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Iacono A, Oremus M, Maxwell CJ, Tyas SL. Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:661-681. [PMID: 37350151 DOI: 10.1080/13825585.2023.2226855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [PM] = 8.0%) or clinical depression (PM = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.
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Affiliation(s)
- Anita Iacono
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Zhang D, Zheng W, Li K. The relationship between marital status and cognitive impairment in Chinese older adults: the multiple mediating effects of social support and depression. BMC Geriatr 2024; 24:367. [PMID: 38658842 PMCID: PMC11040757 DOI: 10.1186/s12877-024-04975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Marital status is a potentially essential factor for cognitive impairment. Relevant research examining the potential pathways through which the marital status of spouseless older people is associated with cognitive impairment needs to be more adequate. Therefore, this study aims to investigate the serial mediating effects of various forms of social support and depression between marital status and cognitive impairment in older Chinese people. METHODS This study involved a secondary analysis of data from the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with a total of 2,647 Chinese older adults and 53.6% being males. Mediation analysis using the SPSS process macro was conducted. RESULTS The results indicated that marital status was significantly predictive of cognitive impairment among older people, and those with a spouse exhibited higher cognitive functioning. Informal social support and depression were found to play partial mediating roles in the association between marital status and cognitive impairment. The findings also revealed that marital status was unrelated to formal social support, and no association between formal social support and cognitive impairment was found. CONCLUSIONS The study findings highlight the need for social service providers to design programs for promoting connections associated with informal support to reduce their risk of depression and cognitive impairment and for policymakers to develop effective formal social support systems for older people without spouses. This study indicated that older people could regain the benefits of marriage to lower the risk of depression and improve their mental health.
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Affiliation(s)
- Donghang Zhang
- Department of Innovative Social Work, Faculty of Humanities and Social Sciences, City University of Macau, Macao, China
| | - Wenhao Zheng
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China
| | - Keyang Li
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China.
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Kojima K, Okada E, Ojima T, Kondo K. Association between hearing status and social participation in Japanese older adults: A cross-sectional study from the Japan gerontological evaluation study. Arch Gerontol Geriatr 2023; 115:105109. [PMID: 37399682 DOI: 10.1016/j.archger.2023.105109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Hearing is known to decline with age. As sensitivity to speech declines, conversation becomes more difficult and social interactions are affected, resulting in increased risk of cognitive decline. This study aimed to examine the relationship between hearing status and social participation. MATERIALS AND METHODS The study included 21,117 adults aged 65 years or older who responded to a survey in 2019. The survey asked participants about their hearing status and how frequently they participated in certain social activities. RESULTS The analysis of the relationship between degree of hearing and social activity showed lower hearing status odds ratios for those who participated more frequently in social activities compared to those who participated less frequently. The odds ratios were as follows, hobby clubs (OR 0.81, 95%CI 0.78-0.84), activities such as teaching skills or passing on experiences to others (OR 0.69, 95%CI 0.65-0.75), and meeting with friends (OR 0.77, 95%CI 0.74-0.79). Compared to those who did not participate in social activities, those who participated in three or more types of groups had significantly lower hearing impairment (OR 0.75, 95% CI 0.72-0.79). CONCLUSION Hearing impairment was shown to inhibit participation in activities, including those that require communication with multiple people or smooth communication, those that involve a wide range of ages, and those that involve work and movement. Hearing impairment should be identified and addressed in its early stages to prevent its negative impact on social participation.
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Affiliation(s)
- Kaori Kojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan.
| | - Eisaku Okada
- Faculty of Social Policy & Administration, Hosei University, 4342 Aihara, Machida, Tokyo 194-0298, Japan.
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan.
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan.
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Lingling, Tsuji T, Ide K, Kondo K. Group leisure activities are associated with a lower risk of dementia than individual leisure activities: A 6-year longitudinal study from the Japan Gerontological Evaluation Study (JAGES). Prev Med 2023; 173:107573. [PMID: 37328035 DOI: 10.1016/j.ypmed.2023.107573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/18/2023]
Abstract
Participating in group leisure activities may lower the risk of dementia compared with doing leisure activities alone. However, only some studies have examined the differences. In this study, we sought to determine whether the incidence of dementia risk differs according to the implementation status of leisure activities (participation in a group or alone). The association between the implementation status of leisure activities and the risk of dementia was examined using Cox proportional hazards models in the 6-year (2010-2016) cohort data of 50,935 participants (23,533 males and 27,402 females) aged 65 years or older of the Japan Gerontological Evaluation Study. Over six years of follow-up, 5395 respondents (10.6%) developed dementia. After adjusting for potential confounders, such as depression and social support, the implementation status of leisure activities was associated with a lower dementia risk in participants who engaged in group leisure activities (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.73-0.85) and a higher dementia risk in those without leisure activity (HR, 1.30; 95% CI, 1.22-1.39), in comparison with those engaging in leisure activities alone. Engagement in group leisure activities may be associated with a reduced risk of dementia.
