Yu Bin, Steptoe Andrew, Chen Yongjie, Jia Xiaohua
Institute of Psychology, Tianjin Medical University, Tianjin, China.
Department of Behavioural Science and Health, University College London, London, UK.
Psychol Med. 2021 Jan 22:1-8. doi: 10.1017/S0033291720001026.
Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults.
This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up.
Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = -0.03, p < 0.01; mental status: β = -0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = -0.05, p < 0.001; mental status: β = -0.03, p < 0.01) even after controlling for loneliness and all confounding variables.
Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.
社会隔离和孤独感均与认知能力下降有关，但此前大多数研究仅限于西方人群。本研究探讨了中国老年人中社会隔离和孤独感与认知功能之间的关系。
本研究使用了中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）的两期数据（2011年和2015年），分析仅限于50岁及以上的受访者。在基线时测量社会隔离、孤独感和认知功能。对7761名参与者（平均年龄 = 60.97，标准差 = 7.31；男性占50.8%）进行了认知功能的随访测量。使用调整了混杂因素的滞后因变量模型来评估基线时的社会隔离、孤独感与随访时认知功能之间的关联。
在部分调整模型中，孤独感与随访时的认知能力下降显著相关（情景记忆：β = -0.03，p < 0.01；精神状态：β = -0.03，p < 0.01）。在考虑了其他混杂变量（慢性病、健康行为、残疾和抑郁症状）后，这些关联变得不显著（所有p > 0.05）。相比之下，即使在控制了孤独感和所有混杂变量之后，社会隔离与随访时所有认知功能指标的下降仍显著相关（情景记忆：β = -0.05，p < 0.001；精神状态：β = -0.03，p < 0.01）。
社会隔离与中国老年人的认知能力下降有关，且这种关系独立于孤独感。这些发现扩展了我们对非西方人群中社会关系与认知功能之间联系的认识。
