Older adults reporting social isolation or loneliness show poorer cognitive function 4 years later

Abstract

Commentary on: Shankar A, Hamer M, McMunn A, et al. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosom Med 2013;75:161-70. Implications for practice and research▪ Population ageing is expected to produce a dramatic increase in the number of individuals with dementia.▪ Patients' social isolation and loneliness are potentially modifiable risk factors for poor cognitive functioning.▪ Attention to a patient's social environment may help preserve cognitive functioning in at-risk older adults. ContextWith the dramatic increase in life expectancy in developed countries, it has become important to identify factors that may mitigate the rising prevalence of cognitive dementia. The social environment in which older adults live has been linked to dementia, but the specific features of the social environment that are predictive have been elusive. Shankar and colleagues investigated the extent to which social isolation and perceived social isolation (loneliness) were predictive of declines in cognitive functioning. MethodsA longitudinal health survey in which participants aged 50 years and above were tested, including follow-up questionnaires every 2 years over a period of 4 years, was conducted in England in the early 2000s. From 2004 to 2005 (wave 2), a baseline, including the first measure of loneliness, was introduced along with a test of short-term and long-term memory and executive function. A total of 8630 of the initial 8688 volunteers completed all the questions in the survey. In 2008-2009 (wave 4), 6034 of these participants (69%) had completed the follow-up. Demographic data (ie, wealth as a measure of socioeconomic status, cardiovascular disease (CVD), employment status, smoking, diabetes, physical activity and depression) were obtained in the 2004-2005 baseline and served as covariates in the regression analysis to determine the association between social isolation and loneliness and performance on each of the three cognitive tasks. FindingsAt baseline, 13.1% of the participants reported depression, 1.7% loneliness and 4.8% isolation. Loneliness and isolation were both positively associated with a series of covariates, such as depression, CVD, smoking and diagnosed diabetes. Higher scores of loneliness and isolation were also associated with poorer cognitive function. After 4 years, the mean scores of cognition were significantly lower than at baseline, although the mean differences were small. After adjusting for covariates, loneliness and isolation were associated with poor memory among those low in education, and isolation was associated with poorer cognitive performance at follow-up. CommentaryLoneliness has previously been related to various aspects of cognition, including cognitive decline and the onset of dementia in the elderly. 1 There are several differences between prior studies and the present study, however, so it is useful to explain this discrepancy. First, both experimental and longitudinal resea...

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“…In other words, it is important to recognize that it is not just the physical body that is attended to but that the social and emotional needs of the ageing body are also recognized and met. Indeed, there is a growing evidence base of the adverse effects of social isolation amongst older people on both their physical health and mental wellbeing (Luanaigh et al, 2008;Holt-Lunstadt et al, 2010;Cacioppo et al, 2014). The design of specialist housing for older people, however, often assumes an ageing body that is relatively static so requiring only limited space.…”