Laboratório de Investigação Médica em Envelhecimento (LIM-66) (JGS,MJRA,CKS), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Department of Pathology (DSF), University of Sao Paulo Medical School, São Paulo, Brazil.
Am J Geriatr Psychiatry. 2023 Aug;31(8):610-620. doi: 10.1016/j.jagp.2023.03.013. Epub 2023 Apr 10.
The association between social isolation and cognitive performance has been less investigated in low-to-middle-income countries (LMIC) and the presence of depression as a moderator on this association has not been examined. The authors examined the associations of social isolation and perceived loneliness with cognitive performance in the Brazilian Longitudinal Study of Aging.
In this cross-sectional analysis, social isolation was evaluated by a composite score including marital status, social contact, and social support. The dependent variable was global cognitive performance, which considered memory, verbal fluency, and temporal orientation tests. Linear and logistic regressions were adjusted for sociodemographic and clinical variables. The authors added interaction terms of depressive symptoms with social isolation and loneliness to examine whether depression, measured through the Center for Epidemiologic Studies-Depression Scale, modified these associations.
Among 6,986 participants (mean age = 62.1 ± 9.2 years), higher levels of social connections were associated with better global cognitive performance (B = 0.02, 95%CI: 0.02; 0.04). Perceived loneliness was associated with worse cognition (B = -0.26, 95%CI = -0.34; -0.18). Interactions of depressive symptoms with social connections scores were found on memory z-score and with loneliness on global and memory z-scores, suggesting a weaker association between social isolation or loneliness and cognition among those with depressive symptoms.
In a large sample from an LMIC, social isolation and loneliness were associated with worse cognitive performance. Surprisingly, depressive symptoms decrease the strength of these associations. Future longitudinal studies are important to assess the direction of the association between social isolation and cognitive performance.
社会隔离与认知表现之间的关系在中低收入国家（LMIC）中研究较少，且抑郁作为该关系的调节因素的存在尚未得到检验。作者在巴西老龄化纵向研究中检验了社会隔离和孤独感与认知表现之间的关系。
在这项横断面分析中，社会隔离通过包括婚姻状况、社会接触和社会支持的综合评分来评估。因变量为整体认知表现，考虑了记忆、言语流畅性和时间定向测试。线性和逻辑回归调整了社会人口统计学和临床变量。作者添加了抑郁症状与社会隔离和孤独感的交互项，以检验抑郁（通过流行病学研究中心抑郁量表测量）是否改变了这些关联。
在 6986 名参与者（平均年龄 62.1±9.2 岁）中，更高水平的社会联系与更好的整体认知表现相关（B=0.02，95%CI：0.02；0.04）。孤独感与认知能力下降相关（B=-0.26，95%CI：-0.34；-0.18）。抑郁症状与社会联系评分的交互作用在记忆 z 评分中发现，与孤独感在整体和记忆 z 评分中发现，这表明在有抑郁症状的人群中，社会隔离或孤独感与认知之间的关联较弱。
在来自 LMIC 的大样本中，社会隔离和孤独感与认知表现较差相关。令人惊讶的是，抑郁症状降低了这些关联的强度。未来的纵向研究对于评估社会隔离与认知表现之间的关联方向很重要。
