Separating the Effects of Transitions Into and Out of Social Isolation and Loneliness on Cognitive Function in Later Life

OBJECTIVES

This study investigates the effects of social isolation and loneliness on cognitive function, distinguishing between the effects of transitioning into and out of these states.

METHODS

This study analyzed data from 6,663 adults aged 65 or older collected over the course of 7 waves (12 years) of the Korean Longitudinal Study of Aging from 2006 to 2018. A novel asymmetric fixed effects model was utilized to separately estimate the effects of transitions into and out of social isolation or loneliness.

RESULTS

The association of transitions into social isolation due to a lack of informal social contact or loneliness with cognitive function (b = -1.387, p < .001 and b = -0.601, p < .001, respectively) was stronger than the association of transitions out of these states (b = 0.345, p < .05 and b = 0.353, p < .001, respectively). The magnitude of the negative and positive coefficients was statistically different (F-statistic = 45.29, p < .001 and F-statistic = 5.12, p < .05, respectively). In contrast, no such asymmetric effects were observed for social isolation due to a lack of formal activity (F-statistic = 0.06, p = .800).

DISCUSSION

The detrimental effects of transitioning into social isolation due to a lack of informal social contact (but not formal activity) or loneliness on cognitive function outweigh the beneficial effects of transitioning out of these states. Preventing the onset of social disconnection should be prioritized as an intervention to improve the cognitive function of older adults.

Social network characteristics moderate associations between cortical thickness and cognitive functioning in older adults

INTRODUCTION

Prior research suggests that the strength of association between Alzheimer's disease (AD) pathology and lower cognitive performance is influenced by modifiable psychosocial factors, such as social network size. However, little is known about distinct social relationship types.

METHODS

The current cross-sectional study used data from the Washington Heights-Inwood Columbia Aging Project to examine whether social network characteristics (i.e., total size, spouse/partner, number of children, other relatives, friends) moderate associations between cortical thickness in regions implicated in AD and cognitive performance.

RESULTS

Lower cortical thickness was associated with worse global cognition among individuals with smaller friend networks, but not among individuals with larger friend networks. This pattern of results was most prominent for language and speed/executive functioning.

DISCUSSION

Longitudinal and intervention studies are needed to determine whether these cross-sectional findings reflect a protective effect of later-life friendships for maintaining cognitive performance in the context of poorer brain health.

Learning by… Knowledge and skills acquisition through work-based learning and research

Purpose

Issues around informal, non-formal and formal learning, intended and unintended learning and competencies and capabilities have been considered in work-based learning (WBL). However, demarcated modes of learning, or what can be called strategies or pedagogies of learning, associated with experience of work environments have yet to be examined. One mode of learning which has been highlighted in relation to work is reflective practice, and its centrality to learning at work has been established. But reflective practice as a core skill, and its relation to other approaches to learning and research in WBL, remains uncovered. The purpose of the present study therefore is to identify different modes of learning as they appear in the literature and to present a proto-theoretical “learning by …” model for WBL and research founded on learning by reflection.

Design/methodology/approach

Proto-theoretical modelling and qualitative descriptions of each mode of learning.

Findings

Work environments, and the higher degree WBL programmes which support them, should provide learning via every available mode of learning, thereby allowing students to find their own best orientation to learning and encourage it by any means.

Originality/value

The proto-theoretical model and 12 modes of learning applied to WBL are unique to this study. WBL provides participants of work with multiple opportunities and approaches to learn and similarly provides multiple modes through which learning can occur on the basis of knowledge and skills in reflective practice.

Psychosocial Protective Factors in Cognitive Aging: A Targeted Review

OBJECTIVE

The lack of disease-modifying pharmacological agents for dementia highlights the critical importance of prevention, but known modifiable factors (e.g., education, physical health and health behaviors, depression, and social isolation) do not fully represent potential intervention targets. Positive psychosocial factors predict cognitive aging outcomes above and beyond known risk factors and may also correspond to upstream determinants that open up new avenues for prevention and intervention, as well as for reducing racial/ethnic inequalities in dementia. In this brief report, I summarize contemporary evidence for three positive psychosocial factors that appear to be particularly relevant to cognitive aging: perceived control, religious involvement, and social relations.

METHODS

Targeted review and synthesis of published studies.

