社会脆弱性及其与老年人认知轨迹的关联：一项前瞻性队列研究。

Social frailty and its association with cognitive trajectories in older adults: a prospective cohort study.

作者信息

Zhang Hui, Hao Meng, Hu Zixin, Jiang Shuai, Li Yi, Wang Xiaofeng, Li Xiangwei

机构信息

School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Human Phenome Institute, Fudan University, Shanghai, 201203, China.

出版信息

Alzheimers Res Ther. 2025 Feb 19;17(1):50. doi: 10.1186/s13195-025-01687-w.

DOI:10.1186/s13195-025-01687-w

PMID:39972471

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11837587/

Abstract

BACKGROUND

Social frailty, a multidimensional construct encompassing various social behaviors, resources, and needs, significantly impacts cognitive health in older adults. Despite existing studies linking specific social factors to cognitive function, the association between social frailty and long-term cognitive trajectories remains underexplored. This study aims to evaluate the longitudinal association between social frailty and trajectory of cognitive function in dementia-free older adults.

METHODS

This prospective cohort study used data from the National Health and Aging Trends Study (NHATS). Social frailty was assessed using the Makizako Social Frailty Index. According to the presence of social components, individuals were categorized into social frailty (≥ 2), pre-social frailty (1), and robust (0), respectively. Cognitive function was annually evaluated through memory, orientation, and executive function tests from 2011 to 2018. Mixed-effects linear models were employed to assess the associations between social frailty and changes in global and domain-specific cognitive function, adjusting for relevant covariates.

RESULTS

In this study, 4956 dementia-free older adults (mean age 76.57 [7.41]) with complete at least 2 times of cognitive tests were included. Compared with the robust, social frailty was associated with significantly faster decline in global cognitive function (β = -0.041, 95% CI [-0.047, -0.036] z score per year) and domain-specific cognitive function (β = -0.045, 95% CI [-0.055, -0.036] z score per year; β = -0.027, 95% CI [-0.034, -0.020] z score per year; β = -0.042, 95% CI [-0.053, -0.032] z score per year) over the follow-up. Additionally, pre social frailty was associated with significantly faster decline in global cognitive function (β = -0.016, 95% CI [-0.021, -0.012] z score per year), memory function (β= -0.045, 95% CI [-0.055, -0.036] z score per year), and orientation function (β= -0.027, 95% CI [-0.034, -0.020] z score per year) over the follow-up.

CONCLUSIONS

Social frailty is associated with faster decline in cognition in older adults, underscoring the necessity for enhanced social support and engagement to mitigate cognitive deterioration in vulnerable populations.

摘要

背景

社会脆弱性是一个多维度概念，涵盖各种社会行为、资源和需求，对老年人的认知健康有重大影响。尽管现有研究将特定社会因素与认知功能联系起来，但社会脆弱性与长期认知轨迹之间的关联仍未得到充分探索。本研究旨在评估无痴呆老年人中社会脆弱性与认知功能轨迹之间的纵向关联。

方法

这项前瞻性队列研究使用了来自国家健康与老龄化趋势研究（NHATS）的数据。使用牧座社会脆弱指数评估社会脆弱性。根据社会成分的存在情况，个体分别被分类为社会脆弱（≥2）、前社会脆弱（1）和强健（0）。从2011年到2018年，每年通过记忆、定向和执行功能测试评估认知功能。采用混合效应线性模型评估社会脆弱性与整体及特定领域认知功能变化之间的关联，并对相关协变量进行调整。

结果

本研究纳入了4956名至少完成2次认知测试的无痴呆老年人（平均年龄76.57岁[7.41]）。与强健组相比，社会脆弱性与整体认知功能的显著更快下降相关（β = -0.041，95%置信区间[-0.047，-0.036]，每年z分数）以及特定领域认知功能的下降相关（β = -0.045，95%置信区间[-0.055，-0.036]，每年z分数；β = -0.027，95%置信区间[-0.034，-0.020]，每年z分数；β = -0.042，95%置信区间[-0.053，-0.032]，每年z分数）。此外，前社会脆弱性与整体认知功能（β = -0.016，95%置信区间[-0.021，-0.012]，每年z分数）、记忆功能（β = -0.045，95%置信区间[-0.055，-0.036]，每年z分数）和定向功能（β = -0.027，95%置信区间[-0.034，-0.020]，每年z分数）在随访期间的显著更快下降相关。