Social Integration and Risk of Dementia Among Older Adults

Abstract We examine the relationship between social integration and cognitive impairment and dementia among older adults using longitudinal data from Waves 1-8 of the National Health and Aging Trends Study (NHATS). The sample includes 7,492 respondents age 65 and older at baseline. We test multidimensional measures of social integration and cognitive well-being using discrete-time hazard models. The risk of dementia is calculated by a series of performance-based tests. Measures include levels of dementia: no dementia, cognitive impairment not dementia (CIND), and dementia, and three domains of cognition functioning: orientation, executive function, and memory. Social integration is an additive index measured by several questions, including marital status, living arrangement, social network, social contact, and social participation. Our results indicate that people with higher social integration have a lower risk of both cognitive impairment (not dementia) and dementia compared to those with lower social integration. This pattern continued across specific domains of cognitive functioning, including lower risk of orientation impairment, executive function impairment, and memory impairment for those with higher social integration. Tests of both gender and racial interactions did not yield any significant differences. Our findings demonstrate the strong association between social integration and lower risk of dementia among older adults. This study can speak to policy makers as the life expectancy of Americans increases and the aging population grows, highlighting the importance of giving support to older adults who are lack of social connectedness.

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Happiness and Cognitive Impairment Among Older Adults: Investigating the Mediational Roles of Disability, Depression, Social Contact Frequency, and Loneliness

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16244954 ◽

2019 ◽

Vol 16 (24) ◽

pp. 4954

Author(s):

Jit Hui Tan ◽

Edimansyah Abdin ◽

Shazana Shahwan ◽

Yunjue Zhang ◽

Rajeswari Sambasivam ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Adult Population ◽

Social Contact ◽

Positive Association ◽

Well Being ◽

Cross Sectional ◽

Mediation Analyses ◽

Frequency Of Contact ◽

Contact Frequency

Background: Understanding the lower level of happiness among older adults with cognitive impairment has been a largely neglected issue. This study (1) reports on the level of happiness among older adults in Singapore and (2) examines the potential mediating roles of depression, disability, social contact frequency, and loneliness in the relationship between cognitive scores and happiness. Methods: Data for this study were extracted from the Well-being of the Singapore Elderly (WiSE) study: a cross-sectional; comprehensive single-phase survey conducted among Singapore citizens and permanent residents that were aged 60 years and above (n = 2565). The Geriatric Mental State examination (GMS) was administered to the participants. Questions pertaining to socio-demographic characteristics; happiness; loneliness; social contact; depression; and, disability were utilized in this study. Logistic regression analyses and mediation analyses were used to explore the correlates of happiness and potential mediating factors. Results: Overall, 96.2% of older adults in Singapore reported feeling either fairly happy or very happy. In the regression analysis, individuals of Malay descent, those who were married/cohabiting, or had higher education levels were more likely to report feeling happy. After controlling for socio-demographic factors, higher cognitive scores were associated with higher odds of reporting happiness. We found that the positive association between cognition and happiness was fully mediated by disability, depression, loneliness, and frequency of contact with friends. Conclusion: The majority of the older adult population reported feeling fairly or very happy. While cognitive impairment has shown limited reversibility in past studies, unhappiness among older adults with cognitive impairment might be potentially mitigated through interventions addressing accompanying issues of social isolation, disability, and depression

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A Longitudinal Analysis of the Association Between Living Arrangements and Health Among Older Adults in China

Research on Aging ◽

10.1177/0164027516680854 ◽

2016 ◽

Vol 40 (1) ◽

pp. 72-97 ◽

Cited By ~ 14

Author(s):

Zi Zhou ◽

Fanzhen Mao ◽

Jiaping Ma ◽

Shichao Hao ◽

Zhengmin (Min) Qian ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Living Arrangements ◽

Living Arrangement ◽

Well Being ◽

Living Alone ◽

Psychological Well Being ◽

Self Rated Health ◽

Health Differences ◽

Adl Disability

This article used the nationally representative Chinese Longitudinal Healthy Longevity Survey to explore the associations between living arrangements and health among older adults. Living arrangements were stratified into six categories. Health was measured by self-rated health, activities of daily living (ADL) disability, and cognitive impairment. Random-effects ordered probit regressions were applied. The results indicated that coresidence had a positive effect on self-rated health compared with living alone. After introducing psychological well-being, the health differences observed in living with a spouse and living with both spouse and children were not significant. Participants with each of the living arrangement were more likely to have a higher rate of cognitive impairment and ADL disability than those living alone. Living arrangements were associated with older adults’ health. Psychological well-being was a key factor in this association, which may result from living with a spouse, and could contribute to the self-rated health of older adults.

