背景：
中老年人隨著年齡的增加，認知功能的衰退風險亦隨之提高，若病程演變為失智症，將會對患者及照顧者造成生活上許多的不便與負擔，也會增加失能的風險。但認知衰退不是老化必然的結果，許多研究以認知儲備假設 (Cogni-tive reserve hypothesis)作為理論基礎，認為透過增進與認知有關的生活型態，例如社會參與，可協助維持認知功能，但是針對不同職業類別，其效果不同。然而，過去研究同時針對職業類別及社會參與對認知功能的影響，主要是在西方國家，臺灣則很少相關研究。因此，本研究旨在探討在不同職業類別下，社會參與對中老年退休族群認知功能之影響。

目的：
本研究目的有四，（一）了解不同職業類別的中老年人，在退休後的認知變化；（二）探討退休後參加各項社團組織或社區活動對於中老年人認知功能的影響；（三）探討社會參與對於不同職業類別退休者的認知功能，是否皆具有顯著效益，或者僅低職業複雜性者有顯著效益(補償作用)；（四）進行職業類別之分層分析，瞭解不同職業的退休者，在退休後參與何種組織或社區活動可以改善認知功能。

方法：
本研究使用「退休規劃與退休歷程對退休後健康狀況之影響調查」之資料庫，研究對象為臺灣 50-74 歲公勞保退休人員，於2015-2016及2018-2019年進行兩波之面訪，共追蹤完訪人數2,448人。本研究的排除條件為：兩波SLUM題目中一題以上遺漏、退休前的職業變項遺漏、社團與組織變項遺漏、社區活動變項遺漏、ADL≥1或遺漏、兩波認知分數(Saint Louis University Mental Status Exam, SLUMS）之變化值為極端值，排除以上的樣本後，剩餘2337個樣本納入統計分析(74.40%)。本研究的自變項為職業類別和社會參與。職業類別合併後分為三類:非技術、半技術與技術、以及專業與管理；社會參與分為兩種:社團組織參與(含數量和細項)以及社區活動參與(含數量和細項)。依變項為兩波認知分數(SLUM)之變化，控制變項包括社會人口學變項、健康行為及健康狀態變項。統計方法包括描述性分析、雙變數分析以及多元線性迴歸分析。

結果：
結果(一)顯示，職業類別層級愈高者，其兩波認知功能分數增加愈高；例如:與非技術類別相比，專業與管理類別其認知分數顯著增加(β= 1.94， p=<.001)，其次為半技術與技術類別(β= 0.74， p=.000)。結果(二)包括兩個：(1)認知分數變化與社團組織細項之線性迴歸分析結果，在控制所有干擾變項及認知前測分數後，發現中老年退休者參與社會服務性組織相較於不參加者，可顯著提升認知分數。(2)認知分數變化與社區活動細項之關係，在控制所有干擾變項及認知前測分數後，發現中老年退休者參與運動/體操/舞蹈活動、藝文/嗜好/教育/服務與其他活動相較於不參加者，可顯著提升認知分數。
結果(三)發現，在不同職業類別中，參加一種或者兩種以上的社團組織、社區活動，相較於不參加者，對於的認知功能皆具有正向的效果，代表社會參與對於各種職業類別者的認知功能，皆有顯著效益。結果(四)包括兩個：(1)在社團組織參與細項之分析發現，不論參與哪一項社團組織，對於各種職業類別者沒有顯著的提升其認知功能。(2)在社區活動參與細項中，發現非技術類別者參與運動/體操/舞蹈活動，其認知分數顯著增加 (β= 2.06，p=.033)，但參與旅遊活動者，認知分數反而下降 (β=-1.7，p=.033)；半技術與技術類別者參與藝文/嗜好/教育/服務與其他活動，可以顯著提升其認知分數 (β= 0.89，p=.007)；而專業與管理類別者則是參與旅遊類活動，認知分數顯著增加分(β=0.9，p=.018)。

結論：
本研究結果顯示退休前之職業類別對於認知功能的影響在退休後仍存在，不論何種職業類別，退休後積極從事社會參與皆有助於認知功能。在各項社團組織、社區活動細項當中，皆以專業與管理類別者參與的比例為最高，而非技術類別參與的比例為最低。建議未來政策可就非技術類別者，設計促進其參與的誘因或內容，或提升社會參與的可近性，使此類族群的社會參與能更佳活躍，以提升晚年的認知健康。
此外， 社會參與的項目對於認知功能的效益會因為職業類別有所不同，以非技術類別者來說，參加運動/體操/舞蹈活動有益於認知功能；半技術及技術類別參加藝文/嗜好/教育/服務與其他活動能有助於認知；而專業及管理類別參加旅遊類活動者的認知功能顯著高於未參加者。

Although the risk of cognitive decline in middle-aged and older adults increases with age, cognitive decline is not inevitable. Many studies are based on the cognitive reserve hy-pothesis, which means that engaging in cognitive-related lifestyles, such as social partici-pation, can help maintain cognitive function. This study aims to investigate the effect of participation in social organizations and community activities on the cognitive function of retired people in different occupational categories. This study was a two-wave follow-up survey comprising 2,337 valid Taiwanese retirees aged 50-74 in the analysis. The inde-pendent variables were the occupational category and social participation. The dependent variable was the change in two-wave cognitive scores (SLUM). Result 1 found that the higher level of occupational category, the more significant change in cognitive function scores. Result 2 consists of two parts. Firstly, those who participated in social service or-ganizations were significantly protected against cognitive decline. Secondly, those who participated in sports/gymnastics/dance activities and art/hobbies/education/services ac-tivities were also significantly protective against cognitive change. Result 3 showed that retirees in various occupations before retirement participating in one or more society or-ganizations or community activities had a significant protective effect against cognitive changes compared with those who did not participate. Result 4 consists of two parts. First-ly, retirees in various occupations before retirement participating in any society organiza-tions did not significantly improve their cognitive function. Secondly, retirees in non-technical occupations before retirement had significant protective effects if they partici-pated in sports/gymnastics/dance activities. However, those who participated in tourism activities would decrease cognitive scores. Moreover, retirees with semi-technical and technical occupations before retirement had significant protective effects if participating in art/hobbies/education/services activities. Retirees with professional and managerial categories were also significantly protected against cognitive decline if they participated in tourism activities.

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