Family and Community Support, Brain-Derived Neurotrophic Factor, and Cognitive Performance in Older Adults: Findings From the Health, Wellbeing and Aging Study Population-Based Cohort

Abstract

Background: Social networks can modulate physiological responses, protects against the detrimental consequences of prolonged stress, and enhance health outcomes. Family ties represent an essential source of social networks among older adults. However, the impact of family support on cognitive performance and the biological factors influencing that relationship is still unclear. We aimed to determine the relationship between family support, cognitive performance and BDNF levels.Methods: Cross-sectional data from three-hundred, eight-six individuals aged on average 60 years enrolled in the Health, Wellbeing and Aging Study (SABE), a population-cohort study, were assessed for family support, community support and cognitive performance. Structural and functional family support was evaluated based on family size and interactions allied to scores in the Family APGAR questionnaire. Community assistance (received or provided) assessed the community support. Cognitive performance was determined using the Mini-Mental State Examination (MMSE), verbal fluency (animals per minute) and backward digital span. Blood samples were obtained to determine BDNF levels.Results: Multivariate analysis showed that functional family support, but not structural, was associated with higher MMSE, verbal fluency and digit span scores, even controlling for potential cofounders (p < 0.001). Providing support to the community, rather than receiving support from others, was associated with better cognitive performance (p < 0.001). BDNF concentration was not associated with community support, family function, or cognitive performance.Conclusion: These findings suggest that emotional components of functional family and community support (e.g., loving and empathic relationship) may be more significant to cognitive health than size and frequency of social interactions.

Community support and promoting cognitive function for the elderly

“…Previous studies have shown that community support has a positive effect on cognitive function of the elderly; in particular, functional support and emotional community support are very important to the cognitive function of the elderly ( Hiroshi et al, 2019 ; Souza-Talarico et al, 2021 ). Functional community support is mainly reflected in medical service, community infrastructure construction, community environment construction, and so on.…”

“…Furthermore, a good lifestyle can slow cognitive decline ( Kang et al, 2021 ), such as physical activity ( Lü et al, 2016 ) and fitness ( Daimiel et al, 2020 ) as well as good nutrition ( Smith and Blumenthal, 2016 ). On the contrary, smoking increases the risk of cognitive impairment in the elderly ( Souza-Talarico et al, 2021 ). In addition, maintaining one’s interests can also help maintain a state of normal cognition ( Iwasa et al, 2012 ).…”

Family dysfunction and cognitive decline in aging: the “Health, Wellbeing, and Aging” (SABE) longitudinal population-based study

“…Cross-sectional data from our research group revealed that the poorer the family support, the lower the cognitive performance (global cognition, verbal fluency and digit span) 12 . However, these findings were drawn from a cross-sectional analysis, precluding any meaningful interpretation of the impact of family functioning on the probability of cognitive decline over time 12 .…”

“…However, unlike the present study, the authors analyzed family relationships rather than family functioning, which potentially explains the disparities in findings. In a cross-sectional analysis of the SABE cohort which included only older adults aged 60–64 years, functional family support, but not structural support (number of individuals living with older adult), was found to be associated with higher scores on the MMSE, verbal fluency and digit span tests 12 . Moreover, the authors found that, unlike receiving social support, providing the community with support services was associated with better cognitive performance 12 .…”

“…In a cross-sectional analysis of the SABE cohort which included only older adults aged 60–64 years, functional family support, but not structural support (number of individuals living with older adult), was found to be associated with higher scores on the MMSE, verbal fluency and digit span tests 12 . Moreover, the authors found that, unlike receiving social support, providing the community with support services was associated with better cognitive performance 12 . It is important to point out, however, that the population in question was younger than that of the present study, and participants with low cognitive performance were not excluded.…”