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221 Social Integration and Sleep Quality during the COVID-19 Pandemic: Prospective Evidence from a Study of Retired Older Adults

SLEEP ◽

10.1093/sleep/zsab072.220 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A88-A89

Author(s):

Brian Chin ◽

Eunjin Tracy ◽

H Matthew Lehrer ◽

Lucas Carroll ◽

Precious Lacey ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Social Integration ◽

Social Contact ◽

Psychosocial Interventions ◽

Well Being ◽

Self Report ◽

Poor Sleep ◽

Sleep Complaints ◽

The Impact

Abstract Introduction Growing evidence has documented the adverse impact of the global coronavirus pandemic on sleep quality. Older adults may be especially susceptible to declines in sleep quality for multiple reasons, including their elevated risk of social isolation and loneliness during the pandemic. Given the adverse health consequences of poor sleep, there is a need to identify resilience factors that help protect older adults against decreased sleep quality. Social integration is a plausible resilience factor because involvement in a broad range of social relationships is thought to promote psychological well-being (e.g., meaning, purpose in life), as well as reduce the intensity and duration of negative psychological states. Social integration may also assume increased importance during the coronavirus pandemic because of normative declines in overall social contact. This prospective study assessed the impact of the coronavirus pandemic on older adults’ sleep quality and tested whether social integration moderated the impact of the pandemic on sleep quality. Methods A sample of 115 retired older adults (mean age = 68.6, 58% female, 89% white) completed self-report assessments of their social integration (number of roles on Cohen’s Social Network Index) and sleep quality (global score on Pittsburgh Sleep Quality Index) before and after the onset of the coronavirus pandemic (mean duration of follow-up = 2.3 years). Results Multilevel analyses indicated that social integration moderated the impact of the coronavirus pandemic on sleep quality; there was no main effect of time. Older adults with low social integration had reduced sleep quality from Time 1 to Time 2 (b=.94, p=.02), whereas older adults with high social integration showed no changes in sleep quality over time (b=-.38, p=.37). Conclusion Broader social networks confer resilience against pandemic-related declines in sleep quality among older adults. The level of social integration should be addressed when studying or treating sleep complaints during the coronavirus pandemic. Additional research is warranted to determine whether psychosocial interventions targeted towards older adults with low social integration can reduce observed differences in sleep quality. Support (if any) This research was supported by R01AG047139, T32HL007560, T32HL082610, T32MH019986.

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Effects of Self-Perceptions of Aging on Social Disconnectedness and Loneliness in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.143 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 38-39

Author(s):

Rita Hu

Keyword(s):

Older Adults ◽

Linear Regression ◽

Social Connectedness ◽

Social Contact ◽

Well Being ◽

Network Size ◽

Self Perceptions ◽

Perceptions Of Aging ◽

Using Data ◽

Retirement Study

Abstract Research shows that self-perceptions of aging (SPA) predict physical, mental, cognitive, and emotional well-being in older adults. Few studies have examined SPA’s effects on social well-being. Using data from the 2014–2018 Health and Retirement Study, we examined SPA’s effects on older adults’ social connectedness and loneliness (age 65+, N = 3,808). SPA was measured by eight items. Social connectedness was operationalized by network size, social contact, and social participation. The UCLA Loneliness Scale assessed loneliness. Linear regression results show that more positive SPA is correlated with increased social connectedness (b = 0.05 SE = 0.01 p = 0.0003) and decreased loneliness (b = -0.09 SE = 0.02 p < 0.0001) in four years, controlling for sociodemographic and health characteristics. Further, loneliness is a mediator between SPA and social connectedness. Findings suggest that older adults with negative SPA are at risk of both objective and subjective social isolation.

