Kay Thwe Kyaw, NYU Grossman School of Medicine, NY, USA,
J Prev Alzheimers Dis. 2023;10(4):903-908. doi: 10.14283/jpad.2023.60.
Observational studies suggest psychosocial factors such as social support and loneliness are associated with vulnerability for cognitive decline in older adults. However, because of racial/ethnic homogeneity in prior studies focused on identifying these associations in predominantly White cohorts, less is known about the generalizability of these putative psychosocial mechanisms in a diverse population. Thus, we evaluated whether lower levels of loneliness were associated with better cognitive performance in our sample.
We conducted a cross-sectional study using 541 participants from (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) Dementia Cohort. Participants' self-reported loneliness as exposure. Cognitive performance is measured using a neuropsychological battery as the outcome. Raw scores were converted into Z scores, and global cognitive function was created. Generalized estimated equation and robust regression analysis).
Better global cognitive function is associated with a lower level of loneliness at (β = -0.0131, 95 % CI -0.1990, -0.0071) after adjustment for age, gender, and education. Lower levels of loneliness were associated with varying cognitive domains after adjustment for age, gender, and education; and persisted after additional adjustments of vascular risk factors.
Self-reported lower loneliness was associated with higher levels of cognitive performance in a rural South African cohort of Black older adults. Although these findings and the potential of reverse causality need to be further validated, our results suggest that an intervention study may be merited to assess whether reducing loneliness lessens vulnerability to cognitive decline.
观察性研究表明,社会支持和孤独等心理社会因素与老年人认知能力下降的易感性有关。然而,由于之前的研究主要集中在确定以白种人为主的队列中这些关联,因此对于这些推测的心理社会机制在不同人群中的普遍性知之甚少。因此,我们评估了在我们的样本中,较低水平的孤独感是否与更好的认知表现相关。
我们使用(非洲的健康和老龄化:南非一个 INDEPTH 社区的纵向研究)痴呆队列中的 541 名参与者进行了一项横断面研究。参与者的孤独感自评作为暴露因素。认知表现使用神经心理学测试作为结果进行测量。原始分数转换为 Z 分数,并创建了总体认知功能。采用广义估计方程和稳健回归分析。
在调整年龄、性别和教育因素后,更好的总体认知功能与较低水平的孤独感相关(β=-0.0131,95%置信区间-0.1990,-0.0071)。在调整年龄、性别和教育因素后,较低的孤独感与不同的认知领域相关;并在进一步调整血管危险因素后仍然存在。
在南非农村黑人老年人群体中,自我报告的孤独感较低与认知表现水平较高相关。尽管这些发现和潜在的反向因果关系需要进一步验证,但我们的结果表明,可能值得进行干预研究,以评估减少孤独感是否会降低认知能力下降的易感性。