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Affiliation(s)
- Lingling
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Community General Support, Hasegawa Hospital, Yachimata-shi, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.
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Iizuka G, Tsuji T, Ide K, Watanabe R, Kondo K. Does social participation foster social support among the older population in Japan? A three-year follow-up study from the Japan gerontological evaluation study. SSM Popul Health 2023; 22:101410. [PMID: 37215158 PMCID: PMC10192997 DOI: 10.1016/j.ssmph.2023.101410] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/27/2023] [Accepted: 04/22/2023] [Indexed: 05/24/2023] Open
Abstract
•Whether social participation has generated new, healthier social support is unclear.•We prospectively examined whether social participation fosters social support.•Social support was dose-responsive to the number of types of social participation.•Social support was fostered by participating in some type of group at any frequency.•Support to encourage social participation may be effective to enhance social support.
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Affiliation(s)
- Gemmei Iizuka
- Advanced Preventive Medical Sciences, Chiba University Graduate School of Medical and Pharmaceutical Sciences, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Seibo International Catholic Hospital Family Medicine Residency, 2-5-1, Nakaochiai, Shinjuku-ku, Tokyo, 161-8521, Japan
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1, Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu-shi, Aichi, 474-8511, Japan
- Center for Well-being Society, Nihon Fukushi University, 5-22-35, Chiyoda, Naka-ku, Nagoya-shi, Aichi, 460-0012, Japan
| | - Katsunori Kondo
- Advanced Preventive Medical Sciences, Chiba University Graduate School of Medical and Pharmaceutical Sciences, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu-shi, Aichi, 474-8511, Japan
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Mogic L, Rutter EC, Tyas SL, Maxwell CJ, O'Connell ME, Oremus M. Functional social support and cognitive function in middle- and older-aged adults: a systematic review of cross-sectional and cohort studies. Syst Rev 2023; 12:86. [PMID: 37211612 DOI: 10.1186/s13643-023-02251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Intact cognitive function is crucial for healthy aging. Functional social support is thought to protect against cognitive decline. We conducted a systematic review to investigate the association between functional social support and cognitive function in middle- and older-aged adults. METHODS Articles were obtained from PubMed, PsycINFO, Sociological Abstracts, CINAHL, and Scopus. Eligible articles considered any form of functional social support and cognitive outcome. We narratively synthesized extracted data by following the Synthesis Without Meta-Analysis (SWiM) guidelines and assessed risk of bias using the Newcastle-Ottawa Scale (NOS). RESULTS Eighty-five articles with mostly low risk-of-bias were included in the review. In general, functional social support-particularly overall and emotional support-was associated with higher cognitive function in middle- and older-aged adults. However, these associations were not all statistically significant. Substantial heterogeneity existed in the types of exposures and outcomes evaluated in the articles, as well as in the specific tools used to measure exposures and outcomes. CONCLUSIONS Our review highlights the role of functional social support in the preservation of healthy cognition in aging populations. This finding underscores the importance of maintaining substantive social connections in middle and later life. SYSTEMATIC REVIEW REGISTRATION Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open;10(4):e037301. https://doi.org/10.1136/bmjopen-2020-037301.
