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目的 探究中国城乡老人宗教参与与认知障碍的相关性,为预防和控制认知障碍提供参考.方法 对目前涉及“宗教-认知”迄今为止最近的全国代表性公开调查资料(2002年中国老年健康影响因素追踪调查)中13 290名老人使用简易精神状态检查表(MMSE)进行调查,利用logistic模型研究城乡老人宗教参与与认知障碍的关系,并探究其原因.结果 无宗教参与老年人中认知障碍1 872人(17.4％),高于有宗教参与行为老人(264人,10.3％).宗教参与与老年人认知障碍存在负向关联和城乡差异:在调整人口学变量、躯体健康、主观情绪和休闲活动变量后,有宗教参与行为老人比无宗教参与行为老人认知障碍发生风险低(OR =0.67,95％ CI=0.57 ～0.70).城市老人认知障碍发生风险低于农村老人(农村OR=0.62,95％ CI =0.51 ～0.77;城市OR =0.75,95％ CI=0.58～0.96).休闲活动变量在“宗教参与-认知障碍”中起调节作用,与模型1比较,模型2中有宗教参与行为与有认知障碍的OR值由0.60(95％ CI =0.51 ～0.70)变为0.67(95％ CI=0.57 ～0.79).结论 宗教参与与中国老年人认知障碍呈负向关联,且该关联作用存在城乡差异,农村老人关联强度高于城市.休闲活动变量在中国老年人“宗教参与-认知障碍”中起调节作用.“,”Objective To explore the correlation between religious participation (RP) and cognitive impairment (CI) in the elderly and to provide references for the prevention and control of cognitive impairment.Methods Data for this study was derived from Chinese Longitudinal Healthy Longevity Survey in 2002,which is a national representative dataset including 13 290 old persons aged 65 years and above and is the latest open data in China so far involving both RP and cognitive function.The Mini Mental State Examination (MMSE) was used for screening CI in the 13 290 participants.Binary logistic model was utilized to analyze the relationship between RP and CI.Results The number of participants identified as CI was 1 872 (17.4％) and 264 (10.3％) among the eldely without and with RP.There were a reverse correlation and a between urban and rural region difference in the correlation of RP with CI in the elderly surveyed.After adjusting for demographic,physical health,subjective emotion,and leisure activities variables,the odds ratio (OR)value of CI was 0.67 (95％ confidence interval[95％ CI]:0.57-0.70) for the elderly with RP compared to the elderly without RP and both rural and urban elderly with RP showed a lower risk of CI compared to the elderly living in the same regions but without RP,with the adjusted OR values of 0.62(95％ CI:0.51-0.77) and 0.75(95％ CI:0.58-0.96).Leisure activities demonstrated a moderating effect on the relationship between RP and CI in the participants.Conclusion Religious participation is reversely associated with cognitive impairment among older person in China.There is a difference in the association of religious participation with cognitive impairment between urban and rural elderly and the association is more close among the rural elderly.Leisure activity could mediate the correlation between religious participation and cognitive impairment among the elderly in China.