The longitudinal association between social network composition and episodic memory in older adulthood: the importance of contact frequency with friends

Home-Based Cognitive Intervention for Healthy Older Adults Through Asking Robots Questions: Randomized Controlled Trial

Background

Asking questions is common in conversations, and while asking questions, we need to listen carefully to what others say and consider the perspective our questions adopt. However, difficulties persist in verifying the effect of asking questions on older adults' cognitive function due to the lack of a standardized system for conducting experiments at participants' homes.

Objective

This study examined the intervention effect of cognitive training moderated by robots on healthy older adults. A focus on the feasibility of the intervention at participants' homes was also maintained. Feasibility was evaluated by considering both the dropout rate during the intervention and the number of questions posed to each participant during the experiment.

Methods

We conducted a randomized controlled trial with 81 adults older than 65 years. Participants were recruited through postal invitations and then randomized into 2 groups. The intervention group (n=40) received sessions where participants listened to photo-integrated stories and posed questions to the robots. The control group (n=41) received sessions where participants listened to photo-integrated stories and only thanked the robots for confirming participation. The participants participated in 12 dialogue sessions for 2-3 weeks. Scores of global cognitive functioning tests, recall tests, and verbal fluency tasks measured before and after the intervention were compared between the 2 groups.

Results

There was no significant intervention effect on the Telephone Interview for Cognitive Status-Japanese scores, recall tests, and verbal fluency tasks. Additionally, our study successfully concluded with no participant dropouts at follow-up, confirming the feasibility of our approach.

Conclusions

There was no statistically significant evidence indicating intervention benefits for cognitive functioning. Although the feasibility of home-based interventions was demonstrated, we identified areas for improvement in the future, such as setting up more efficient session themes. Further research is required to identify the effectiveness of an improved cognitive intervention involving the act of asking questions.

Social Support From Family and Friends, Educational Attainment, and Cognitive Function

This study assessed the extent to which associations between perceived and received social support from family and friends and changes in older adults' cognitive function were moderated by educational attainment. Sibling pairs in the Wisconsin Longitudinal Study (WLS) (N = 4,297) completed a survey about social support in 2011 and a cognitive battery in 2011 and 2020. Participants' mean age in 2020 was 80.2 years old. Multilevel linear regressions indicated that perceived, but not received, support from friends was associated with better cognitive function 9 years later. Perceived family support was cognitively advantageous for older adults at most levels of educational attainment. However, among postgraduates, perceived family support was unrelated to cognitive function. That the association between perceived support and cognitive function differs based on educational attainment gives interventionists additional information needed to identify groups of older adults most susceptible to cognitive impairment.

Everyday functioning among older adults with subjective cognitive decline: a scoping review

PURPOSE

Older adults with subjective cognitive decline (SCD) experience cognitive difficulties without objectively measurable cognitive impairments but which may affect their everyday functioning. However, everyday functioning in this population has not yet been characterized. We sought to describe the empirical literature on the everyday functioning of community-dwelling older adults with SCD, their recruitment methods, and the measurements used.

METHODS

A scoping review was conducted for primary research articles including at least one measure of everyday functioning. Retrieved records were independently screened. Data were extracted then analyzed using descriptive statistics and summative content analysis.

RESULTS

6544 studies were screened; 21 studies were included. All were observational analytic studies. Most compared an SCD group with a group of healthy control (47.6%), mild cognitive impairment (71.5%), and/or dementia (33.3%). Subjective cognition was measured via interview (28.6%) or clinical question(s) (14.3%). Normal cognition was determined by a wide variety of cognitive tests. The most studied everyday functioning domain was instrumental activities of daily living (90.5%). Most studies used questionnaires (81.0%), and measured ability to do an everyday life task (76.2%).

CONCLUSIONS

More research is needed on everyday functioning other than IADL, with greater focus on measures that consider an individual's real-life participation.

