Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons
Publication: Annals of Internal Medicine
Volume 131, Number 3
Submit a Comment
Contributors must reveal any conflict of interest. Comments are moderated. Please see our information for authorsregarding comments on an Annals publication.
Abstract
Background:
Social engagement, which is defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. However, few longitudinal studies of this relation have been done.
Objective:
To determine the relation between social disengagement and incident cognitive decline in community-dwelling elderly persons.
Design:
Cohort study.
Setting:
New Haven, Connecticut.
Participants:
2812 noninstitutionalized elderly persons (65 years of age or older) who were interviewed in their homes in 1982, 1985, 1988, and1994.
Measurements:
A global social disengagement scale was constructed from the following indicators: presence of a spouse, monthly visual contact with three or more relatives or friends, yearly nonvisual contact with 10 or more relatives or friends, attendance at religious services, group membership, and regular social activities. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. Response to the questionnaire was scored as high, medium, or low. Cognitive decline was defined as a transition to a lower category.
Results:
Compared with persons who had five or six social ties, those who had no social ties were at increased risk for incident cognitive decline after adjustment for age, initial cognitive performance, sex, ethnicity, education, income, housing type, physical disability, cardiovascular profile, sensory impairment, symptoms of depression, smoking, alcohol use, and level of physical activity. The 3-year odds ratio was 2.24 (95% CI, 1.40 to 3.58; P < 0.001), the 6-year odds ratio was 1.91 (CI, 1.14 to3.18; P = 0.01), and the 12-year odds ratio was2.37 (CI, 1.07 to 4.88; P = 0.03).
Conclusion:
Social disengagement is a risk factor for cognitive impairment among elderly persons.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Gribbin K, Schaie KW, Parham IA. Complexity of life style and maintenance of intellectual abilities. Journal of Social Issues. 1980;36:47-61.
2.
Arbuckle TY, Gold D, Andres D. Cognitive functioning of older people in relation to social and personality variables. Psychol Aging. 1986;1:55-62.
3.
Arbuckle TY, Gold DP, Andres D, Schwartzman A, Chaikelson J. The role of psychosocial context, age, and intelligence in memory performance of older men. Psychol Aging. 1992;7:25-36.
4.
Hultsch DF, Hammer M, Small BJ. Age differences in cognitive performance in later life: Relationships to self-reported health and activity life style. J Gerontol. 1993;48:1-11.
5.
Christensen H, Korten A, Jorm AF, Henderson AS, Scott R, Mackinnon AJ. Activity levels and cognitive functioning in an elderly community sample. Age Ageing. 1996;25:72-80.
6.
Langer EJ, Rodin J, Beck P, Weinman C, Spitzer L. Environmental determinants of memory improvement in late adulthood. J Pers Soc Psychol. 1979;37:2003-13.
7.
Koh K, Ray R, Lee J, Nair A, Ho T, Ang PC. Dementia in elderly patients: can the 3R mental stimulation programme improve mental status? Age Ageing. 1994;23:195-9.
8.
Schooler C. Psychological effects of complex environments during the life span: a review and theory. In: Schooler C, Schaie KW, eds. Cognitive Functioning and Social Structure over the Life Course. Norwood, NJ: Ablex; 1987:24-49.
9.
Taylor SE. Health Psychology. 3d ed. New York: McGraw-Hill; 1995.
10.
Beard CM, Kokmen E, Offord KP, Kurland LT. Lack of association between Alzheimer's disease and education, occupation, marital status, or living arrangement. Neurology. 1992;42:2063-8.
11.
Bickel H, Cooper B. Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychol Med. 1994;24:179-92.
12.
Fabrigoule C, Letenneur L, Dartigues JF, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc. 1995;43:485-90.
13.
Cornoni-Huntley J, Ostfeld AM, Taylor JO, Wallace RB, Blazer D, Berkman LF, et al . Established populations for epidemiologic studies of the elderly: study design and methodology. Aging-Clinical and Experimental Research. 1993;5:27-37.
14.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23:433-41.
15.
Shapiro E, Tate RB. The impact of a mental status score and a dementia diagnosis on mortality and institutionalization. Journal of Aging and Health. 1991;3:28-46.
16.
Ferrucci L, Guralnik JM, Salive ME, Pahor M, Corti MC, Baroni A, et al . Cognitive impairment and risk of stroke in the older population. J Am Geriatr Soc. 1996;44:237-41.
17.
Sturmer T, Glynn RJ, Field TS, Taylor JO, Hennekens CH. Aspirin use and cognitive function in the elderly. Am J Epidemiol. 1996;143:683-91.
