Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, CA, 90089-0411, Los Angeles, USA.
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
BMC Geriatr. 2021 Feb 16;21(1):123. doi: 10.1186/s12877-021-02066-4.
This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment.
Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (M = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale- 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health.
In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28).
Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.
本研究考察了老年韩裔美国人中社会隔离、孤独感与认知健康风险之间的关联，重点关注孤独感在社会隔离与认知障碍的客观和主观测量指标之间的关系中所起的中介作用。
数据来自于 2061 名参加“老年韩裔美国人研究”的参与者，这是一项针对 60 岁及以上韩裔移民的多州调查（M = 73.2，SD = 7.93）。社会隔离采用 Lubben 社会网络量表-6 进行评估；孤独感采用 UCLA 孤独感量表短式版进行评估。认知障碍的客观和主观测量指标包括简易精神状态检查和一项认知健康的自评单项。
在客观认知障碍的逻辑回归模型中，社会隔离具有显著相关性，但孤独感没有。在主观认知障碍的模型中，社会隔离和孤独感都是显著因素。然而，当考虑到孤独感时，社会隔离的效应变得不显著，表明孤独感可能起到了中介作用。随后的中介分析证实，社会隔离通过孤独感对主观认知障碍的间接效应具有统计学意义（B = .20，SE = .03，95%CI = .12，.28）。
我们的分析为孤独感在社会隔离与主观认知障碍之间的关系中所起的中介作用提供了证据。干预措施应侧重于减少老年移民所经历的孤独感，可能的方法是让他们参与具有社交意义和认知刺激的活动。