Determinants of Social Cognitive Aging: Predicting Resilience and Risk

This review focuses on conceptual and empirical research on determinants of social cognitive aging. We present an integrated model [the social cognitive resource (SCoRe) framework] to organize the literature and describe how social cognitive resilience is determined jointly by capacity and motivational resources. We discuss how neurobiological aging, driven by genetic and environmental influences, is associated with broader sensory, neural, and physiological changes that are direct determinants of capacity as well as indirect determinants of motivation via their influence on expectation of loss versus reward and cognitive effort valuation. Research is reviewed that shows how contextual factors, such as relationship status, familiarity, and practice, are fundamental to understanding the availability of both types of resource. We conclude with a discussion of the implications of social cognitive change in late adulthood for everyday social functioning and with recommendations for future research.

Social engagement and its links to cognition differ across non-Hispanic Black and White older adults

OBJECTIVE

Racial inequalities in dementia have been linked to disparities in socioeconomic status, chronic diseases, and psychosocial stress. Less focus has been given to psychosocial protective factors. Previous studies suggest that social engagement promotes better cognitive aging, but few have examined whether social engagement or its associations with cognition vary across non-Hispanic Whites (NHW) and Blacks (NHB).

METHOD

Participants included 465 adults (53% NHB) from the Michigan Cognitive Aging Project (Mage = 63.59 ± 3.15) who completed a comprehensive neuropsychological battery. Social engagement was operationalized as network size, frequency of social activity participation, and social support. Cognition was operationalized using factor scores corresponding to five domains: episodic memory, executive functioning, processing speed, language, and visuospatial functioning. Cross-sectional associations between social engagement and cognitive outcomes were examined using race-stratified regressions controlling for age, sex/gender, education, wealth, marital status, depressive symptoms, and chronic diseases.

RESULTS

There were no racial differences in social network size or social support. NHB participants reported less social activity participation than NHW participants. Social activity participation was positively associated with memory in NHW, but not NHB.

CONCLUSIONS

These findings may suggest a threshold effect whereby NHB older adults are less likely to participate in social activities at the level needed to yield cognitive benefits. Lower social activity participation among NHB may reflect structural barriers and/or cultural differences in patterns of social engagement. This study highlights the need to improve measurement of and access to culturally relevant social activities for NHB to combat racial inequalities in cognitive aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations between social network components and cognitive domains in older adults

Previous research shows that social network components are associated with cognitive function later in life. However, fewer studies consider different cognitive domains or disaggregate the social network by relationship type. Using data from 2,553 participants aged 65 or older in the Health and Retirement Study's Harmonized Cognitive Assessment Protocol, this study examined relationships between social network structure (i.e., size, contact frequency) and quality (i.e., support, strain) and performance in five cognitive domains (i.e., episodic memory, executive function, visuoconstruction, language, and processing speed) 2-4 years later, controlling for sociodemographics and previous global cognition. Separate linear regressions were conducted for each cognitive outcome. When averaged across relationship types, network size was not associated with any domain. Contact frequency was positively associated with all domains except episodic memory. Support and strain were negatively associated with all cognitive domains. When considering individual relationship types, larger friend networks were positively associated with visuoconstruction, and greater contact frequency with friends was positively associated with all cognitive domains. Larger family networks were associated with worse executive function, visuoconstruction, and speed. Strain from friends had a negative relationship with every domain except episodic memory. Support from family was negatively associated with episodic memory, executive function, and language. These associations were equivalent to one to 3.5 years of cognitive aging. These results showed that both social network structure and quality may be consequential for cognitive functioning and that links between social relations and cognition differ across domains and as a function of relationship type. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social support, social strain and declines in verbal memory: sex-specific associations based on 16-year follow-up of the English Longitudinal Study of Ageing cohort

OBJECTIVES

Previous investigations of cognitive aging have mainly focused on structural aspects of social relations (e.g. network size and composition), thereby neglecting the role of qualitative aspects of social relations. The current longitudinal study examined sex-specific differences in verbal memory decline by measures of perceived relationship quality (social support/strain) by relationship type.

