Relationship Between Cognitive Function Improvements and Social Participation in Employed and Unemployed Elderly with Mild Cognitive Impairment

Abstract

Independent living and community integration are hampered by cognitive impairment in older adults. The results of therapeutic tactics and cognitive resilience may be impacted by employment position. Using a structured aerobic and computer-based cognitive training program, the goal is to determine how improvements in cognitive function relate to changes in social participation and health-related quality of life in older adults with mild cognitive impairment (MCI) who are employed or unemployed. Methods: 168 older adults (60–65 years old) with MCI were randomly assigned to one of two groups: employed elderly (Group A; n = 84) or unemployed elderly (Group B; n = 84). A three-month intervention consisting of four days a week of 30 minutes of computerized cognitive training and 30 minutes of walking was given to both groups. Community participation and quality of life were evaluated using the Community Integration Questionnaire (CIQ) and EuroQoL-5D (EQ-5D) at baseline, and at 6-month follow-up post intervention. Results-Both groups showed significant improvements in CIQ and EQ-5D scores post-intervention and at 6-month follow-up (p < 0.01). Group A (employed) showed a greater increase in CIQ scores (Mean difference = +4.2, p < 0.001) compared to Group B (+2.5, p < 0.01). EQ-5D scores also improved more significantly in Group A (Mean difference = +0.15, p < 0.001) than in Group B (+0.08, p = 0.03). A positive correlation was observed between CIQ and EQ-5D at follow-up (r = 0.63, p < 0.001), indicating that improved social participation was associated with better quality of life. Conclusion: Sequential aerobic and computer-based cognitive training improved community integration and health-related quality of life in elderly with MCI, with employed participants experiencing greater benefits. These findings emphasize the value of holistic interventions and the potential moderating effect of employment status.

Keywords: Aerobic exercise, Cognitive training, Community integration, Community Integration Questionnaire (CIQ), Elderly, Employment status, EuroQoL-5D, Health-related quality of life.

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