18.
Field TS. Risk factors for change in the ability to perform basic activities of daily living among the elderly [Dissertation]. Boston: Boston University School of Public Health; 1993.
19.
Breteler MM, Claus JJ, van Duijn CM, Launer LJ, Hofman A. Epidemiology of Alzheimer's disease. Epidemiol Rev. 1992;14:59-82.
20.
Hebert R, Brayne C. Epidemiology of vascular dementia. Neuroepidemiology. 1995;14:240-57.
21.
Katz S, Downs TD, Cash HR, Grotz RC. Progress in the development of the index of ADL. Gerontologist. 1970;10:20-30.
22.
Rosow I, Breslau N. A Guttman health scale for the aged. J Gerontol. 1966;21:556-9.
23.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385-401.
24.
Shah BV, Barnwell BG, BielerGS. SUDAAN User's Manual, Version 7.0. Research Triangle Park,NC: Research Triangle Institute; 1996.
25.
Zeger SL, Liang KY, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988;44:1049-60.
26.
Colsher PL, Wallace RB. Epidemiologic considerations in studies of cognitive function in the elderly: methodology and nondementing acquired dysfunction. Epidemiol Rev. 1991;13:1-27.
27.
Larson EB, Kukull WA, Katzman RL. Cognitive impairment: dementia and Alzheimer's disease. Annu Rev Public Health. 1992;13:431-49.
28.
Eisdorfer C, Cohen D, Paveza GJ, Ashford JW, Luchins DJ, Gorelick PB, et al . An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's disease. Am J Psychiatry. 1992;149:190-4.
29.
Bassuk SS, Berkman LF, Wypij D. Depressive symptomatology and incident cognitive decline in an elderly community sample. Arch Gen Psychiatry. 1998;55:1073-81.
30.
Orrell M, Sahakian B. Education and dementia [Editorial]. BMJ. 1995;310:951-2.
31.
Katzman R. Education and the prevalence of dementia and Alzheimer's disease. Neurology. 1993;43:13-20.
32.
Sapolsky RM. Stress, the Aging Brain, and the Mechanisms of Neuron Death. Cambridge, MA: MIT Pr; 1992.
33.
McEwen BS, Sapolsky RM. Stress and cognitive function. Curr Opin Neurobiol. 1995;5:205-16.
34.
Seeman TE, McEwen BS, Singer BH, Albert MS, Rowe JW. Increase in urinary cortisol excretion and memory declines: MacArthur studies of successful aging. J Clin Endocrinol Metab. 1997;82:2458-65.
35.
Hurst DF, Boswell DL, Boogaard SE, Watson MW. The relationship of self-esteem to the health-related behaviors of the patients of a primary care clinic. Arch Fam Med. 1997;6:67-70.
36.
Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, et al . 15-year longitudinal study of blood pressure and dementia. Lancet. 1996;347:1141-5.
37.
Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA. 1997;277:813-7.
38.
Aronson MK, Ooi WL, Morgenstern H, Hafner A, Masur D, Crystal H, et al . Women, myocardial infarction, and dementia in the very old. Neurology. 1990;40:1102-6.
39.
Riley MW. Changing lives and changing social structures: common concerns of social science and public health [Editorial]. Am J Public Health. 1994;84:1214-7.
40.
Butler RN. Living longer, contributing longer. JAMA. 1997;278:1372-3.
Information & Authors
Information
Published In
Annals of Internal Medicine
Volume 131 • Number 3 • 3 August 1999
Pages: 165 - 173
History
Published in issue: 3 August 1999
Published online: 15 August 2000
Keywords
Copyright
© 1999 American College of Physicians.
Authors
Metrics & Citations
Metrics
Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. For an editable text file, please select Medlars format which will download as a .txt file. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
Download article citation data for:
Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons. Ann Intern Med.1999;131:165-173. doi:10.7326/0003-4819-131-3-199908030-00002
Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons. Ann Intern Med.1999;131:165-173. doi:10.7326/0003-4819-131-3-199908030-00002
View More
Login Options:
Purchase
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
Access to EPUBs and PDFs for FREE Annals content requires users to be registered and logged in. A subscription is not required. You can create a free account below or from the following link. You will be redirected to acponline.org to create an account that will provide access to Annals. If you are accessing the Free Annals content via your institution's access, registration is not required.
Create your Free Account
You will be redirected to acponline.org to create an account that will provide access to Annals.
Comments
0 Comments