Association between housework frequency and cognitive impairment among Chinese older adults: a prospective cohort study based on CLHLS

Background: Housework is a crucial aspect of instrumental activities of daily living (IADL), essential for maintaining the independence of older adults. This study aims to explore the association between housework frequency and cognitive impairment by incorporating a multidimensional assessment of cognitive impairment risk factors. Methods: This study utilized data from the Chinese Longitudinal Health and Longevity Survey (CLHLS, 2014–2018), including 2797 older adults, after excluding individuals aged < 65 years, with cognitive impairment or self-reported dementia, or missing education data at baseline, along with those missing Chinese Mini-Mental State Examination (CMMSE) scores at either baseline or follow-up. Cognitive function was assessed using the education-adjusted CMMSE scores, while housework frequency was classified into three levels. Logistic regression models were employed to examine the association of housework frequency with the risk of cognitive impairment, after adjusting for demographics, living habits, and health-related factors. Further adjustments were made sequentially for baseline CMMSE scores and exercise. Results: The risk of cognitive impairment was higher among females, those aged 85 and above and non-exercisers. Compared with those who did housework almost everyday, the risk of cognitive impairment was significantly increased among those who did housework sometimes (OR = 1.50; 95% CI, 1.03–2.17), and even higher among those who never did housework (OR = 1.98; 95% CI, 1.49–2.65) after adjusting for demographics, living habits, and health-related factors. Similar associations were obtained after further adjustments sequentially for baseline CMMSE scores and exercise. In addition, hearing loss, social isolation, and non-smoking were identified as risk factors influencing cognitive impairment. No significant interaction effects were found between age and gender with housework frequency. Conclusions: Our study revealed that Chinese older adults who engaged in less housework had a higher risk of cognitive impairment. Doing housework could serve as a cost-effective strategy to reduce this risk in the context of a healthy aging population in China.