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Affiliation(s)
- Lana Mogic
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Emily C Rutter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Mark Oremus
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
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Wang S, Molassiotis A, Guo C, Leung ISH, Leung AYM. Association between social integration and risk of dementia: A systematic review and meta-analysis of longitudinal studies. J Am Geriatr Soc 2023; 71:632-645. [PMID: 36307921 DOI: 10.1111/jgs.18094] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/24/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of the association between different aspects of social integration and the risk of dementia is unclear. METHODS Five databases were systematically searched. Newcastle-Ottawa scale for assessing the quality of the reporting was used for quality appraisal. Longitudinal cohort studies examining the association between social integration and the risk of dementia were analyzed using random effects model. A series of sensitivity analyses was conducted to enhance the robustness of the findings. RESULTS Forty publications generated from 32 studies/databases were included. The meta-analysis showed that strong social engagement (overall RR = 0.81, 95% CI = 0.74-0.89, p < 0.001) and frequent social contact (overall RR = 0.86, 95% CI = 0.76-0.97, p = 0.018) were positively associated with decreased risk of dementia. The influence of social support (overall RR = 0.92, 95% CI = 0.80-1.06, p = 0.238) and close social contact (overall RR = 0.74, 95% CI = 0.48-1.13, p = 0.167) was not significant. Loneliness was significantly associated with an increased risk of dementia (overall RR = 1.42, 95% CI = 1.26-1.60, p < 0.001), whereas the influence of social isolation (overall RR = 1.58, 95% CI = 0.80-3.12, p = 0.192) was not significant. A larger social network size (RR = 0.75, 95% CI = 0.59-0.97, p = 0.028) was a promising influencing factor even though the number of studies was insufficient for a meta-analysis. However, the heterogeneity among studies was generally high even though sensitivity analysis was conducted. CONCLUSIONS Our findings reveal that high social engagement and frequent social contact are significantly associated with a lower risk of dementia, whereas loneliness is associated with a higher risk. The promising impact of large social network size is also identified. Substantial heterogeneity appeared in most of the analysis, making the inference tentative. Nevertheless, the sensitivity analysis provided valuable implications that enhancing social engagement and reducing loneliness may prevent or delay the onset of dementia among middle-aged and older adults.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Chunlan Guo
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hung Hom, Hong Kong SAR, China
| | - Isaac Sze Him Leung
- Department of Statistics, The Chinese University of Hong Kong, Hung Hom, Hong Kong SAR, China
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
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Zhu X, He M, Dong Y, Zhang S, Fang S, Wang W, Zhang M, Sun J. How tablets/applications enhance social connections and social support in people with dementia: A qualitative systematic review. Int J Ment Health Nurs 2023; 32:727-743. [PMID: 36715170 DOI: 10.1111/inm.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/31/2023]
Abstract
The 2020 Lancet issue identified social isolation as one of 12 modifiable risk factors for dementia and revealed that enhanced social connections and social support can effectively reduce the incidence of social isolation. During the COVID-19 pandemic, technology attracted an increasing amount of attention, and it is necessary to synthesize ideas from existing evidence. First, we explored how people with dementia experienced changes in social connection and social support due to tablet/app use. Second, we explored the attitudes of people with dementia towards tablets and mobile applications. Third, we explored the feasibility of using tablets and mobile applications to enhance social connection and social support among people with dementia. We systematically searched the PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases. Two reviewers independently screened the titles and abstracts of studies, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. A total of nine studies were included. Eight studies used mobile applications via tablets, and one study collected textual data from Twitter for analysis. Four themes were synthesized: (1) change from the perspective of caregivers; (2) growth of nonsingle aspects; (3) emotional feeling of belonging; and (4) feasibility of using digital technology. Tablet- and mobile application-based interventions can enhance both online and offline social connections and provide multiple types of social support among people with dementia. People with dementia have positive attitudes towards tablets and mobile applications. Overall, it is feasible for people with dementia to use technology.
