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Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians.
Alzheimers Dement. 2010 Jul; 6(4):319-325.e1.AD

Abstract

BACKGROUND

Although numerous social factors have been associated with cognition in older adults, these findings have been limited by the consideration of individual factors in isolation. We investigated whether social vulnerability, defined as an index comprising many social factors, is associated with cognitive decline.

METHODS

In this secondary analysis of the Canadian Study of Health and Aging, 2468 community-dwellers aged 70 and older were followed up for 5 years. The social vulnerability index incorporated 40 social variables. Each response was scored as 0 if the "deficit" was absent and 1 if it was present; the 40 deficit scores were then summed. For some analyses, index scores were split into tertiles of high, intermediate, and low social vulnerability. Cognitive decline was defined as a >or=5-point decline in the Modified Mini-Mental State Examination (3MS). Associations of social vulnerability with 5-year cognitive decline (adjusting for age, sex, frailty, and baseline cognition) were analyzed by using logistic regression.

RESULTS

Mean social vulnerability was 0.25 (standard deviation, 0.09) or 9.9 deficits of the list of 40. The median cognitive change of -1.0 (interquartile range, -6 to 2) points on the 3MS was noted at 5 years. About 743 individuals (30% of the sample) experienced a decline of >or=5 points on the 3MS. Each additional social deficit was associated with increased odds of cognitive decline (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.06; P = .02). Compared with those with low social vulnerability, individuals with high social vulnerability had a 36% increased odds of experiencing cognitive decline (odds ratio, 1.36; 95% confidence interval, 1.06 to 1.74; P = .015).

CONCLUSIONS

Increasing social vulnerability, defined by using a social vulnerability index incorporating many social factors, was associated with increased odds of cognitive decline during a period of 5 years in this study of older Canadians. Further study of social vulnerability in relation to cognition is warranted, with particular attention to potential interventions to alleviate its burden.

Authors+Show Affiliations

Division of Geriatric Medicine and Geriatric Medicine Research Unit, Dalhousie University, Halifax, NS, Canada.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20630414

Citation

Andrew, Melissa K., and Kenneth Rockwood. "Social Vulnerability Predicts Cognitive Decline in a Prospective Cohort of Older Canadians." Alzheimer's & Dementia : the Journal of the Alzheimer's Association, vol. 6, no. 4, 2010, pp. 319-325.e1.
Andrew MK, Rockwood K. Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians. Alzheimers Dement. 2010;6(4):319-325.e1.
Andrew, M. K., & Rockwood, K. (2010). Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians. Alzheimer's & Dementia : the Journal of the Alzheimer's Association, 6(4), 319-e1. https://doi.org/10.1016/j.jalz.2009.11.001
Andrew MK, Rockwood K. Social Vulnerability Predicts Cognitive Decline in a Prospective Cohort of Older Canadians. Alzheimers Dement. 2010;6(4):319-325.e1. PubMed PMID: 20630414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians. AU - Andrew,Melissa K, AU - Rockwood,Kenneth, PY - 2008/11/20/received PY - 2009/10/09/revised PY - 2009/11/13/accepted PY - 2010/7/16/entrez PY - 2010/7/16/pubmed PY - 2010/10/20/medline SP - 319 EP - 325.e1 JF - Alzheimer's & dementia : the journal of the Alzheimer's Association JO - Alzheimers Dement VL - 6 IS - 4 N2 - BACKGROUND: Although numerous social factors have been associated with cognition in older adults, these findings have been limited by the consideration of individual factors in isolation. We investigated whether social vulnerability, defined as an index comprising many social factors, is associated with cognitive decline. METHODS: In this secondary analysis of the Canadian Study of Health and Aging, 2468 community-dwellers aged 70 and older were followed up for 5 years. The social vulnerability index incorporated 40 social variables. Each response was scored as 0 if the "deficit" was absent and 1 if it was present; the 40 deficit scores were then summed. For some analyses, index scores were split into tertiles of high, intermediate, and low social vulnerability. Cognitive decline was defined as a >or=5-point decline in the Modified Mini-Mental State Examination (3MS). Associations of social vulnerability with 5-year cognitive decline (adjusting for age, sex, frailty, and baseline cognition) were analyzed by using logistic regression. RESULTS: Mean social vulnerability was 0.25 (standard deviation, 0.09) or 9.9 deficits of the list of 40. The median cognitive change of -1.0 (interquartile range, -6 to 2) points on the 3MS was noted at 5 years. About 743 individuals (30% of the sample) experienced a decline of >or=5 points on the 3MS. Each additional social deficit was associated with increased odds of cognitive decline (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.06; P = .02). Compared with those with low social vulnerability, individuals with high social vulnerability had a 36% increased odds of experiencing cognitive decline (odds ratio, 1.36; 95% confidence interval, 1.06 to 1.74; P = .015). CONCLUSIONS: Increasing social vulnerability, defined by using a social vulnerability index incorporating many social factors, was associated with increased odds of cognitive decline during a period of 5 years in this study of older Canadians. Further study of social vulnerability in relation to cognition is warranted, with particular attention to potential interventions to alleviate its burden. SN - 1552-5279 UR - https://www.unboundmedicine.com/medline/citation/20630414/Social_vulnerability_predicts_cognitive_decline_in_a_prospective_cohort_of_older_Canadians_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1552-5260(09)02331-0 DB - PRIME DP - Unbound Medicine ER -