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Peer-reviewedCC BYInternational journal of public health

Joint trajectories of online and offline social activity, cognitive decline, and frailty progression among middle-aged and older adults in China.

  • Xueshan Sun1
  • Danyi Sun1
  • Zhongliang Zhou1
  • Jiao Lu1
  1. 1School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
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Abstract

To identify joint trajectories of online and offline social activity and examine their associations with cognitive decline and frailty progression among middle-aged and older adults in China. Data from 14,340 adults aged ≥45 years in CHARLS (2011-2018) were analyzed; outcome-specific samples included 10,323 participants for cognition and 13,960 for frailty. Group-based multi-trajectory modeling identified trajectories. Linear mixed-effects models estimated associations with annual changes in cognition and frailty. Three trajectories were identified: persistently low social activity engagement (G1, 47.8%), offline social activity dominant (G2, 47.0%), and online social activity increasing (G3, 5.2%). Compared with G1, G2 showed slower cognitive decline (0.010 SD units/year, 95% CI [0.002, 0.018]) and frailty progression (-0.014 SD units/year, 95% CI [-0.020, -0.007]); G3 showed stronger associations for cognition (0.044 SD units/year, 95% CI [0.029, 0.060]) and frailty (-0.041 SD units/year, 95% CI [-0.055, -0.026]). The Offline Social Activity Dominant Group was associated with slower cognitive decline and frailty progression, with stronger associations for the Online Social Activity Increasing Group. Integrating online and offline social participation may support healthy aging.

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Cite

BibTeXRIS
BibTeX
@article{sun2026joint,
  title = {{Joint trajectories of online and offline social activity, cognitive decline, and frailty progression among middle-aged and older adults in China.}},
  author = {Xueshan Sun and Danyi Sun and Zhongliang Zhou and Jiao Lu},
  journal = {International journal of public health},
  year = {2026},
  month = oct,
  doi = {10.3389/ijph.2026.1610116},
  url = {https://europepmc.org/article/MED/42952780},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Joint trajectories of online and offline social activity, cognitive decline, and frailty progression among middle-aged and older adults in China.
AU  - Xueshan Sun
AU  - Danyi Sun
AU  - Zhongliang Zhou
AU  - Jiao Lu
PY  - 2026
DA  - 2026/10/14
JO  - International journal of public health
DO  - 10.3389/ijph.2026.1610116
UR  - https://europepmc.org/article/MED/42952780
AB  - To identify joint trajectories of online and offline social activity and examine their associations with cognitive decline and frailty progression among middle-aged and older adults in China. Data from 14,340 adults aged ≥45 years in CHARLS (2011-2018) were analyzed; outcome-specific samples included 10,323 participants for cognition and 13,960 for frailty. Group-based multi-trajectory modeling identified trajectories. Linear mixed-effects models estimated associations with annual changes in cognition and frailty. Three trajectories were identified: persistently low social activity engagement (G1, 47.8%), offline social activity dominant (G2, 47.0%), and online social activity increasing (G3, 5.2%). Compared with G1, G2 showed slower cognitive decline (0.010 SD units/year, 95% CI [0.002, 0.018]) and frailty progression (-0.014 SD units/year, 95% CI [-0.020, -0.007]); G3 showed stronger associations for cognition (0.044 SD units/year, 95% CI [0.029, 0.060]) and frailty (-0.041 SD units/year, 95% CI [-0.055, -0.026]). The Offline Social Activity Dominant Group was associated with slower cognitive decline and frailty progression, with stronger associations for the Online Social Activity Increasing Group. Integrating online and offline social participation may support healthy aging.
SN  - 1661-8564
SN  - 1661-8556
ER  -