Exploring the psychosocial determinants of cognitive health in the elderly: An exploratory factor analysis approach

Pham Thanh Binh; Thanh Nguyen Nghi

doi:10.31893/multirev.2025361

Keywords:

cognitive health

psychosocial determinants

social engagement

healthy aging

Vietnam

Abstract

This study investigates the psychosocial determinants influencing cognitive health in the elderly within Vietnam’s rapidly transforming socio-cultural context. Utilizing data collected from 200 older adults and applying multivariate linear regression analysis, the research identifies four critical factors—social engagement, mental health, physical activity and lifestyle, and cognitive stimulation—as significant contributors to cognitive well-being. Social engagement enhances cognitive resilience by fostering emotional support, reducing loneliness, and encouraging interpersonal interaction, which is essential for maintaining neural plasticity. Mental health, encompassing emotional and psychological stability, mitigates neurobiological risks associated with anxiety, depression, and inflammation, thus preserving executive function and memory. Concurrently, physical activity and a healthy lifestyle—including regular exercise, balanced nutrition, and adequate sleep—support brain function, reduce the incidence of chronic diseases, and strengthen cognitive performance. Cognitive stimulation, through activities such as reading, learning, and problem-solving, is crucial in reinforcing cognitive reserve and delaying neurodegeneration. The findings underscore the interdependence of these psychosocial factors and their collective impact on cognitive health, offering a holistic understanding of healthy aging. Situated within Vietnam’s unique cultural setting, where traditional values intersect with rapid modernization, this study fills a critical gap in the literature by providing localized insights into aging and cognitive function. The research highlights the importance of culturally tailored, multidimensional strategies that integrate traditional practices and modern interventions to enhance elderly care. These insights are valuable for healthcare practitioners, policymakers, and community leaders aiming to design inclusive programs that promote resilience, independence, and well-being among older adults. Ultimately, this study contributes to the global discourse on aging by offering a context-sensitive framework for supporting cognitive health in aging societies.
References
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52. Van, N. H. N., Thi Khanh Huyen, N., Hue, M. T., Luong, N. T., Quoc Thanh, P., Duc, D. M., ... & Hong, T. T. (2021). Perceived barriers to mental health services among the elderly in the rural of Vietnam: A cross-sectional survey in 2019. Health Services Insights, 14, 11786329211026035.
53. Waldman-Levi, A., Erez, A. B. H., & Katz, N. (2015). Healthy aging is reflected in well-being, participation, playfulness, and cognitive-emotional functioning. Healthy Aging Research, 4(8), 1–7.
54. Walsh, E. I., Smith, L., Northey, J., Rattray, B., & Cherbuin, N. (2020). Towards an understanding of the physical activity-BDNF-cognition triumvirate: A review of associations and dosage. Ageing Research Reviews, 60, 101044. https://doi.org/10.1016/j.arr.2020.101044
55. Williams, K. N., & Kemper, S. (2010). Interventions to reduce cognitive decline in aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Binh, P. T., & Nghi, T. N. (2025). Exploring the psychosocial determinants of cognitive health in the elderly: An exploratory factor analysis approach. Multidisciplinary Reviews, 8(11), 2025361. https://doi.org/10.31893/multirev.2025361

[1] Agresti, A., & Finlay, B. (2009). Statistical methods for the social sciences. Pearson.

[2] Ahluwalia, Y., & Balhara, Y. P. S. (2024). Ensuring mental well-being in the digital world: Challenges and approaches. Indian Journal of Clinical Psychiatry, 4(01), 79–91.

[3] American Psychiatric Association. (2020). The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. American Psychiatric Pub.

[4] Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., Marsiske, M., ... & ACTIVE Study Group. (2002). Effects of cognitive training interventions with older adults: A randomized controlled trial. JAMA, 288(18), 2271–2281.

[5] Barnes, D. E., & Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. The Lancet Neurology, 10(9), 819–828.

[6] Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109(2), 186–204.

[7] Bryk, A. S., & Raudenbush, S. W. (1992). Hierarchical linear models: Applications and data analysis methods. Sage Publications, Inc.

[8] Buchman, A. S., Yu, L., Wilson, R. S., Lim, A., Dawe, R. J., Gaiteri, C., ... & Bennett, D. A. (2019). Physical activity, common brain pathologies, and cognition in community-dwelling older adults. Neurology, 92(8), e811–e822.

