Social support and the incidence of cognitive impairment among older adults in China : Findings from the CLHLS study

Abstract Objective: Social support is thought to be associated with cognitive impairment (CI) in the older adults. However, the longitudinal relationship between the distinct dimensions of social support and incidence of cognitive impairment remains unclear. This study aims to investigate the association between social support and the incidence of cognitive impairment among the older adults in China. Method: We used longitudinal data (2005-2014) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005-2014, mean follow-up years 5.32 ± 2.64). In total, 5930 participants (aged 81.7 ± 9.7 years, range 65-112 years, 48.9% male) were enrolled. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). Social supports included support from family (marital status; contact with children, siblings, relatives, friends and others; money received from children; children’s visit; siblings’ visit) and social community (social service, social insurance). We calculated subdistribution hazard ratios (SHR) of cognitive impairment by establishing Cox regression model, adjusting for residence, gender, age, education, participation in physical exercise, activities of daily living abilities, depressive symptoms, smoking and drinking. Results: Children’s visit and marital status were significantly associated with decreased incidence rate of cognitive impairment. However, social support from other resources did not consistently predict the incidence of cognitive impairment. Specifically, (1) participants who were married had a lower incidence rate of cognitive impairment compared to the widowed (SHR = 0.849, 95% confidence interval, 0.730-0.987, p = 0.033); (2) participants who had frequent visits from their children showed lower incidence of cognitive impairment compared to those who had not (SHR = 0.778, 95% confidence interval, 0.646-0.938, p = 0.008).Conclusion: Social support from family predicts a lower incidence of cognitive impairment among Chinese older adults.

Download Full-text

Development and Validation of a Nomogram Based on Motoric Cognitive Risk Syndrome for Cognitive Impairment

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.618833 ◽

2021 ◽

Vol 13 ◽

Author(s):

Yong Liu ◽

Kai Wei ◽

Xinyi Cao ◽

Lijuan Jiang ◽

Nannan Gu ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Confidence Interval ◽

Cox Regression ◽

Good Discrimination ◽

Healthy Older Adults ◽

Cox Regression Analysis ◽

Cognitive Risk ◽

Individualized Prediction ◽

Good Calibration

ObjectiveTo develop and validate a prediction nomogram based on motoric cognitive risk syndrome for cognitive impairment in healthy older adults.MethodsUsing two longitudinal cohorts of participants (aged ≥ 60 years) with 4-year follow-up, we developed (n = 1,177) and validated (n = 2,076) a prediction nomogram. LASSO (least absolute shrinkage and selection operator) regression model and multivariable Cox regression analysis were used for variable selection and for developing the prediction model, respectively. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness.ResultsThe individualized prediction nomogram was assessed based on the following: motoric cognitive risk syndrome, education, gender, baseline cognition, and age. The model showed good discrimination [Harrell’s concordance index (C-index) of 0.814; 95% confidence interval, 0.782–0.835] and good calibration. Comparable results were also seen in the validation cohort, which includes good discrimination (C-index, 0.772; 95% confidence interval, 0.776–0.818) and good calibration. Decision curve analysis demonstrated that the prediction nomogram was clinically useful.ConclusionThis prediction nomogram provides a practical tool with all necessary predictors, which are accessible to practitioners. It can be used to estimate the risk of cognitive impairment in healthy older adults.

Download Full-text

Social support and the incidence of cognitive impairment among older adults in China : Findings from the CLHLS study

10.21203/rs.2.18404/v2 ◽

2019 ◽

Author(s):

Shufei Yin ◽

Quan Yang ◽

Jinli Xiong ◽

Tian Li ◽

Xinyi Zhu

Keyword(s):

Social Support ◽

Older Adults ◽

Cognitive Impairment ◽

Journal Submission

Abstract The authors have withdrawn the journal submission associated with this preprint and requested that the preprint also be withdrawn.

