Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
Int J Geriatr Psychiatry. 2019 Nov;34(11):1613-1622. doi: 10.1002/gps.5174. Epub 2019 Jul 25.
This study aimed to examine the association of loneliness and social isolation on cognition over a 3-year follow-up period in middle- and older-aged adults.
Data from a Spanish nationally representative sample were analyzed (n = 1691; aged 50 years or older). Loneliness, social isolation, and cognition (immediate recall, delayed recall, verbal fluency, forward digit span, backward digit span, and a composite cognitive score) were assessed both at baseline and at follow-up. Adjusted generalized estimating equations models were performed.
Loneliness was significantly associated with lower scores in the composite cognitive score, immediate and delayed recall, verbal fluency, and backward digit span (B = -0.14 to B = -3.16; P < .05) and with a more rapid decline from baseline to follow-up in two out of six cognitive tests. Higher social isolation was associated with lower scores in the composite cognitive score, verbal fluency, and forward digit span (B = -0.06 to B = -0.85; P < .05). The effect of loneliness and social isolation on cognition remained significant after the exclusion of individuals with depression.
Both loneliness and social isolation are associated with decreased cognitive function over a 3-year follow-up period. The development of interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction.
本研究旨在探讨中老年人在 3 年随访期间孤独感和社会隔离与认知之间的关系。
分析了来自西班牙全国代表性样本的数据(n=1691;年龄在 50 岁及以上)。在基线和随访时评估了孤独感、社会隔离以及认知(即刻回忆、延迟回忆、言语流畅性、顺背数字广度、倒背数字广度和综合认知评分)。采用调整后的广义估计方程模型进行分析。
孤独感与综合认知评分、即刻回忆、延迟回忆、言语流畅性和倒背数字广度的得分较低显著相关(B=-0.14 至 B=-3.16;P<.05),并且在六个认知测试中的两个测试中,从基线到随访的认知下降速度更快。较高的社会隔离与综合认知评分、言语流畅性和顺背数字广度的得分较低显著相关(B=-0.06 至 B=-0.85;P<.05)。排除抑郁患者后,孤独感和社会隔离对认知的影响仍然显著。
孤独感和社会隔离均与 3 年随访期间认知功能下降有关。制定包括增强社会参与和维持情感支持关系的干预措施,可能有助于预防认知能力下降和降低风险。