[9] Centorbi, M., Di Martino, G., Della Valle, C., Buonsenso, A., Calcagno, G., Fiorilli, G., & di Cagno, A. (2024). Enhancing physical and cognitive efficiency in elderly individuals at risk for dementia using whole-body electrostimulation: A randomized controlled trial. Journal of Functional Morphology and Kinesiology, 9(4), 246. https://doi.org/10.3390/jfmk9040246

[10] Cortina, J. M. (1993). What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology, 78(1), 98–104. https://doi.org/10.1037/0021-9010.78.1.98

[11] Daulatzai, M. A. (2014). Role of stress, depression, and aging in cognitive decline and Alzheimer’s disease. In Behavioral neurobiology of stress-related disorders (pp. 265–296).

[12] Dominguez, L. J., Veronese, N., Vernuccio, L., Catanese, G., Inzerillo, F., Salemi, G., & Barbagallo, M. (2021). Nutrition, physical activity, and other lifestyle factors in the prevention of cognitive decline and dementia. Nutrients, 13(11), 4080.

[13] Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., ... & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017–3022.

[14] Fabel, K., & Kempermann, G. (2008). Physical activity and the regulation of neurogenesis in the adult and aging brain. Neuromolecular Medicine, 10, 59–66.

[15] Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 272.

[16] Field, A. (2013). Discovering statistics using IBM SPSS statistics (4th ed.). Sage Publications.

[17] Fisher, G. G., Chaffee, D. S., Tetrick, L. E., Davalos, D. B., & Potter, G. G. (2017). Cognitive functioning, aging, and work: A review and recommendations for research and practice. Journal of Occupational Health Psychology, 22(3), 314.

[18] Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50.

[19] Fowler Jr, F. J. (2013). Survey research methods. Sage Publications.

[20] Fratiglioni, L., Paillard-Borg, S., & Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3(6), 343–353.

[21] Gatz, M., Fratiglioni, L., Johansson, B., Berg, S., Mortimer, J. A., Reynolds, C. A., ... & Pedersen, N. L. (2005). Complete ascertainment of dementia in the Swedish Twin Registry: The HARMONY study. Neurobiology of Aging, 26(4), 439–447.

[22] Ghisletta, P., Bickel, J. F., & Lövdén, M. (2006). Does activity engagement protect against cognitive decline in old age? Methodological and analytical considerations. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61(5), P253–P261.

[23] Gorsuch, R. L. (2014). Factor analysis: Classic edition. Routledge.

[24] Greene, W. H. (2008). The econometric approach to efficiency analysis. In The measurement of productive efficiency and productivity growth, 1(1), 92–250.

[25] Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Exploratory factor analysis. In Multivariate data analysis (7th ed., pp. 100–100).

[26] Hair, J. F., Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed.). Prentice-Hall.

[27] Hair, J. F., Jr., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Partial least squares structural equation modeling (PLS-SEM) using R: A workbook. Springer Nature.

[28] Hair, J. F., Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24.

[29] Hertzog, C., Kramer, A. F., Wilson, R. S., & Lindenberger, U. (2008). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest, 9(1), 1–65.

[30] Huang, C. Y., Zane, N. W., Hunter, L., Vang, L., Apesoa-Varano, E. C., & Joseph, J. (2025). Promoting mental and physical health of Vietnamese immigrants through a cultural movement intervention. Cultural Diversity & Ethnic Minority Psychology, 31(1), 46–57. https://doi.org/10.1037/cdp0000591

[31] James, B. D., Wilson, R. S., Barnes, L. L., & Bennett, D. A. (2011). Late-life social activity and cognitive decline in old age. Journal of the International Neuropsychological Society, 17(6), 998–1005.

[32] Jesus, I. T. M. D., Orlando, F. D. S., & Zazzetta, M. S. (2018). Frailty and cognitive performance of elderly in the context of social vulnerability. Dementia & Neuropsychologia, 12, 173–180.

[33] Kline, R. B. (2023). Principles and practice of structural equation modeling. Guilford Publications.

[34] Kuiper, J. S., Zuidersma, M., Voshaar, R. C. O., Zuidema, S. U., van den Heuvel, E. R., Stolk, R. P., & Smidt, N. (2015). Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 22, 39–57.

[35] Kutner, M. H., Nachtsheim, C. J., Neter, J., & Li, W. (2005). Applied linear statistical models. McGraw-Hill.