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Affiliation(s)
| | - Meng He
- School of Nursing, Jilin University, Jilin, China
| | - Yueyang Dong
- School of Nursing, Jilin University, Jilin, China
| | - Shuang Zhang
- School of Nursing, Jilin University, Jilin, China
| | - Shuyan Fang
- School of Nursing, Jilin University, Jilin, China
| | - Wenxia Wang
- School of Nursing, Jilin University, Jilin, China
| | | | - Jiao Sun
- School of Nursing, Jilin University, Jilin, China
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Posis AIB, Yarish NM, McEvoy LK, Jain P, Kroenke CH, Saquib N, Ikramuddin F, Schnatz PF, Bellettiere J, Rapp SR, Espeland MA, Shadyab AH. Association of Social Support with Mild Cognitive Impairment and Dementia Among Older Women: The Women's Health Initiative Memory Study. J Alzheimers Dis 2023; 91:1107-1119. [PMID: 36565123 PMCID: PMC9905323 DOI: 10.3233/jad-220967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and dementia. OBJECTIVE To examine associations of perceived social support with incident MCI and dementia among community-dwelling older women. METHODS This prospective cohort study included 6,670 women from the Women's Health Initiative Memory Study who were cognitively unimpaired at enrollment. We used Cox proportional hazards models to assess associations between perceived social support with incident MCI, dementia, or either MCI/dementia during an average 10.7 (SD = 6.1)-year follow-up. Modelling was repeated for emotional/information support, affection support, tangible support, and positive social interaction subscales of social support. RESULTS Among 6,670 women (average age = 70 years [SD = 3.8]; 97.0% non-Hispanic/Latina; 89.8% White), greater perceived social support was associated with lower risk of MCI/dementia after adjustment for age, ethnicity, race, hormone therapy, education, income, diabetes, hypertension, and body mass index (Tertile [T]3 versus T1: HR = 0.85, 95% CI 0.74-0.99; ptrend = 0.08). Associations were significant for emotional/information support (T3 versus T1: HR = 0.84, 95% CI 0.72-0.97; ptrend = 0.04) and positive social interaction (T3 versus T1: HR = 0.85, 95% CI 0.73-0.99; ptrend = 0.06) subscales. Associations were attenuated and not significant after adjustment for depressive symptom severity. OBJECTIVE Perceived social support, emotional/information support, and positive social interaction were associated with incident MCI/dementia among older women. Results were not significant after adjustment for depressive symptom severity. Improving social support may reduce risk of MCI and dementia in older women.
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Affiliation(s)
- Alexander Ivan B. Posis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Natalie M. Yarish
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Linda K. McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
| | - Purva Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Nazmus Saquib
- Department of Epidemiology, College of Medicine at Sulaiman, Al Rajhi University, Saudi Arabia
| | - Farha Ikramuddin
- Division of Physical Medicine and Rehabilitation, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, USA
| | - Peter F. Schnatz
- Reading Hospital / Tower Health, West Reading, Pennsylvania, USA
- Drexel University, Philadelphia, Pennsylvania, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
| | - Stephen R. Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A. Espeland
- Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
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Carbone E, Piras F, Pellegrini FF, Caffarra P, Borella E. Individual differences among older adults with mild and moderate dementia in social and emotional loneliness and their associations with cognitive and psychological functioning. BMC Geriatr 2022; 22:859. [DOI: 10.1186/s12877-022-03517-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Loneliness is a major health issue among older adults. The aim of this study was to assess the relationship between loneliness, in its social and emotional facets, and the cognitive (language), and behavioral/psychological functioning as well as quality of life (QoL) in people with mild and moderate dementia, i.e., considering dementia severity as an individual characteristic.
Methods
This cross-sectional study involved 58 people with mild dementia and 55 people with moderate dementia. Participants completed the Social and Emotional Loneliness scale, along with measures assessing their language skills, the frequency and severity of their behavioral and psychological symptoms, and their QoL.
Results
Socio-demographic characteristics and depression, but not loneliness or its social and emotional facets, contributed to explain participants’ behavioral and psychological symptoms, regardless of dementia severity. Loneliness explained, though to a small extent (8% of variance), language skills in people with moderate dementia, with social loneliness only accounting for language skills (18% of variance) in this group. Loneliness also modestly accounted for dysphoria symptoms in both the mildly and moderately impaired (6% and 5% of variance, respectively) individuals with social loneliness predicting dysphoric mood in the former group only (7% of variance). Loneliness also explained, to a larger extent, QoL in both the mildly impaired and moderately impaired individuals (27% and 20% of variance, respectively), its social facet predicting QoL in the mildly impaired (30% of variance), and its emotional facet in the moderately impaired (21% of variance) group.
Conclusion
These findings suggest that loneliness and its facets have a clear impact on perceived QoL, and influence the language skills and dysphoria symptoms of people with dementia, to a degree that depends on dementia severity. The assessment of loneliness and its facets in people with dementia considering dementia severity, and the promotion of social inclusion to reduce it should be considered by professionals.