RESULTS

Each of the multidimensional constructs appears to contain "active ingredients" that could help to optimize cognitive aging through disparate mechanisms. Although historically marginalized racial/ethnic groups face disproportionate barriers to accessing certain psychosocial protective factors (e.g., perceived control), these same groups also exhibit naturally occurring sources of psychosocial resilience (e.g., religious involvement) that allow them to achieve better late-life cognitive health than would be otherwise expected. With regard to social relations, converging evidence from disparate studies shows that fostering late-life friendships in particular may have high potential for building cognitive reserve and promoting healthy cognitive aging.

CONCLUSIONS

Positive psychosocial factors represent culturally relevant resources that, through careful research, could ultimately be harnessed to promote better cognitive aging for a growing and increasingly diverse population of older adults.

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.

Daily Activities Related to Mobile Cognitive Performance in Middle-Aged and Older Adults: An Ecological Momentary Cognitive Assessment Study

Background

Daily activities have been associated with neurocognitive performance. However, much of this research has used in-person neuropsychological testing that requires participants to travel to a laboratory or clinic, which may not always be feasible and does not allow for the examination of real-time relationships between cognition and behavior. Thus, there is a need to understand the real-time relationship between activities in the real world and neurocognitive functioning to improve tracking of symptoms or disease states and aid in the early identification of neurocognitive deficits among at-risk individuals.

Objective

We used a smartphone-based ecological momentary cognitive assessment (EMCA) platform to examine real-time relationships between daily activities and neurocognitive performance (executive functioning and verbal learning) in the everyday environment of middle-aged and older adults with and without HIV.

Methods

A total of 103 adults aged 50-74 years (67 persons with HIV; mean age 59 years, SD 6.4) were recruited from the University of California, San Diego HIV Neurobehavioral Research Program and the San Diego community. Participants completed our EMCA protocol for 14 days. Participants reported their current daily activities 4 times per day; following 2 of the 4 daily ecological momentary assessment (EMA) surveys, participants were administered the mobile Color-Word Interference Test (mCWIT) and mobile Verbal Learning Test (mVLT), each once per day. Activities were categorized into cognitively stimulating activities, passive leisure activities, and instrumental activities of daily living (IADLs). We used multilevel modeling to examine the same-survey and lagged within-person and between-person effects of each activity type on mobile cognitive performance.

Results

On average, participants completed 91% of the EMA surveys, 85% of the mCWIT trials, and 80% of the mVLT trials, and they reported engaging in cognitively stimulating activities on 17% of surveys, passive leisure activities on 33% of surveys, and IADLs on 20% of surveys. Adherence and activity percentages did not differ by HIV status. Within-persons, engagement in cognitively stimulating activities was associated with better mCWIT performance (β=−1.12; P=.007), whereas engagement in passive leisure activities was associated with worse mCWIT performance (β=.94; P=.005). There were no lagged associations. At the aggregate between-person level, a greater percentage of time spent in cognitively stimulating activities was associated with better mean mVLT performance (β=.07; P=.02), whereas a greater percentage of time spent in passive leisure activities was associated with worse mean mVLT performance (β=−.07; P=.01). IADLs were not associated with mCWIT or mVLT performance.

Conclusions

Smartphones present unique opportunities for assessing neurocognitive performance and behavior in middle-aged and older adults’ own environment. Measurement of cognition and daily functioning outside of clinical settings may generate novel insights on the dynamic association of daily behaviors and neurocognitive performance and may add new dimensions to understanding the complexity of human behavior.

The Relationship Between Physical Activity and Executive Functions Among Youth in Low-Income Urban Schools in the Northeast and Southwest United States

The purpose of this study was to examine if physical activity is related to greater executive functions among youth in poverty. Executive functions (cognitive flexibility, inhibition, and working memory) and physical activity were measured in participants (N = 149) in the fifth to eighth grade from three schools located in high-poverty districts. Pearson correlations revealed a statistically significant correlation between physical activity and cognitive flexibility (r = .18, p < .05). Hierarchical multiple regressions revealed that physical activity significantly improved prediction for cognitive flexibility, R2 = .09, F(6, 142) = 2.26, p = .041, adjusted R2 = .05, above sex, maturity, and school district. A two-way multivariate analysis of covariance revealed statistically significant differences in working memory in more active youth compared with less active but no statistically significant differences in cognitive flexibility or inhibition (p < .05). Greater physical activity is associated with greater working memory among youth in poverty.

Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study

BACKGROUND

Recent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that non-social cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI.

METHODS

Sixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer.

RESULTS

We observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention.

CONCLUSION

Our findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis.