METHOD

In the English Longitudinal Study of Ageing (ELSA), 10,109 participants aged 50-89 years were assessed at wave 1 (baseline: 2002-03) and followed to wave 9 (2017-18). Verbal memory was assessed by immediate and delayed word-recall tasks. Social support/strain was measured by relationship type (spouse; children; family; friends). Random effects within-between (REWB) modelling was used to separate between- and within-person effects. We estimated associations between social support/strain and (1) baseline levels of memory (main effects), and (2) rate of decline in memory (interaction with time-since-baseline).

RESULTS

Longitudinal associations were most prominent for men, specific to relationship type, and showed between- rather than within-person effects. Among men, higher spousal strain was associated with faster memory decline (β_{between-effect×time} = -0.043; 95% CI [-0.084, -0.002]; p = .039), whilst greater support from children was associated with slower decline (β_{between-effect×time} = 0.020; 95% CI [0.002, 0.039]; p = .033). Men with higher strain from friends showed lower baseline memory (β_{between-effect} = -0.382; 95% CI [-0.627, -0.137]; p=.002) and faster decline (β_{between-effect×time} = -0.047; 95% CI [-0.095, 0.000]; p = .051).

CONCLUSION

Between-person differences in social support/strain were modestly associated with memory decline, especially among men.

Disorder, networks, and cognition: do social networks buffer the influence of neighborhood and household disorder on cognitive functioning?

OBJECTIVES

To examine whether neighborhood and household disorder matter for cognitive functioning among middle-aged and older adults and whether the disorder-cognition link is moderated by social network resources.

METHOD

Data are drawn from National Social Life, Health, and Aging Project (NSHAP) Wave 2 (N = 3198). Both neighborhood and household were considered as key residential contexts that shape one's social life and health. Exposure to neighborhood and household disorder was measured using interviewer assessments of signs of disorder and decay, including the presence of disrepair, trash, noise, and unpleasant smells such as air pollution, in the buildings and streets in which the respondent lives. Cognitive function was measured using the survey-adapted Montreal Cognitive Assessment (MoCA-SA). Network size, network range, and frequency of interaction among network members were assessed as moderators.

RESULTS

Neighborhood and household disorder were independently associated with cognitive function. However, disorder in the household appeared to have more direct associations with cognitive function than did the neighborhood when both were present. The association between household disorder and cognitive function was mitigated by network size, such that poor housing conditions were associated with lower cognitive function only for those with small social networks.

CONCLUSION

This study suggests a larger network may play a role in minimizing the negative influence of household disorder on cognitive function for middle-aged and older adults. Social policy and intervention aimed at promoting network ties may help reduce further disparities in cognitive function, especially for those vulnerable groups living in a poor-quality household.

Occupational Disruption during the COVID-19 Pandemic: The Lived Experience of Community-Dwelling Older Adults

This qualitative descriptive study presents the experience of an abrupt disruption of daily activities among community-dwelling older adults during the early months of the COVID-19 pandemic. Sixteen older adults (age: 71 ± 6.4) were interviewed in April–June, 2020. Five themes were identified: (1) Understanding and applying COVID-19 guidelines: guidelines were clear and participants adhered closely to them, motivated mainly by fear; ageing-specific guidelines are needed. (2) Daily life during lockdown: the abrupt occupational disruption was managed by transitioning to virtual activities, and/or performing more activities at home. New daily activities were generally more sedentary and less meaningful. (3) Social context: family assistance aroused mixed feelings, as it compromised independence; limited compliance at the community level created stress. (4) Mood and affect: mood often fluctuated, and participants employed various coping strategies. (5) Aging: participants became more aware of their age and were concerned about negative health implications of adherence to COVID-19 guidelines.

Why the cognitive "fountain of youth" may be upstream: Pathways to dementia risk and resilience through social connectedness

Research suggests social connectedness may help older adults with dementia maintain cognitive functionality and quality of life. However, little is known about its specific social and biological mechanisms. This paper proposes two pathways through social bridging (i.e., cognitive enrichment through expansive social networks) and bonding (i.e., neuroendocrine benefits of integration in cohesive social networks). We provide preliminary evidence for these pathways using neuroimaging, cognitive, and egocentric social network data from the Social Networks and Alzheimer's Disease (SNAD) study (N = 280). We found that network size, density, and presence of weak ties (i.e., social bridging) moderated the association between brain atrophy and cognitive function, while marriage/cohabitation (i.e., social bonding) moderated the association between perceived stress and cognitive function. We argue that social connectedness may have downstream implications for multiple pathophysiological processes in cognitive aging, even negating existing structural damage to the brain, making it a strong candidate for clinical or policy intervention.

