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Oken BS, Kaplan J, Klee D, Gallegos AM. Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer's pathology: a narrative review. Front Hum Neurosci 2024; 18:1380002. [PMID: 38873650 PMCID: PMC11169707 DOI: 10.3389/fnhum.2024.1380002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer's disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.
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Affiliation(s)
- Barry S. Oken
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Josh Kaplan
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Daniel Klee
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Autumn M. Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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Foong HF, Ibrahim R, Hamid TA, Bagat MF. The Individual and Combined Effects of Social Networks and Loneliness on Life Satisfaction among Community-Dwelling Residing Older Adults: A Longitudinal Study. Healthcare (Basel) 2023; 11:healthcare11070935. [PMID: 37046862 PMCID: PMC10094333 DOI: 10.3390/healthcare11070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Social networks and loneliness are correlates of life satisfaction in old age. However, the evidence of the combined effects of social isolation and loneliness on life satisfaction is lacking; therefore, this study also aimed to investigate the combined effects of social networks and loneliness on life satisfaction in Malaysian older adults. Data from two waves of the "Neuroprotective Model for Healthy Longevity among Malaysian Older Adults" study were extracted. The first wave of data collection was completed in February 2013, while the second wave was conducted three years after the first wave. The main statistical analysis used was multivariable logistic regression. For individual effect, social networks (B = 0.375, p = 0.007), but not loneliness (B = -0.178, p = 0.368) significantly determined life satisfaction. Increasing social network size causes increasing life satisfaction. For combined effects, those in "the lone farmers" group (B = 0.279, p = 0.044) and "the majority" group (B = -0.413, p = 0.004) were linked to life satisfaction. Social engagement in older people is important for wellbeing in later life. Therefore, community programs and investing in a quality relationship should be encouraged to obtain adequate support and ultimately promote higher life satisfaction.
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Affiliation(s)
- Hui Foh Foong
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Rahimah Ibrahim
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Mohamad Fazdillah Bagat
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
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Luchetti M, Ledermann T, Aschwanden D, Nikitin J, O’Súilleabháin PS, Stephan Y, Terracciano A, Sutin AR. Actor and Partner Effect of Loneliness on Episodic Memory and Verbal Fluency: A Dyadic Multilevel Analysis of Romantic Couples Across 28 Countries. J Gerontol B Psychol Sci Soc Sci 2022; 77:2202-2211. [PMID: 35758343 PMCID: PMC9799178 DOI: 10.1093/geronb/gbac086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES There is evidence that loneliness is detrimental to cognitive health. Most studies, however, do not consider the association between loneliness and cognition in the context of close relationships, such as a spouse or romantic partner. This study examines loneliness, experienced by both the individual and their romantic partner, and cognitive performance. METHODS Data were from 24,689 opposite-sex couples (49,378 participants) from 28 countries in the Survey of Health, Aging and Retirement in Europe. Each couple participant reported loneliness and completed memory and verbal fluency tasks. A multilevel sex-stratified analysis was used to account for the nested data structure and evaluate actor and partner effects of loneliness on cognitive performance for male and female partners. RESULTS Consistent with the literature, there were small actor effects of loneliness on memory and verbal fluency for both males and females: A person's own loneliness was associated negatively with their cognitive performance on both tasks. There were also small partner effects: A person with a partner who was lonely tended to have worse cognitive performance above and beyond their own loneliness. Actor and partners effects were similar for male and female partners, replicated in most countries, and generally held controlling for age, education, household size, and disease burden. For memory, loneliness effects were slightly stronger among older participants. DISCUSSION Both the experience of loneliness and loneliness of a partner have a negative association with cognitive health.
