Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA.
Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA.
Int J Geriatr Psychiatry. 2020 Jul;35(7):794-801. doi: 10.1002/gps.5304. Epub 2020 May 4.
To test whether loneliness is associated with the risk of cognitive impairment up to 11 years later in a European sample of middle-aged and older adults. The study examines whether this association is independent of measures of social isolation, depression, and other risk factors for cognitive impairment and dementia.
Participants (N = 14 114) from the Survey of Health, Ageing and Retirement in Europe (SHARE) answered a single item on loneliness at baseline and were assessed for cognitive impairment every 2-to-3 years for 11 years. Participants who scored at least 1.5 standard deviations below the age-graded mean on both a memory recall task and verbal fluency task were classified as impaired. A three-item measure of loneliness was available for a sample of respondents followed up to 4 years.
Feeling lonely was associated with increased risk of incident cognitive impairment (HR = 1.31, 95%CI = 1.19-1.44), after accounting for age, sex, education, and SHARE country strata. The association was robust but reduced in magnitude when controlling for clinical and behavioral risk factors, health-related activity limitations, social isolation, social disengagement, and depressive symptoms. The association was not moderated by socio-demographic factors and was also apparent when using the three-item loneliness scale instead of the single-item measure.
These findings expand the extant literature on loneliness and the risk of cognitive impairment in older adulthood. Loneliness is one modifiable factor that can be intervened prior to the development of severe impairment or dementia.
在欧洲中老年人群体中检验孤独感是否与 11 年后认知障碍的风险相关。本研究考察了这种关联是否独立于社会隔离、抑郁以及其他认知障碍和痴呆风险因素的测量结果。
欧洲健康、衰老和退休调查（SHARE）的参与者（N=14114）在基线时回答了一个关于孤独感的单项问题，并在接下来的 11 年内每 2-3 年评估一次认知障碍。在记忆回忆任务和言语流畅性任务上的得分均低于年龄分级均值 1.5 个标准差的参与者被归类为受损。对于随访 4 年的样本，有一个三项目的孤独感测量方法。
在考虑了年龄、性别、教育和 SHARE 国家分层后，感到孤独与认知障碍的发生风险增加（HR=1.31，95%CI=1.19-1.44）相关。当控制临床和行为风险因素、与健康相关的活动受限、社会隔离、社会脱离和抑郁症状时，这种关联仍然存在，但强度降低。这种关联不受社会人口因素的调节，并且当使用三项目的孤独感量表而不是单项测量时，也很明显。
这些发现扩展了关于孤独感和老年期认知障碍风险的现有文献。孤独感是一种可以在严重损害或痴呆发生之前进行干预的可改变因素。
