Contexts, kin and cognition: Effects of living arrangements and family resources on the cognitive function of older adults in Vietnam

Research findings on the relationship between living arrangements and older adult cognition are mixed, with some studies finding greater risks of cognitive impairment in those living solo or only with a spouse, while others observe the opposite. Vietnam, a rapidly aging lower-middle-income country with an increasing burden of dementia, is witnessing a rapid transformation in living arrangements, characterized by a decline in multigenerational co-residence and an increase in solo living. Analyzing data from the Vietnam Health and Aging Study, we adopt a family resource model to examine the relationship between living arrangements and cognitive functioning among Vietnamese older adults and to ascertain how this association is mediated by material and psychosocial pathways. Results from mediation analyses demonstrate that older adults across all other living arrangements have poorer cognitive functioning relative to those residing with both a spouse and child(ren), with older adults living alone being the most vulnerable. This pathway is mediated by household assets, social engagement, psychological distress, and loneliness. People living alone have fewer assets, less social engagement, more loneliness, and distress, contributing to poorer cognitive functioning. Living with only a spouse is associated with fewer assets and lower levels of social engagement, but not loneliness or distress. For older adults living with children, only lower levels of social engagement mediate the relationship and contribute to poorer cognitive functioning. After highlighting the material and psychosocial pathways linking living arrangements and cognition, we suggest interventions to protect cognitive function among Vietnamese older adults, especially those living alone.