Pessimistic expectations and poorer experiences: The role of (low) extraversion in anticipated and experienced enjoyment of social interaction

Given research suggesting that social interactions are beneficial, it is unclear why individuals lower in extraversion engage less in social interactions. In this study, we test whether individuals lower in extraversion reap fewer hedonic rewards from social interactions and explore social psychological processes that explain their experiences. Before participants socialized, we measured extraversion, state positive affect, cognitive capacity, and expectations about the social interactions. After participants socialized with one another, we measured state positive affect and cognitive capacity again as well as fear of negative evaluation and belief in limited cognitive capacity. Participants also rated the social skillfulness of each interaction partner. We found that less extraverted individuals expect to feel worse after socializing. However, all but those extremely low in extraversion (17% of sample) actually experience an increase in positive affect after socializing. Surprisingly, those low in extraversion did not show reduced cognitive capacity after socializing. Although they are more likely to believe that cognitive capacity is limited and to be fearful of negative evaluation, these characteristics did not explain the social experience of those low in extraversion.

I-Through-We: How Supportive Social Relationships Facilitate Personal Growth

Personal growth is usually considered an outcome of intrapersonal processes-personal resources residing within the person. Comparatively, little research has examined the interpersonal processes underlying personal growth. We investigated how one interpersonal factor-people's relationships with others-influences personal growth. Study 1 showed that brief reminders of a supportive (vs. nonsupportive) other led people to choose a job that promoted personal growth over one that offered a higher salary. Moreover, feelings of self-confidence from thinking about a supportive (vs. nonsupportive) other mediated personal growth. Extending these results, Studies 2 and 3 demonstrated that people's perceptions of how supportive their close others are predicted personal growth in two distinct cultures with varying emphasis on individual (vs. collective) growth. Consistent with Study 1's findings, the results were also mediated by feelings of self-confidence. These findings suggest that the link between supportive relationships and personal growth may reflect a general process.

Cultivating Effective Social Support Through Abstraction: Reframing Social Support Promotes Goal-Pursuit

Social support, in theory, should promote individual goal-pursuit. However, a growing number of studies shows that receiving support can undermine goal-pursuit. Addressing this paradox, we investigated a novel idea of the effects of how people think about their social support on their goal-pursuit. Four experiments showed that participants who were led to think abstractly (vs. concretely) about their social support showed higher intent to pursue their goal (Studies 1-3) and worked harder toward their goal (Study 4). The benefits of abstracting one's social support occurred over a variety of personal goals, support types, and support-providers, indicating the generalizability and robustness of our findings. These results demonstrate that how people think about their social support influences goal-pursuit and suggest ways in which support-recipients can maximize their social support.

Cooperative and competitive contexts do not modify the effect of social intention on motor action

In social interactions, the movements performed by others can be used to anticipate their intention. The present paper investigates whether cooperative vs competitive contexts influence the kinematics of object-directed motor actions and whether they modulate the effect of social intention on motor actions. An "Actor" and a "Partner" participated in a task consisting in displacing a wooden dowel under time constraint. Before this Main action, the Actor performed a Preparatory action which consisted in placing the dowel at the center of the table. Information about who would make the forthcoming Main action was provided only to the Actor through headphones. Results demonstrate an exaggeration of spatial and temporal actions' parameters when acting for the Partner, in cooperative, as well as in competitive context. This finding suggests that the motor manifestation of social intention is largely determined by non-conscious implicit processes that seem little influenced by the context of social interaction.

Cooperation, but not competition, improves 4-year-old children's reasoning about others' diverse desires

Three experiments examined whether cooperation or competition affects 4-year-old children's reasoning about other people's desires-which differed from their own-in a gift selection task. Experiment 1 (N=72) found that children's performance in selecting an adult-preferred gift for an adult experimenter was enhanced by a short period of preceding cooperative, but not competitive or individualistic, play with the experimenter. Experiment 2 (N=24) ruled out the alternative explanation that children resisted satisfying their opponent after competition. Experiment 3 (N=48) replicated the cooperation advantage in selecting a gift for someone else, indicating that children's understanding of diverse desires was generally improved by cooperation but not competition. These findings support the constructivist view of social development and highlight the advantage of cooperation.

