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Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults.
J Gen Intern Med 2016; 31(8):854-62JG

Abstract

BACKGROUND

An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited.

OBJECTIVE

We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender.

DESIGN

United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP).

PARTICIPANTS

Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %.

MAIN MEASURES

Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition.

KEY RESULTS

Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively.

CONCLUSION

Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers.

Authors+Show Affiliations

Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA. akotwal@partners.org.Department of Urban Sociology, University of Seoul, Seoul, South Korea.Department of Sociology, University of Chicago, Chicago, IL, USA.Department of Medicine, University of Chicago, Chicago, IL, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27130624

Citation

Kotwal, Ashwin A., et al. "Social Function and Cognitive Status: Results From a US Nationally Representative Survey of Older Adults." Journal of General Internal Medicine, vol. 31, no. 8, 2016, pp. 854-62.
Kotwal AA, Kim J, Waite L, et al. Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults. J Gen Intern Med. 2016;31(8):854-62.
Kotwal, A. A., Kim, J., Waite, L., & Dale, W. (2016). Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults. Journal of General Internal Medicine, 31(8), pp. 854-62. doi:10.1007/s11606-016-3696-0.
Kotwal AA, et al. Social Function and Cognitive Status: Results From a US Nationally Representative Survey of Older Adults. J Gen Intern Med. 2016;31(8):854-62. PubMed PMID: 27130624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults. AU - Kotwal,Ashwin A, AU - Kim,Juyeon, AU - Waite,Linda, AU - Dale,William, Y1 - 2016/04/29/ PY - 2015/10/19/received PY - 2016/03/28/accepted PY - 2016/03/09/revised PY - 2016/5/1/entrez PY - 2016/5/1/pubmed PY - 2018/1/9/medline KW - MoCA KW - aging KW - cognition KW - community dwelling KW - social relationships SP - 854 EP - 62 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 31 IS - 8 N2 - BACKGROUND: An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE: We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender. DESIGN: United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP). PARTICIPANTS: Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %. MAIN MEASURES: Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition. KEY RESULTS: Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively. CONCLUSION: Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/27130624/Social_Function_and_Cognitive_Status:_Results_from_a_US_Nationally_Representative_Survey_of_Older_Adults_ L2 - https://dx.doi.org/10.1007/s11606-016-3696-0 DB - PRIME DP - Unbound Medicine ER -