[36] Lampit, A., Hallock, H., & Valenzuela, M. (2014). Computerized cognitive training in cognitively healthy older adults: A systematic review and meta-analysis of effect modifiers. PLoS Medicine, 11(11), e1001756.

[37] Larose, D. T., & Larose, C. D. (2014). Discovering knowledge in data: An introduction to data mining (Vol. 4). John Wiley & Sons.

[38] Linåker, J., Sulaman, S. M., Maiani de Mello, R., & Höst, M. (2015). Guidelines for conducting surveys in software engineering.

[39] Lowenstein, A. (2007). Intergenerational solidarity: Strengthening economic and social ties [Background paper]. Department of Economic and Social Affairs Division for Social Policy and Development.

[40] Nguyen, T. T., & Trevisan, M. (2020). Vietnam a country in transition: health challenges. BMJ Nutrition, Prevention & Health, 3(1), 60–66. https://doi.org/10.1136/bmjnph-2020-000069

[41] Nguyen, T., Tran, T., Tran, H., Tran, T. D., & Fisher, J. (2021). Challenges in integrating mental health into primary care in Vietnam. In Innovations in global mental health (pp. 1249–1269). Cham: Springer International Publishing.

[42] Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). McGraw-Hill.

[43] Ownby, R. L., Crocco, E., Acevedo, A., John, V., & Loewenstein, D. (2006). Depression and risk for Alzheimer disease: Systematic review, meta-analysis, and metaregression analysis. Archives of General Psychiatry, 63(5), 530–538.

[44] Park, D. C., Lodi-Smith, J., Drew, L., Haber, S., Hebrank, A., Bischof, G. N., & Aamodt, W. (2014). The impact of sustained engagement on cognitive function in older adults: The Synapse Project. Psychological Science, 25(1), 103–112.

[45] Rovio, S., Kåreholt, I., Helkala, E. L., Viitanen, M., Winblad, B., Tuomilehto, J., ... & Kivipelto, M. (2005). Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. The Lancet Neurology, 4(11), 705–711.

[46] Sofi, F., Valecchi, D., Bacci, D., Abbate, R., Gensini, G. F., Casini, A., & Macchi, C. (2011). Physical activity and risk of cognitive decline: A meta‐analysis of prospective studies. Journal of Internal Medicine, 269(1), 107–117.

[47] Steffens, D. C., Otey, E., Alexopoulos, G. S., Butters, M. A., Cuthbert, B., Ganguli, M., ... & Yesavage, J. (2006). Perspectives on depression, mild cognitive impairment, and cognitive decline. Archives of General Psychiatry, 63(2), 130–138.

[48] Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448–460.

[49] Tabachnick, B. G., Fidell, L. S., & Ullman, J. B. (2013). Using multivariate statistics (Vol. 6, pp. 497–516). Pearson.

[50] Valenzuela, M., & Sachdev, P. (2009). Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. The American Journal of Geriatric Psychiatry, 17(3), 179–187.

[51] Van Regenmortel, T., & De Witte, J. (2023). An empowerment perspective on older persons: The power of resilience. In Silver Empowerment: Fostering Strengths and Connections for an Age-Friendly Society (pp. 19–54). Leuven University Press.

[52] Van, N. H. N., Thi Khanh Huyen, N., Hue, M. T., Luong, N. T., Quoc Thanh, P., Duc, D. M., ... & Hong, T. T. (2021). Perceived barriers to mental health services among the elderly in the rural of Vietnam: A cross-sectional survey in 2019. Health Services Insights, 14, 11786329211026035.

[53] Waldman-Levi, A., Erez, A. B. H., & Katz, N. (2015). Healthy aging is reflected in well-being, participation, playfulness, and cognitive-emotional functioning. Healthy Aging Research, 4(8), 1–7.

[54] Walsh, E. I., Smith, L., Northey, J., Rattray, B., & Cherbuin, N. (2020). Towards an understanding of the physical activity-BDNF-cognition triumvirate: A review of associations and dosage. Ageing Research Reviews, 60, 101044. https://doi.org/10.1016/j.arr.2020.101044

[55] Williams, K. N., & Kemper, S. (2010). Interventions to reduce cognitive decline in aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51.

[56] Zhang, K., Ma, Y., Luo, Y., Song, Y., Xiong, G., Ma, Y., ... & Kan, C. (2023). Metabolic diseases and healthy aging: Identifying environmental and behavioral risk factors and promoting public health. Frontiers in Public Health, 11, 1253506.

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References

How to cite