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Samtani S, Mahalingam G, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kim KW, Riedel-Heller S, Röhr S, Pabst A, Shahar S, Numbers K, Ganguli M, Jacobsen E, Hughes TF, Crowe M, Ng TP, Maddock J, Marseglia A, Mélis R, Szcześniak D, Wiegelmann H, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Associations between social connections and cognition: a global collaborative individual participant data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2022; 3:e740-e753. [PMID: 36273484 PMCID: PMC9750173 DOI: 10.1016/s2666-7568(22)00199-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis. METHODS We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression. FINDINGS Of the 40 006 participants in the 13 cohort studies, we excluded 1392 people with dementia at baseline. 38 614 individual participants were included in our analyses. For the main models, being in a relationship or married predicted slower global cognitive decline (b=0·010, 95% CI 0·000-0·019) than did being single or never married; living with others predicted slower global cognitive (b=0·007, 0·002-0·012), memory (b=0·017, 0·006-0·028), and language (b=0·008, 0·000-0·015) decline than did living alone; and weekly interactions with family and friends (b=0·016, 0·006-0·026) and weekly community group engagement (b=0·030, 0·007-0·052) predicted slower memory decline than did no interactions and no engagement. Never feeling lonely predicted slower global cognitive (b=0·047, 95% CI 0·018-0·075) and executive function (b=0·047, 0·017-0·077) decline than did often feeling lonely. Degree of social support, having a confidante, and relationship satisfaction did not predict cognitive decline across global cognition or cognitive domains. Heterogeneity was low (I2=0·00-15·11%) for all but two of the significant findings (association between slower memory decline and living with others [I2=58·33%] and community group engagement, I2=37·54-72·19%), suggesting robust results across studies. INTERPRETATION Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline. FUNDING EU Joint Programme-Neurodegenerative Disease Research grant, funded by the National Health and Medical Research Council Australia, and the US National Institute on Aging of the US National Institutes of Health.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Gowsaly Mahalingam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luís Blay
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition University Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University College of Medicine and Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Henrik Wiegelmann
- Department of Health Care Research, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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Niotis K, Akiyoshi K, Carlton C, Isaacson R. Dementia Prevention in Clinical Practice. Semin Neurol 2022; 42:525-548. [PMID: 36442814 DOI: 10.1055/s-0042-1759580] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Over 55 million people globally are living with dementia and, by 2050, this number is projected to increase to 131 million. This poses immeasurable challenges for patients and their families and a significant threat to domestic and global economies. Given this public health crisis and disappointing results from disease-modifying trials, there has been a recent shift in focus toward primary and secondary prevention strategies. Approximately 40% of Alzheimer's disease (AD) cases, which is the most common form of dementia, may be prevented or at least delayed. Success of risk reduction studies through addressing modifiable risk factors, in addition to the failure of most drug trials, lends support for personalized multidomain interventions rather than a "one-size-fits-all" approach. Evolving evidence supports early intervention in at-risk patients using individualized interventions directed at modifiable risk factors. Comprehensive risk stratification can be informed by emerging principals of precision medicine, and include expanded clinical and family history, anthropometric measurements, blood biomarkers, neurocognitive evaluation, and genetic information. Risk stratification is key in differentiating subtypes of dementia and identifies targetable areas for intervention. This article reviews a clinical approach toward dementia risk stratification and evidence-based prevention strategies, with a primary focus on AD.