Download Full-text

Cognitive impairment and fear of falling in elderly with different social support levels: Findings from a community survey in Central Vietnam

10.21203/rs.2.13296/v1 ◽

2019 ◽

Author(s):

Thi Hue Man Vo ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Hoang Thuy Linh Nguyen ◽

Thang Van Vo

Keyword(s):

Social Support ◽

Cognitive Impairment ◽

Cognitive Function ◽

Marital Status ◽

Fear Of Falling ◽

The Elderly ◽

Related Factors ◽

Support Level ◽

High Social Support ◽

History Of

Abstract Background Fear of falling (FoF) in the elderly is one of the major public health concerns in this era of aging of the population. Identifying risk factors is a step towards devising interventions for FoF. The aim of this study was to determine the prevalence of FoF and the associations between cognitive impairment and FoF by the social support level, after adjustments for potential confounders. Methods Data from the “Health needs assessment of elderly in Thua Thien Hue Province, Vietnam in 2018” survey of 725 elderly aged 60 years or older were used for analysis. FoF was assessed using the Fall Efficacy Scale - International. High FoF was defined as a score above 28. The Multidimensional Scale of Perceived Social Support was used to measure the perception of support. Logistic regression analysis was performed to investigate the factors that might be significantly (p <0.05) associated with the FoF. Results The prevalence of high FoF among the elderly was 40.8%. Female gender, advanced age, a marital status of single or formerly married, living alone, history of injury, history of falls, chronic diseases (arthritis and/or hypertension), limitations of the IADL and BADL, visual difficulty and walking difficulty, low social support, and cognitive impairment were all significantly associated with a high FoF. After adjustments for the age, gender, marital status, history of falls and health-related factors, cognitive impairment remained significantly associated with a high FoF among the elderly with a low to moderate social support level (OR = 2.97, 95% CI 1.49-5.89), but not in those with a high social support level. Conclusions Impairment of cognitive function was associated with a high FoF among the elderly who perceived themselves as having low or moderate support levels, even after adjustments for socio demographic and physical functional factors. However, this association was not observed among the elderly who perceived themselves as having high social support levels. Fall prevention programs for the elderly with various levels of social support should be carefully devised, keeping in mind the cognitive function levels of the target recipients.

Download Full-text

Factors associated with poor physical performance in older adults of 11 Peruvian high Andean communities

F1000Research ◽

10.12688/f1000research.17513.1 ◽

2019 ◽

Vol 8 ◽

pp. 59

Author(s):

Diego Urrunaga-Pastor ◽

Fernando M. Runzer-Colmenares ◽

Tania M. Arones ◽

Rosario Meza-Cordero ◽

Silvana Taipe-Guizado ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Urinary Incontinence ◽

Cognitive Impairment ◽

Physical Performance ◽

Poisson Regression ◽

Prevalence Ratio ◽

Female Gender ◽

Cross Sectional ◽

Factors Associated

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

Download Full-text

Physical Work and Exercise Reduce the Risk of Cognitive Impairment in Older Adults: A Population-based Longitudinal Study

Current Alzheimer Research ◽

10.2174/1567205018666211118100451 ◽

2021 ◽

Vol 18 ◽

Author(s):

Fan He ◽

Junfen Lin ◽

Fudong Li ◽

Yujia Zhai ◽

Tao Zhang ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Rural Areas ◽

Tai Chi ◽

Cox Regression ◽

Population Based ◽

Independent Effect ◽

Physical Work ◽

Protective Effects

Background: The independent effect of physical work on the risk of cognitive impairment in older Chinese adults living in rural areas remains to be elucidated. Objective: We aimed to determine whether physical work and physical exercise can reduce the risk of cognitive impairment. Methods: We collected data from 7,000 permanent residents without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. We used the Chinese version of the Mini-Mental State Ex- amination (MMSE) to assess cognitive function. We performed multivariate Cox regression analyses to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (%95 CIs) as measures of the association between physical work/exercise and cognitive impairment while controlling for potential confounders. Results: Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. After adjustment for potential confounders, participating in physical work (HR: 0.51; 95% CI: 0.43-0.60) or physical exer- cise (HR: 0.53; 95% CI: 0.44-0.65) was associated with a reduced risk of cognitive impairment. Strati- fied analyses suggested additive and multiplicative interactions between physical work and exercise. Agricultural work (HR: 0.46; 95% CI: 0.38-0.55), walking/tai chi (HR: 0.54; 95% CI: 0.44-0.67), and brisk walking/yangko (HR: 0.57; 95% CI: 0.33-0.97) exerted significant protective effects against cognitive impairment. Conclusion: Both physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.

