美国不同种族和民族中年及老年成年人的孤独感与整体认知功能
Loneliness and global cognitive functioning in racially and ethnically diverse US midlife and older adults.
作者信息
Camacho David, Pacheco Kelly, Moxley Jerad, Aranda Maria P, Reid M. Carrington, Wethington Elaine
机构信息
Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, United States.
Weill Cornell Medicine, Cornell University, New York, NY, United States.
出版信息
Front Psychol. 2024 Jun 19;15:1344044. doi: 10.3389/fpsyg.2024.1344044. eCollection 2024.
INTRODUCTION
Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages ≥ 50).
METHODS
We analyzed Wave 3 of the National Social Life, Health, and Aging Project ( = 2,757). We examined loneliness using one item from the CES-D and the Felt Loneliness Measure (NFLM); cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) tool, where higher scores indicated better functioning. We used weighted ordinary least squares regressions to examine the effects of loneliness (CES-D loneliness and NFLM in separate models) on MoCA scores. In exploratory analyses, we examined if these relationships varied by race and ethnicity. We adjusted all models for sociodemographic and other salient factors (e.g., chronic disease, depressive symptoms, living alone).
RESULTS
Mean age was 63.49 years, 52% were female, and 9% were Black and 6% Latino persons. Approximately 54% endorsed feeling lonely on at least one measure; 31% (CES-D) and 46% (NFLM). The relationship between loneliness measures was positive and significant, (1, = 2,757) = 435.493 < 0.001. However, only 40% of lonely individuals were identified as lonely on both assessments. CES-D loneliness was inversely (βˆ = -0.274, = 0.032) associated with MoCA scores and this association did not vary by race and ethnicity. Greater NFLM loneliness was positively associated (βˆ = 0.445, < 0.001) with higher MoCA scores for
DISCUSSION
Loneliness appears to be an important predictor of cognitive functioning. However, the association of loneliness and cognitive functioning varied when using the CES-D loneliness item or the NFLM. Future work is needed to understand how loneliness and its clinically relevant dimensions (social, emotional, existential, chronicity) relate to global and individual cognitive domains. Research is needed with racially and ethnically diverse midlife and older adults, particularly to understand our counterintuitive finding for Latino participants. Finally, findings also support the need for research on interventions to prevent cognitive decline targeting loneliness.
引言
在美国,很少有研究探讨孤独感与认知功能之间的关联。我们使用了两种常见的孤独感测量方法,并在大量美国黑人、拉丁裔和白人成年人(年龄≥50岁)样本中研究了它们之间的关联。
方法
我们分析了“全国社会生活、健康与老龄化项目”的第三轮数据(n = 2757)。我们使用流行病学研究中心抑郁量表(CES-D)中的一个条目和感知孤独量表(NFLM)来测量孤独感;使用蒙特利尔认知评估量表(MoCA)工具评估认知功能,得分越高表明功能越好。我们使用加权普通最小二乘法回归来研究孤独感(在单独模型中分别为CES-D孤独感和NFLM)对MoCA得分的影响。在探索性分析中,我们研究了这些关系是否因种族和民族而异。我们对所有模型进行了社会人口统计学和其他显著因素(如慢性病、抑郁症状、独居)的调整。
结果
平均年龄为63.49岁,52%为女性,9%为黑人,6%为拉丁裔。约54%的人在至少一项测量中认可感到孤独;31%(CES-D)和46%(NFLM)。孤独感测量之间的关系呈正且显著,r(1, n = 2757) = 0.435, p < 0.001。然而,只有40%的孤独个体在两项评估中都被认定为孤独。CES-D孤独感与MoCA得分呈负相关(β̂ = -0.274, p = 0.032),且这种关联不因种族和民族而有所不同。NFLM孤独感越强,MoCA得分越高,二者呈正相关(β̂ = 0.445, p < 0.001)。
讨论
孤独感似乎是认知功能的一个重要预测因素。然而,使用CES-D孤独感条目或NFLM时,孤独感与认知功能的关联有所不同。未来需要开展研究,以了解孤独感及其临床相关维度(社会、情感、存在、慢性程度)如何与整体和个体认知领域相关联。需要对不同种族和民族的中年及老年人进行研究,尤其是为了理解我们对拉丁裔参与者得出的违反直觉的发现。最后,研究结果也支持针对孤独感开展预防认知衰退干预措施的研究必要性。