The Role of Social Connection/Engagement in Episodic Memory Change in Stroke

BACKGROUND AND OBJECTIVES

Positive associations between social connection/engagement and cognitive function are well documented. However, little is known about whether social connection/engagement can buffer the impact of serious brain injury such as stroke on cognitive functioning.

RESEARCH DESIGN AND METHODS

Participants were 898 individuals with incident stroke from the Health and Retirement Study (HRS) between 1998-2012. Multilevel modeling was used to examine how social connection/engagement were associated with episodic memory pre- and post-stroke. Models controlled for age, gender, education, race/ethnicity, number of health conditions, and functional health.

RESULTS

Participants who were lonely pre-stroke recalled significantly fewer words at time of stroke, and participants who had children residing within 10 miles pre-stroke showed significantly less decline in word recall over time. Participants who provided help to others pre-stroke showed less stroke-related decline in word recall. Within-person increase in partnered status, having friends, and helping others were related to better word recall in the post-stroke period.

DISCUSSION AND IMPLICATIONS

Higher pre-stroke levels of social connection/engagement predicted better episodic memory at stroke, smaller decline in episodic memory with stroke, and less decline in episodic memory over time. Increases in social connection/engagement from pre- to post-stroke also predicted better post-stroke episodic memory. Beyond the widely documented benefits of social connection/engagement to well-being, they may also increase cognitive stimulation and cognitive reserve and thus contribute to stroke recovery in the cognitive domain. Social connection/engagement is an important and modifiable risk factor in older adults.

Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review

BACKGROUND

Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia.

METHODS

A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels.

RESULTS

Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level.

CONCLUSIONS

Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.

Associations between life course marital biography and late-life memory decline

Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life cognitive trajectories, as well as gender differences in the effects of marital biography, remain to be explored. Associations between (a) marital status at study baseline (currently married, previously married, never married) and (b) retrospectively reported life course marital biography (i.e., age at first marriage, time spent unmarried following initial marriage, history of divorce, history of widowhood) and up to 20 years of subsequent episodic memory trajectories were examined using latent growth curve models in 3,061 participants aged 51 + in the Health and Retirement Study 2017 Life History Mail Survey. Gender differences were examined with multiplicative interaction terms and stratified models. Participants who were married at study baseline demonstrated higher initial memory than previously and never married individuals. Older age at first marriage and shorter duration spent unmarried were each associated with better initial episodic memory among previously married individuals only; longer duration spent unmarried was associated with slower memory decline. Stratified models suggested that these associations may be driven by women. These results highlight the importance of considering multiple aspects of marital biography, not just current marital status, in cognitive aging research. Marital biography may have an enduring influence on cognitive aging, particularly among previously married older women. Future work is needed to identify mechanisms (e.g., socioeconomic resources, cognitive stimulation, self and spousal health, emotional support) through which marital histories influence cognitive aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The link between social and emotional isolation and dementia in older black and white Brazilians

OBJECTIVE

To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians.

DESIGN

Cross-sectional clinical-pathological cohort study.

SETTING

Medical center in Sao Paulo, Brazil.

PARTICIPANTS

As part of the Pathology, Alzheimer's and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents.

MEASUREMENTS

The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI).

RESULTS

Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI.

CONCLUSION

Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.

Occupational performance issues in older adults with subjective cognitive decline

PURPOSE

To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI).

METHODS

Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF).

RESULTS

Both groups identified issues in all nine ICF "Activities and Participation" domains, with no significant group effects on seven of them. The most frequently affected "Activities and Participation" domains in both groups were "Self-care" (e.g. exercise and diet); "Community, social and civic life" (e.g. social-leisure activities); and "General tasks and demands" (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in "Mental functions" (e.g. memory and higher-level cognitive functions).