Download Full-text

IMPACT OF SOCIAL SUPPORT AND STRAIN ON DEPRESSIVE SYMPTOMS: MARITAL STATUS AND GENDER DIFFERENCES

Innovation in Aging ◽

10.1093/geroni/igz038.3350 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S919-S919

Author(s):

Deborah Carr ◽

Yeonjung Jane Lee

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Marital Status ◽

Late Life ◽

Well Being ◽

Negatively Associated ◽

Fine Grained ◽

And Gender ◽

The Impact

Abstract Social relationships are a well-established correlate of late-life well-being. Extensive research finds social support is associated with fewer depressive symptoms, yet few studies distinguish fine-grained types of support from spouse, children, other family and friends, nor whether these linkages differ by gender and marital status. Studies exploring coarse associations between support and well-being may conceal gender and marital status differences. We use data from two waves of the Health and Retirement Study (HRS; 2006 and 2010) to study fine-grained linkages between diverse types of relationship strain and support and depressive symptoms (CESD) among adults aged 51+. The results show that the association between support/strain and depressive symptoms varies based on the source of support. For instance, among married/partnered older adults, spousal support is negatively associated with depressive symptoms whereas friend strain is positively associated with depressive symptoms. Among widowed respondents, friend support is negatively associated with depressive symptoms. These marital status patterns differed by gender however, such that the impact of friend strain on depressive symptoms was especially large for divorced men. Our results suggest that no single form of social support (or strain) is uniformly protective (or distressing), so services and interventions to enhance late-life mental health should more fully consider older adults’ social location, including gender and marital status. For current cohorts of older adults, who have lower rates of marriage and childbearing than their predecessors, it is critically important to understand both the levels and impacts of alternative sources of support from other kin and friends.

Download Full-text

Influence of Social Support on Older Adults with Cognitive Impairment, Depressive Symptoms, or Both Coexisting

The International Journal of Aging and Human Development ◽

10.2190/ag.76.3.b ◽

2013 ◽

Vol 76 (3) ◽

pp. 199-214 ◽

Cited By ~ 4

Author(s):

José C. Millán-Calenti ◽

Alba Sánchez ◽

Laura Lorenzo-López ◽

Ricardo Cao ◽

Ana Maseda

Keyword(s):

Social Support ◽

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms

Download Full-text

Factors Associated With Social Isolation Among Older Adults: The Singapore Chinese Health Study

Innovation in Aging ◽

10.1093/geroni/igaa057.543 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 168-168

Author(s):

Jon Barrenetxea ◽

Yang Yi ◽

Woon Puay Koh ◽

Feng Qiushi

Keyword(s):

Social Support ◽

Older Adults ◽

Cognitive Impairment ◽

Social Isolation ◽

Well Being ◽

Population Based ◽

Living Alone ◽

Health Study ◽

Factors Associated ◽

Singapore Chinese

Abstract Social isolation is a determinant of mortality and well-being among older people. Factors associated with isolation could be different in societies where older adults live mainly with family, as individuals might feel isolated despite living with others. We studied the factors associated with isolation among 16,948 older adults from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age of 73, range: 61-96 years). We defined social isolation as having “zero hour per week” of participation in social activities involving 3 or more people and scoring the lowest decile on the Duke Social Support Scale of perceived social support. We used multivariable logistic regressions to compute odds ratio (OR) and 95% confidence interval (CI) for factors associated with likelihood of social isolation. Although only 14.4% of isolated participants lived alone, living alone remained a significant factor associated with isolation (OR 1.93, 95% CI 1.58-2.35), together with cognitive impairment (OR 1.73, 95% CI 1.46-2.04) and depression (OR 2.44, 95% CI 2.12-2.80). Higher education level was inversely associated with isolation (p for trend<0.001). In stratified analysis, among those living alone, compared to women, men had higher odds of social isolation (OR 2.18, 95% CI 1.43-3.32) than among those not living alone (OR 0.99, 95% CI 0.84-1.17) (p for interaction<0.001). Our results showed that living alone, cognitive impairment and depression were indicators of isolation among older Singaporeans. In addition, among those living alone, men were more likely to experience social isolation than women.

