Social support, cognition, and mental health among older people in China: A longitudinal life course study

Research suggests that stronger social support systems across life stages facilitate continuous learning and emotional well-being, contributing to better cognition and mental health. However, evidence on the cumulative effect of social support over the life course remains scarce, and even less is known about the impact of broader neighborhood-level social support on individuals’ cognition—a crucial dimension in many countries, where neighborhoods serve as key support units for individuals. Using data from 2014, 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study, we employed mediation analysis to explore how individual and neighborhood social support accumulated across life stages are associated with cognition and depression at older ages. Our findings indicate that receiving individual support in youth was associated with a 0.5-point improvement in later-life cognitive scores, although no direct association was observed with depression. In addition, a one-point increase in the neighborhood support score was associated with a 1.2-point improvement in cognitive scores and 0.5 fewer depressive symptoms at older ages. These associations persist among individuals who were socioeconomically disadvantaged in their youth. Furthermore, both individual and neighborhood support in youth exert indirect effects on later-life cognition and depression by helping individuals maintain social support as they age. Our findings contribute theoretical insights into the importance of social support across life stages and highlight the stronger role of neighborhood support in shaping cognition and depression. Strengthening neighborhood social support and fostering lifelong supportive environments may help mitigate disadvantages in earlier life stages and reduce health disparities.