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Affiliation(s)
- Martina Luchetti
- Address correspondence to: Martina Luchetti, PhD, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 West Call Street, Tallahassee, FL 32306-4300, USA. E-mail:
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, USA
| | | | - Jana Nikitin
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria
| | - Páraic S O’Súilleabháin
- Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, USA
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Foong HF, Ibrahim R, Hamid TA, Haron SA. Social networks moderate the association between physical fitness and cognitive function among community-dwelling older adults: a population-based study. BMC Geriatr 2021; 21:679. [PMID: 34876024 PMCID: PMC8650559 DOI: 10.1186/s12877-021-02617-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical fitness declines with age. Low levels of physical fitness appear to be a risk factor of cognitive impairment. Literature elucidates social networking as a potential moderator for the relationship between physical fitness and cognitive impairment. Present study aimed to examine the relationship between physical fitness and cognitive function among community-dwelling older Malaysians, and if social network moderates said relationship. METHODS Data of 2322 representative community-dwelling older adults were obtained from the first wave of the "Longitudinal Study on Neuroprotective Model for Healthy Longevity" national survey. Cognitive function, physical fitness and social network was assessed through Malay-version of Mini-Mental State Examination, 2-min step test and Lubben Social Network Scale-6 respectively. Moderated hierarchical multiple regression was employed to investigate if social networks moderate the relationship between physical fitness and cognitive function. RESULTS A positive association between physical fitness and cognitive function were found upon controlling for covariates. Moderated hierarchical multiple regression revealed social networks to be a moderator of the association between physical fitness and cognitive function. When physical fitness was low, those with small social network revealed lowest cognitive function. CONCLUSIONS Social networks moderated the relationship between physical fitness and cognitive function as older adults with low levels of physical fitness and small social networks revealed lowest cognitive function. Therefore, community support or peer-based interventions among physically unfit older adults should be implemented to promote cognitive function.
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Affiliation(s)
- Hui Foh Foong
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Rahimah Ibrahim
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. .,Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Sharifah Azizah Haron
- Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
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Foong HF, Haron SA, Koris R, Hamid TA, Ibrahim R. Relationship between financial well-being, life satisfaction, and cognitive function among low-income community-dwelling older adults: the moderating role of sex. Psychogeriatrics 2021; 21:586-595. [PMID: 33969594 DOI: 10.1111/psyg.12709] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low financial well-being is a common predicament among older adults living in poverty. The existing literature suggests a correlation between financial well-being and mental health in old age. Therefore, this study aimed to identify the relationships among financial well-being, life satisfaction, and cognitive function among low-income older adults and to examine the moderating effect of sex on these relationships. METHODS This study involved 2004 nationally representative community-dwelling older Malaysians from the bottom 40% household income group. Financial well-being was assessed by the four-item financial satisfaction scale, while life satisfaction was measured by the Satisfaction with Life Scale. Cognitive function was measured by using the Malay version of the Mini-Mental State Examination. Hierarchical multiple regression was used as the prime method for statistical analysis. RESULTS Financial well-being was positively associated with life satisfaction and cognitive function. Sex moderated the relationship between financial well-being and life satisfaction but not between financial well-being and cognitive function. CONCLUSIONS Financial well-being and life satisfaction were strongly correlated among older women, although no gender difference was found for the relationship between financial well-being and cognitive function. It appears financial well-being strongly predicts mental health. As such, poverty eradication initiatives targeting low-income older adults should be implemented to sustain life satisfaction and cognitive function.
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Affiliation(s)
- Hui Foh Foong
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia
| | - Sharifah Azizah Haron
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia.,Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roshanim Koris
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia.,Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Kuala Nerus, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia
| | - Rahimah Ibrahim
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia.,Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia
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Foong HF, Hamid TA, Ibrahim R, Haron SA. The association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity: a gender perspective in Malaysia. Psychogeriatrics 2020; 20:891-899. [PMID: 32985044 DOI: 10.1111/psyg.12614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/04/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Little is known about gender differences in the relationship between religious orientation and life satisfaction in older adults living with chronic disease(s). Therefore, the purpose of this article was to examine the moderating effect of gender on the association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity. METHODS The study involved 1790 community-dwelling older adults aged 60 and above living with at least one chronic medical condition. The Satisfaction with Life Scale and Revised Intrinsic/Extrinsic Religious Orientation Scale were used to measure life satisfaction and religious orientation. Moderated hierarchical multiple regression was used to test the moderation effect. RESULTS Results showed that while intrinsic religiosity was positively associated with life satisfaction, extrinsic religiosity was found to have a negative relationship with life satisfaction. Gender moderated the association between intrinsic religiosity and life satisfaction. CONCLUSIONS The findings suggested that the positive impact of intrinsic religiosity on life satisfaction was stronger in older women living with morbidity and multimorbidity. Healthcare practitioners can help disadvantaged older women in identifying their religious values and practices to improve their subjective wellbeing.
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Affiliation(s)
- Hui F Foong
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra, Malaysia, Serdang, Malaysia
| | - Tengku A Hamid
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra, Malaysia, Serdang, Malaysia
| | - Rahimah Ibrahim
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra, Malaysia, Serdang, Malaysia.,Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra, Malaysia, Serdang, Malaysia
| | - Sharifah A Haron
- Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra, Malaysia, Serdang, Malaysia
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