Download Full-text

Fear of falling and cognitive impairment in elderly with different social support levels: Findings from a community survey in Central Vietnam

10.21203/rs.2.13296/v4 ◽

2020 ◽

Author(s):

Thi Hue Man Vo ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Hoang Thuy Linh Nguyen ◽

Thang Van Vo

Keyword(s):

Social Support ◽

Cognitive Impairment ◽

Cognitive Function ◽

Marital Status ◽

Fear Of Falling ◽

The Elderly ◽

Related Factors ◽

Support Level ◽

High Social Support ◽

History Of

Abstract Background : Fear of falling (FoF) in the elderly is one of the major public health concerns in this era of aging of the population. As there is limited evidence on how cognitive function may differ by social support level in relation to FoF among the elderly, this cross-sectional study aims to investigate the prevalence of FoF and the associations between cognitive impairment and FoF by the social support level, after adjustments for potential confounders. Methods : Data from the “Health needs assessment of elderly in Thua Thien Hue Province, Vietnam in 2018” survey of 725 elderly aged 60 years or older were used for analysis. FoF was assessed using the Fall Efficacy Scale - International. High FoF was defined as a score above 28. The Multidimensional Scale of Perceived Social Support was used to measure the perception of support. Logistic regression analysis was performed to investigate the association between cognitive function and FoF by social support levels (p <0.05). Results: The prevalence of high FoF among the elderly was 40.8%. Female gender, advanced age, a marital status of single or formerly married, living alone, history of injury, history of falls, chronic diseases (arthritis and/or hypertension), limitations of the IADL and BADL, visual difficulty and walking difficulty, low social support, and cognitive impairment were all significantly associated with a high FoF. After adjustments for the age, gender, marital status, history of falls and health-related factors, cognitive impairment remained significantly associated with a high FoF among the elderly with a low to moderate social support level (OR = 2.97, 95% CI 1.49-5.89), but not in those with a high social support level. Conclusions: A high FoF was associated with impairment of cognitive function among the elderly who perceived themselves as having low or moderate support levels, even after adjustments for socio demographic and physical functional factors. However, this association was not observed among the elderly who perceived themselves as having high social support levels. Fall prevention programs for the elderly with various levels of social support should be carefully devised, keeping in mind the cognitive function levels of the target recipients.

Download Full-text

Cognitive Dysfunction and Gait Abnormalities in CKD

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.16091020 ◽

2021 ◽

pp. CJN.16091020

Author(s):

Melanie J. Koren ◽

Helena M. Blumen ◽

Emmeline I. Ayers ◽

Joe Verghese ◽

Matthew K. Abramowitz

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Confidence Interval ◽

Cognitive Dysfunction ◽

Gray Matter ◽

Community Dwelling ◽

Gray Matter Atrophy ◽

Gait Abnormalities

Background and objectivesCognitive impairment is a major cause of morbidity in CKD. We hypothesized that gait abnormalities share a common pathogenesis with cognitive dysfunction in CKD, and therefore would be associated with impaired cognitive function in older adults with CKD, and focused on a recently defined gait phenotype linked with CKD.Design, setting, participants, & measurementsGait assessments and neuropsychological testing were performed in 312 nondisabled, community-dwelling older adults (aged ≥65 years). A subset (n=115) underwent magnetic resonance imaging. The primary cognitive outcome was the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale score. Associations with cognitive function were tested using multivariable linear regression and nearest-neighbor matching. The risk of developing mild cognitive impairment syndrome was assessed using Cox proportional hazards models.ResultsLower eGFR was associated with lower RBANS score only among participants with the gait phenotype (P for interaction =0.04). Compared with participants with neither CKD nor the gait phenotype, adjusted RBANS scores were 5.4 points (95% confidence interval, 1.8 to 9.1) lower among participants with both, who demonstrated poorer immediate memory, visuospatial ability, delayed memory, and executive function. In a matched analysis limited to participants with CKD, the gait phenotype was similarly associated with lower RBANS scores (−6.9; 95% confidence interval, −12.2 to −1.5). Neuroimaging identified a pattern of gray matter atrophy common to both CKD and the gait phenotype involving brain regions linked with cognition. The gait phenotype was associated with higher risk of mild cognitive impairment (hazard ratio, 3.91; 95% confidence interval, 1.46 to 10.44) independent of eGFR.ConclusionsThe gait phenotype was associated with poorer function in a number of cognitive domains among older adults with CKD, and was associated with incident mild cognitive impairment independent of eGFR. CKD and the gait phenotype were associated with a shared pattern of gray matter atrophy.

Download Full-text