Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Epidemiol Psychiatr Sci. 2024 Oct 25;33:e53. doi: 10.1017/S204579602400060X.
Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race-ethnicity and dementia.
We analyzed 11 years (2011-2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race-ethnicity was associated with incident dementia risk.
Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period ( = -7.35, < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], = .11). Race-ethnicity was not a significant moderator in the association between social isolation and dementia.
Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race-ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk.
社会隔离与认知障碍的发展有关，但在少数族裔人群中的相关研究仍然有限。本研究探讨了社会隔离、种族和痴呆之间的相互作用。
我们分析了 11 年（2011-2021 年）的国家健康老龄化趋势研究（NHATS）数据，这是一项针对美国 65 岁及以上医疗保险受益人的全国代表性前瞻性队列研究。痴呆状态使用经过验证的 NHATS 算法确定。我们使用经过验证的社会隔离变量为我们的 6155 名居住在社区的受访者样本构建了一个纵向评分。Cox 回归确定了社会隔离与种族之间的相互作用与新发痴呆风险的关系。
在 11 年期间，与非西班牙裔白人成年人相比，年龄较大的黑人（27.6%）、西班牙裔（26.6%）和亚裔（21.0%）受访者的纵向社会隔离频率更高（ = -7.35，<0.001）。在调整了社会人口学协变量后，较高的社会隔离频率与痴呆风险增加（约 47%）显著相关（调整后的危害比[aHR] = 1.47，95%置信区间[CI] [1.15, 1.88]，<0.01），但在调整了健康协变量后，这种相关性并不显著（aHR = 1.21，95%CI [0.96, 1.54]， =.11）。种族并不是社会隔离与痴呆之间关联的显著调节因素。
来自少数族裔的老年人经历了更高的纵向社会隔离频率。然而，种族并没有调节观察到的社会隔离与痴呆之间的正相关关系。需要进一步研究，以探讨导致社会隔离和痴呆种族差异的潜在机制，并制定有针对性的干预措施来减轻相关的痴呆风险。
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