CONCLUSIONS

Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI.Implications for RehabilitationOlder adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks.The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI.Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction.Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.

The role of social communication technologies in cognition and affect in older adults

Affect and cognition have both been associated with communication across one's social network during ageing. Thus, it is important to consider how communication varies by different aspects of one's social network, and by communication mode, including phone, email and social media. This study aimed to investigate the relationship between technology-mediated communication, depression and an executive function-related fluid-reasoning measure among older adults. Data were drawn from the Health and Retirement dataset's 2016 wave. Hierarchical regression analyses were conducted to examine the link between communication modes (phone, email and social media) with children, family and friends with a fluid-reasoning cognition measure and Center for Epidemiologic Studies Depression Scale, controlling for demographic covariates, among 3,798 older American adults. Phone and email communication, but not social media, were significantly related to depression and cognition. The model fit was considerably stronger for the analyses with cognition than depression. Curvilinear associations were found for communication via phone and email with cognition, suggesting moderate amounts of communication by phone and email across social groups were most closely linked with higher scores on fluid reasoning. For depression, curvilinear relationships were found for talking on the phone with family and friends, and emailing for children and family, indicating that moderate communication levels revealed the lowest depression levels. Implications for how older adults’ social support may contribute to depression and cognition status are discussed.

Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings from the English Longitudinal Study of Ageing

OBJECTIVES

Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network.

METHOD

11,418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network.

RESULTS

Frequent offline (B=0.23; SE=0.09) and combined offline and online (B=0.71; SE=0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B=0.50, SE=0.11) but not with strictly offline interactions (B=0.01, SE=0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B=0.79, SE=0.20; combined online and offline: B=1.27, SE=0.20). Sensitivity analyses confirmed the robustness of these findings.

DISCUSSION

Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.

Positive Psychosocial Factors and Cognitive Decline in Ethnically Diverse Older Adults

OBJECTIVES

Previous cross-sectional studies have documented associations between positive psychosocial factors, such as self-efficacy and emotional support, and late-life cognition. Further, the magnitudes of concurrent associations may differ across racial and ethnic groups that differ in Alzheimer's disease risk. The goals of this longitudinal study were to characterize prospective associations between positive psychosocial factors and cognitive decline and explicitly test for differential impact across race and ethnicity.

METHODS

578 older adults (42% non-Hispanic Black, 31% non-Hispanic White, and 28% Hispanic) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests over 2.4 years. Latent difference scores were used to model associations between positive psychosocial factors and cognitive decline controlling for baseline cognition, sociodemographics, depressive symptoms, physical health, and other positive psychosocial factors. Multiple-group modeling was used to test interactions between the positive psychosocial factors and race/ethnicity.

RESULTS

Higher NIH Toolbox Friendship scores predicted less episodic memory decline. One standard deviation increase in friendship corresponded to 6 fewer years of memory aging. This association did not significantly differ across racial/ethnic groups.

CONCLUSIONS

This longitudinal study provides support for the potential importance of friendships for subsequent episodic memory trajectories among older adults from three ethnic groups. Further study into culturally informed interventions is needed to investigate whether and how friend networks may be targeted to promote cognitive health in late life.

Family Ties and Aging in a Multiethnic Cohort

Objective: Lack of social support is linked to lower cognitive function and cognitive decline. We investigated the effects of a specific type of social relationship, family ties, on cognitive trajectories in non-Hispanic whites, non-Hispanic blacks, and Hispanics. Methods: Using multiple-group latent growth curve models, we analyzed associations between the number of children/grandchildren/siblings/other relatives contacted within the past month at baseline and cognitive trajectories in 1420 older adults who were nondemented at baseline. Language, memory, and visuospatial abilities were assessed at baseline and at 18- and 24-month follow-ups for up to six visits. Inferential analyses assessed the differential effects of sex/gender and race/ethnicity for each family tie. Results: Independent of all covariates, contact with more relatives was associated with better initial memory (b = .01) and language functioning (b = .01) across race/ethnicity and sex/gender. Conclusion: The size of peripheral rather than immediate family networks may be more likely to affect cognitive function in older adults.