The Paradoxical Effect of Living Alone on Cognitive Reserve and Mild Cognitive Impairment among Women Aged 60+ in Mexico City

Abstract

An elderly person who lives alone must often be autonomous and self-sufficient in daily living activities. We explored if living alone and marital status were associated with mild cognitive impairment and low cognitive reserve in a sample of Mexican women aged 60+ attending continuing education courses using a cross-sectional design. Objective cognitive functions were assessed using the MMSE and Blessed Dementia Scale. We administered the Cognitive Reserve Questionnaire. Independence skills were assessed with the Katz index and Lawton index. Multivariate logistic regression analysis was used. We recruited 269 participants (x¯ = 69.0 ± 5.8 years). Single, widowed, separated, and divorced women comprised 73% of the participants. A third lived alone and 84% had completed high school. Mild cognitive deficit was observed among 24.5–29.0%; the upper range for cognitive reserve was 61.7%. Living alone versus living with someone was associated with cognitive impairment (OR = 0.51, p = 0.04) and with low to medium cognitive reserve (OR = 0.51, p = 0.02) after adjusting for confounding variables. Living alone was an independent factor associated with a lower probability of displaying mild cognitive impairment and a higher probability of displaying high cognitive reserve. Women living alone in this study had a more robust cognitive framework and had built their own support networks.

Health-related heterogeneity in brain aging and associations with longitudinal change in cognitive function

“…This was despite the comparable proportion of these factors in the resilient and advanced brain age groups. Here, discrepancies may partly reflect a benefit of independent living on cognitive function through flexible neural processes, even with increasing brain atrophy (i.e., cognitive reserve; Evans et al, 2019 ; Stern et al, 2020 ; Villa et al, 2021 ). Living alone is a common occurrence for older adults due to the natural shift in social environments with aging ( Evans et al, 2019 ; Bzdok and Dunbar, 2020 ; Villa et al, 2021 ).…”

“…Here, discrepancies may partly reflect a benefit of independent living on cognitive function through flexible neural processes, even with increasing brain atrophy (i.e., cognitive reserve; Evans et al, 2019 ; Stern et al, 2020 ; Villa et al, 2021 ). Living alone is a common occurrence for older adults due to the natural shift in social environments with aging ( Evans et al, 2019 ; Bzdok and Dunbar, 2020 ; Villa et al, 2021 ). Although this imposes a greater risk for social isolation and loneliness ( Finlay and Kobayashi, 2018 ), there is some evidence to suggest older people who live alone are more likely to engage in regular social activities ( Evans et al, 2019 ).…”

“…Social engagement requires complex cognitive processes that may help improve reserve ( Stern et al, 2020 ). While this remains speculative, people with advanced brain aging may have maintained a higher cognitive performance through the influence of independent living on cognitive reserve, but this warrants further investigation ( Evans et al, 2019 ; Stern et al, 2020 ; Villa et al, 2021 ).…”