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Affiliation(s)
- Kellyann Niotis
- Department of Neurology, Weill Cornell Medicine and New York - Presbyterian, New York, New York
| | - Kiarra Akiyoshi
- Department of Neurology, Weill Cornell Medicine and New York - Presbyterian, New York, New York
| | - Caroline Carlton
- Department of Neurology, Weill Cornell Medicine and New York - Presbyterian, New York, New York
| | - Richard Isaacson
- Department of Neurology, Weill Cornell Medicine and New York - Presbyterian, New York, New York.,Department of Neurology, Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, Florida
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13
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Oh DJ, Yang HW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Bae JB, Han JW, Kim KW. Association of Low Emotional and Tangible Support With Risk of Dementia Among Adults 60 Years and Older in South Korea. JAMA Netw Open 2022; 5:e2226260. [PMID: 35951325 PMCID: PMC9372780 DOI: 10.1001/jamanetworkopen.2022.26260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
IMPORTANCE The association between social support and dementia risk has been debated. Most previous prospective studies have not differentiated the subtypes of social support. OBJECTIVE To examine whether the association between social support and risk of dementia differs by subtype of social support and by sex. DESIGN, SETTING, AND PARTICIPANTS This nationwide prospective cohort study included randomly sampled South Korean adults 60 years or older. The study was launched November 1, 2010, with follow-up every 2 years until November 30, 2020. The 5852 participants who completed the assessment for social support and were not diagnosed as having dementia, severe psychiatric disorders including major depressive disorder, or major neurological disorders at the baseline assessment were included in the analysis. EXPOSURES Geriatric psychiatrists administered the structured diagnostic interviews and physical examinations to every participant based on the Korean version of the Consortium to Establish a Registry for Alzheimer Disease (CERAD-K) Assessment Packet Clinical Assessment Battery. MAIN OUTCOMES AND MEASURES Baseline levels of emotional and tangible support using the Medical Outcomes Survey Social Support Survey. RESULTS Among the 5852 participants (mean [SD] age, 69.8 [6.6] years; 3315 women [56.6%]; mean [SD] follow-up duration, 5.9 [2.4] years), 237 (4.0%) had incident all-cause dementia and 160 (2.7%) had incident Alzheimer disease (AD) subtype of dementia. Compared with women who reported having emotional support, those with low emotional support had almost a 2-fold higher incidence of all-cause dementia (18.4 [95% CI, 13.6-23.2] vs 10.7 [95% CI, 9.0-12.5] per 1000 person-years) and AD (14.4 [95% CI, 10.2-18.6] vs 7.8 [95% CI, 6.3-9.3] per 1000 person-years). Adjusted Cox proportional hazard analysis revealed that low emotional support was associated with increased risk of all-cause dementia (hazard ratio, 1.61 [95% CI, 1.10-2.36]; P = .02) and AD (hazard ratio, 1.66 [95% CI, 1.07-2.57]; P = .02) only in women. Low tangible support was not associated with a risk of all-cause dementia or AD regardless of sex. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that older women with low emotional support constitute a population at risk for dementia. The level of emotional support should be included in risk assessments of dementia.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU (Seoul National University) Boramae Medical Center, Seoul, South Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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14
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Gela YY, Fekadu SA, Belsti Y, Akalu Y, Dagnew B, Getnet M, Seid MA, Diress M. Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia, 2020. Sci Rep 2022; 12:7545. [PMID: 35534683 PMCID: PMC9082466 DOI: 10.1038/s41598-022-11735-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/21/2022] [Indexed: 11/09/2022] Open
Abstract
Cognitive impairment and dementia are age-related major public health concerns in the elderly population. It is a major cause of disability, dependency, and poor quality of life. However, in Ethiopia, the magnitude of this cognitive impairment among the elderly community was not investigated. Hence, this study sought to determine the prevalence of cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia, in 2020. A community-based cross-sectional study was conducted at Gondar town, from February 20 to April 30, 2020. Using a single-stage cluster sampling technique, 403 study participants were recruited. Data was collected by a pretested interviewer-administered structured questionnaire which consisting of sociodemographic variables, the Oslo Social Support Scale, and a Standardized Mini-mental State Examination (SMMSE) tool. Epi data version 3.0 was used to enter coded data and then exported into STATA 14 for analysis. Variables with a p-value < 0.25 in the bi-variable logistic regression were included in the multivariable regression. From multivariable logistic regression, variables having a p-value ≤ 0.05 were declared as statistically significant variables. In this study, a total of 403 study participants were involved, and 393 (97.5%) of them completed the survey. Among older participants screened for cognitive impairment, 43.8% was positive for cognitive impairment with a 95% CI (38.8-48.7%). The majority of the participants were (57.5%) male and (44.8%) aged over 60 years. After adjustment, the variables associated with cognitive impairment were age ≥ 75 years [odds ratio (OR) = 7.03, 95% CI 2.78-17.77] and between 61 and 74 years [OR = 3.18, 95% CI 1.81-5.59], and unable to read and write [OR = 5.05, 95% CI 2.04-12.50], low income level [OR = 2.60, 95% CI 1.26-5.20], being female [OR = 2.52, 95% CI 1.50-4.26], poor social support [OR = 2.50, 95% CI 1.30-4.81], and rural residence [OR = 2.39, 95% CI 1.26-4.51]. The prevalence of older participants who screened positively for cognitive impairment was high at Gondar town. The independent predictors of cognitive impairment among older individuals were older age, being unable to read and write, being female, low income, poor social support, and rural dwelling. Therefore, routine screening and social support, as well as free healthcare services for the mature and older community, are needed. Moreover, we strongly recommend the next researcher to use a diagnosis tool to estimate the actual prevalence of the problems among older people.
