contact with children was negatively related to cognitive decline; conversely, fre-quent face-to-face contact with children was positively related to cog-nitive decline in older adults (Lee & Kim, 2016). Lee and Kim (2016) explained these contradictory results may be attributed to the stress of supporting their adult children in home-based commitments. In many Asian cultures involving family interdependence, adult children may ask for their parents' help in the house or for childcare; many older adults often provide their adult children with these forms of support. The physical and mental burden on older adults in these situ-ations may generate stress, which could result in neuronal degenera-tion and cognitive decline. It is also plausible that frequent face-to-face contact with adult children implies a need to receive aid from them owing to age-related functional dependence and chronic dis-ease. Several studies have shown inconsistent results; therefore, fur-ther studies are needed to identify plausible relationships between social contact and cognitive function.
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How to cite this article: Choi MK. Association between social participation and cognitive function among community-dwelling older adults living alone: Analysis of a nationally representative survey. Int J Nurs Pract. 2020;e12841.https://
doi.org/10.1111/ijn.12841
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