Conclusions about interventions, programs, and approaches for improving executive functions that appear justified and those that, despite much hype, do not

The 'Executive Functions' (EFs) of inhibitory control, working memory, and cognitive flexibility enable us to think before we act, resist temptations or impulsive reactions, stay focused, reason, problem-solve, flexibly adjust to changed demands or priorities, and see things from new and different perspectives. These skills are critical for success in all life's aspects and are sometimes more predictive than even IQ or socioeconomic status. Understandably, there is great interest in improving EFs. It's now clear they can be improved at any age through training and practice, much as physical exercise hones physical fitness. However, despite claims to the contrary, wide transfer does not seem to occur and 'mindless' aerobic exercise does little to improve EFs. Important questions remain: How much can EFs be improved (are benefits only superficial) and how long can benefits be sustained? What are the best methods for improving EFs? What about an approach accounts for its success? Do the answers to these differ by individual characteristics such as age or gender? Since stress, sadness, loneliness, or poor health impair EFs, and the reverse enhances EFs, we predict that besides directly train EFs, the most successful approaches for improving EFs will also address emotional, social, and physical needs.

Computerised working-memory focused cognitive remediation therapy for psychosis--A preliminary study

BACKGROUND

Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how best to maximise this benefit while minimising the cost is an important next step in optimising this intervention for clinical use.

AIMS

To examine the effects of a novel working-memory focused cognitive remediation (CR) training on cognitive difficulties based on internet delivery of training and weekly telephone support.

METHOD

Participants with a diagnosis of psychosis (n=56) underwent either 8 weeks of CR (approximately 20 h) or 8 weeks of treatment as usual (TAU). General cognitive ability, working memory and episodic memory were measured both pre and post intervention for all participants.

RESULTS

In addition to improvements on trained working memory tasks, CR training was associated with significant improvements in two tests of verbal episodic memory. No association between CR and changes in general cognitive ability was observed. Effect sizes for statistically significant changes in memory were comparable to those reported in the literature based primarily on 1:1 training.

CONCLUSIONS

The cognitive benefits observed in this non-randomised preliminary study indicate that internet-based working memory training can be an effective cognitive remediation therapy. The successes and challenges of an internet-based treatment are discussed.

Delayed Positive Effects of an Acute Bout of Coordinative Exercise on Children's Attention

Since attention is an important prerequisite for learning, it is particularly worthwhile to promote it in schools, through specific interventions. The present study examined the effects of an acute bout of coordinative exercise in physical education on the attention of primary school children. A total of 90 fifth grade primary school children (41 boys, 49 girls; M = 11.0 yr., SD = 0.6) participated in the study and were randomly assigned to either the experimental or the control group. The experimental group received a cognitively demanding physical education lesson consisting of different coordinative exercises; the control group attended a normal sedentary school lesson. Before, immediately after, and 90 min. after each experimental condition, the children's attentional performance was tested using the revised version of the d2 Test of Attention (d2–R). Results of the repeated-measures analysis of variance (ANOVA) revealed that children's attentional performance increased through the specifically designed physical education lesson, not immediately but 90 min. after cessation. The results are discussed in terms of mechanisms explaining the relationship between acute physical exercise, and immediate and delayed effects on attention.

Supportive social relationships attenuate the appeal of choice

People like having options when choosing, but having too many options can lead to negative decision-related consequences. The present study focused on how social-relational factors--common aspects of daily life--can maintain or attenuate the appeal of choice. Study 1 examined the effect of a supportive- or nonsupportive-relationship prime on the decision to pay for having more options in choosing a consumer product. People who thought of supportive relationships, compared with those who thought of nonsupportive ones (and control participants), were less willing to pay for a larger choice set. Study 2 showed that the activation of thoughts of security and calmness in participants recalling supportive relationships (compared with participants recalling nonsupportive relationships) mediated the appeal of choice. This finding offers one possible explanation for the reduced desire for options when people are reminded of supportive relationships.

Social strain and executive function across the lifespan: the dark (and light) sides of social engagement

We investigated how the association between social strain and cognitive efficiency varies with task demands across adulthood, from latencies on simpler speeded tasks to tests involving executive function. Participants (N = 3280) were drawn from the MIDUS survey, a large, diverse national sample of adults who completed cognitive tests including speeded task-switching (Tun & Lachman, 2008, Developmental Psychology, 44, 1421). After controlling for demographic and health variables, we found that higher levels of reported social strain were associated with slower processing speed, particularly for the complex task-switching test relative to simpler speeded tests. Effects of strain were greatest for those with the lowest general cognitive ability. Moreover, those with very high levels of social strain but low levels of social support gave the poorest task-switching performance. These findings provide further evidence for the complex relationship between the social environment and cognition across adulthood, particularly the association between efficiency of executive functions and negative social interactions.