Lee Ji Hyun, Sutin Angelina R, Hajek André, Karakose Selin, Aschwanden Damaris, O'Súilleabháin Páraic S, Stephan Yannick, Terracciano Antonio, Luchetti Martina
Department of Human Development and Community Health, Montana State University, Bozeman, MT, USA.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
Psychol Med. 2025 Feb 20;55:e58. doi: 10.1017/S003329172500011X.
Loneliness is a risk factor for late-life dementia. There is less consistent evidence of its association with cognitive performance. This study examined the replicability of the association between loneliness and overall and domain-specific cognitive function and informant-rated cognitive decline in cohorts from seven countries: the United States, England, India, China, South Africa, Mexico, and Chile.
Data were from the Harmonized Cognitive Assessment Protocol administered in seven population-based studies (total N > 20,000). Participants reported their loneliness, completed a battery of cognitive tests, and nominated a knowledgeable informant to rate their cognitive decline. Random-effect meta-analyses were used to summarize the associations from each cohort.
Loneliness was associated with poor overall cognitive performance and informant-rated cognitive decline controlling for sociodemographic factors (meta-analytic correlation for overall cognition = -.10 [95% CI = -.13, -.06] and informant-rated decline = .16 [95% CI = .14, .17]). Despite some heterogeneity, the associations were significant across samples from Africa, Asia, Europe, North, Central, and South America. The meta-analysis also indicated an association with specific cognitive domains: episodic memory, speed-attention, visuospatial abilities, numeric reasoning, and verbal fluency. The associations were attenuated but persisted when depressive symptoms were added as a covariate. Depression, cognitive impairment, and sociodemographic factors did not consistently moderate the associations across samples.
Loneliness is associated with poor performance across multiple domains of cognition and observer-rated cognitive decline, associations that replicated across diverse world regions and cultures.
孤独是晚年痴呆症的一个风险因素。关于其与认知表现之间的关联，证据尚不统一。本研究检验了在来自七个国家（美国、英国、印度、中国、南非、墨西哥和智利）的队列中，孤独与总体及特定领域认知功能以及 informant 评定的认知衰退之间关联的可重复性。
数据来自七项基于人群的研究中实施的统一认知评估方案（总样本量 N > 20,000）。参与者报告他们的孤独感，完成一系列认知测试，并指定一位了解情况的 informant 对他们的认知衰退进行评分。采用随机效应荟萃分析来总结每个队列中的关联。
在控制社会人口学因素后，孤独与总体认知表现不佳以及 informant 评定的认知衰退相关（总体认知的荟萃分析相关性 = -0.10 [95% 置信区间 = -0.13, -0.06]，informant 评定的衰退 = 0.16 [95% 置信区间 = 0.14, 0.17]）。尽管存在一些异质性，但这些关联在来自非洲、亚洲、欧洲、北美洲、中美洲和南美洲的样本中均显著。荟萃分析还表明与特定认知领域有关联：情景记忆、速度注意力、视觉空间能力、数字推理和语言流畅性。当将抑郁症状作为协变量纳入时，这些关联虽有所减弱但仍然存在。抑郁、认知障碍和社会人口学因素并未始终如一地调节各样本间的关联。
孤独与多个认知领域的不佳表现以及观察者评定的认知衰退相关，这些关联在不同的世界区域和文化中都有重复。
