College of Nursing and Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, 03080, Seoul, Korea.
School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
BMC Geriatr. 2024 Jan 15;24(1):63. doi: 10.1186/s12877-024-04685-z.
Anxiety is common in older adults and social isolation is one of the leading factors associated with their anxiety. However, what is unknown is how the relationship between social isolation and anxiety differs by cognitive status. Therefore, this study was conducted to (1) compare the level of social isolation and anxiety in older adults who developed probable dementia and mild cognitive impairment (MCI) to those who maintained normal cognitive function over 5 years; and (2) determine if cognitive impairment moderates the relationship between changes in social isolation and changes in anxiety over 5 years.
A secondary data analysis was conducted using the National Social Life, Health, and Aging Project (NSHAP): Wave 2 (2010-2011) and Wave 3 (2015-2016). The participants were categorized into three groups: Participants who developed probable dementia over 5 years (4.3%), developed probable MCI (19.1%), or maintained normal cognitive function (76.6%). Weighted linear regression analyses with a group interaction were used to examine the moderating effect of cognitive impairment on the relationship between changes in social isolation and anxiety.
At the 5-year follow up, there were statistically significant differences in social isolation between the three groups (p = 0.043). Regression analyses showed that increased social isolation over time was related to increased anxiety over 5 years regardless of cognitive status after controlling for covariates (p = 0.017).
The relationship between social isolation and anxiety was a universal phenomenon regardless of cognitive status. Tailored interventions targeting both people with or without cognitive impairment are needed to lessen social isolation and anxiety.
焦虑在老年人中很常见，社会隔离是导致他们焦虑的主要因素之一。然而，目前尚不清楚社会隔离与焦虑之间的关系在认知状态方面有何不同。因此，本研究旨在：（1）比较在 5 年内发展为可能痴呆和轻度认知障碍（MCI）的老年人与保持正常认知功能的老年人的社会隔离和焦虑水平；（2）确定认知障碍是否调节了 5 年内社会隔离变化与焦虑变化之间的关系。
使用国家社会生活、健康和老龄化项目（NSHAP）的二次数据分析：第 2 波（2010-2011 年）和第 3 波（2015-2016 年）。参与者分为三组：在 5 年内发展为可能痴呆的参与者（4.3%）、发展为可能 MCI 的参与者（19.1%）或保持正常认知功能的参与者（76.6%）。使用带有组间交互作用的加权线性回归分析来检验认知障碍对社会隔离变化与焦虑变化之间关系的调节作用。
在 5 年的随访中，三组之间的社会隔离存在统计学上的显著差异（p=0.043）。回归分析显示，无论认知状态如何，随着时间的推移，社会隔离的增加与 5 年内焦虑的增加有关（p=0.017）。
社会隔离与焦虑之间的关系是一种普遍现象，与认知状态无关。需要针对有或没有认知障碍的人制定有针对性的干预措施，以减轻社会隔离和焦虑。