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The effects of combined cognitive training on prospective memory in older adults with mild cognitive impairment

Scientific Reports ◽

10.1038/s41598-021-95126-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yifan Chen ◽

Wei Zhou ◽

Zijing Hong ◽

Rongrong Hu ◽

Zhibin Guo ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Executive Function ◽

Cognitive Training ◽

Prospective Memory ◽

Training Group ◽

Strategy Training ◽

Control Group ◽

Executive Function Training ◽

Encoding Strategy

AbstractThis study aimed to assess the effects of combined cognitive training on prospective memory ability of older adults with mild cognitive impairment (MCI). A total of 113 participants were divided into a control group and three intervention groups. Over three months, the control group received only community education without any training, whereas for the first six weeks, an executive function training group received executive function training, a memory strategy training group received semantic encoding strategy training, and the combined cognitive training group received executive function training twice a week for the first six weeks, and semantic encoding strategy training twice a week for the next six weeks. The combined cognitive training group showed improvement on the objective neuropsychological testing (Montreal Cognitive Assessment scale). The memory strategy training group showed improvement on the self-evaluation scales (PRMQ-PM). Combined cognitive training improved the prospective memory and cognitive function of older adults with MCI.

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Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

BMC Psychiatry ◽

10.1186/s12888-021-03257-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

T. Muhammad ◽

Shobhit Srivastava ◽

T. V. Sekher

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Activities Of Daily Living ◽

Psychological Health ◽

Daily Living ◽

Basic Needs ◽

Well Being ◽

Asset Ownership ◽

Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

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Financial Resources and Later-Year Relocation From the Annuitized Assessment of Income and Assets

Innovation in Aging ◽

10.1093/geroni/igaa057.162 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 50-50

Author(s):

Jun-Hong Chen ◽

Sojung Park

Keyword(s):

Older Adults ◽

Living Arrangement ◽

Panel Study ◽

Behavioral Model ◽

Well Being ◽

Economic Factor ◽

Health Condition ◽

Financial Resources ◽

Individual Level ◽

Mortality Table

Abstract Solid evidence has shown financial resources play important roles in housing decisions among older adults. Despite the growing research on the joint assessment of income and assets as valid economic well-being, little attention is paid to its role in relocation in old age. Drawing from the Behavioral Model of Elderly Migration, this study examined to what extent financial resources are associated with the likelihood of moving in later years. The data came from the 2017 Panel Study of Income Dynamic (PSID). A sample of 1354 people, 65 years and older, was used in the analyses. We used the annuitized approach, which is different from conventional approaches that assume people draw down all available assets to satisfy daily needs and leave no assets for use in later years. We (1) assessed annuitized assets based on the 2019 IRS Mortality Table, (2) assessed yearly income using supplementary income (i.e. income plus non-discretionary expense). A final indicator of the summed score was used in a logistic regression to predict the likelihood of moving. A set of covariates known to affect later- year relocation at an individual level (e.g. health condition, living arrangement change), environmental level (e.g. rural, non-metro area) are controlled for. In clear conflict with previous studies, we found annual financial resources did not significantly influence relocation among older adults. The notable absence of the well-known role of the economic factor provides critical initial evidence about the importance of simultaneous assessment of financial resources for the literature on later year relocation.

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Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

Gerontology ◽

10.1159/000492931 ◽

2018 ◽

Vol 65 (2) ◽

pp. 164-173 ◽

Cited By ~ 13

Author(s):

Frederico Pieruccini-Faria ◽

Yanina Sarquis-Adamson ◽

Manuel Montero-Odasso

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Dual Task ◽

Gait Speed ◽

Step Length ◽

Gait Control ◽

Dual Tasking ◽

Brain Study

Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

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Effects of Participation in Social Activities on Cognitive Function Among Middle-Aged and Older Adults in Korea

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102315 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2315 ◽

Cited By ~ 3

Author(s):

Jongnam Hwang ◽

Sangmin Park ◽

Sujin Kim

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Social Connectedness ◽

Social Activity ◽

Later Life ◽

Well Being ◽

Social Activities ◽

The Social ◽

Gender Groups

Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006–2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.

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