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Affiliation(s)
- Yibeltal Yismaw Gela
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Sofonias Addis Fekadu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yitayeh Belsti
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Getnet
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Physiology, Biomedical Department, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mengistie Diress
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kittle KR, Boerner K, Kim K, Fredriksen-Goldsen KI. Social Resource Variations Among LGBT Middle-Aged and Older Adults: The Intersections of Sociodemographic Characteristics. THE GERONTOLOGIST 2022; 62:1324-1335. [PMID: 35106592 PMCID: PMC9579464 DOI: 10.1093/geront/gnac021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one's particular lesbian, gay, bisexual, and transgender (LGBT) identity and the intersection of LGBT identity with other sociodemographic characteristics, including age. RESEARCH DESIGN AND METHODS Using 2010 data from Caring and Aging With Pride (N = 2,536), this study examined how access to social resources varied by LGBT identity and whether the effect of LGBT identity was modified by additional sociodemographic characteristics among LGBT adults aged 50-95 years. RESULTS Lesbian respondents had larger social networks than gay male respondents, and gay male respondents had smaller networks than transgender respondents. Lesbian respondents reported more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay male respondents, and bisexual male respondents reported less community belonging than gay male respondents. Age and education moderated the association between LGBT identity and social support. DISCUSSION AND IMPLICATIONS This study demonstrated differences in access to social resources according to environmental circumstances that can intersect and govern access to social resources. Findings highlight the importance of considering social support separately from social network size; thus, large social networks do not necessarily provide ample social support. LGBT older adults had different perceptions of social support than their middle-aged counterparts. Health and human service professionals should not only consider the sexual and gender identity of their LGBT clients, but also education and age when assessing access to social resources.
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Affiliation(s)
- Krystal R Kittle
- Address correspondence to: Krystal R. Kittle, PhD, Department of Environmental and Occupational Health, Social & Behavioral Health Program, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Parkway, Suite #335, Las Vegas, NV 89119, USA. E-mail:
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Kyungmin Kim
- Department of Child Development and Family Studies, Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
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Noguchi T, Nakagawa T, Komatsu A, Ishihara M, Shindo Y, Otani T, Saito T. Social functions and adverse outcome onset in older adults with mild long-term care needs: A two-year longitudinal study. Arch Gerontol Geriatr 2022; 100:104631. [DOI: 10.1016/j.archger.2022.104631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/24/2022]
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Siette J, Pomare C, Dodds L, Jorgensen M, Harrigan N, Georgiou A. A comprehensive overview of social network measures for older adults: A systematic review. Arch Gerontol Geriatr 2021; 97:104525. [PMID: 34536656 DOI: 10.1016/j.archger.2021.104525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The size and type of older adults' social networks is associated with health, mental and social outcomes. Investigators within many disciplines are now measuring social networks, but it is not always clear what they are assessing, or which measures may best meet their objectives. To undertake a systematic review to identify (i) social network measures used for older adults, (ii) variety of social network dimensions and (iii) how measures have developed over time. MATERIALS AND METHODS The MEDLINE, EMBASE, CINAHL, PsycInfo and Cochrane Library databases were systematically searched to identify social network instruments, followed by categorization of the domains into quantitative, qualitative and alter domains. RESULTS A total of 229 studies and 21 social network measures were included, with 11 quantitative dimensions (e.g., size, frequency), 5 qualitative dimensions (e.g., support satisfaction, emotional bond) and 7 alter members (e.g., family, neighbours) of social networks identified. Measures commonly clustered on quantifiable network size (n = 19), availability of supportive networks (n = 14) and presence of family ties (n = 21). The period between 1985 and 1995 produced the greatest number of newly developed social network measures (n = 10) with a stronger focus on qualitative features. DISCUSSION AND IMPLICATIONS This review provides researchers with an organized summary of measures and dimensions for consideration when appraising social connections in older adults. This can enable better study design through providing information that makes explicit inevitable trade-offs between survey length, comprehensiveness of dimension coverage, and utilization of the measure for researchers. PROSPERO Registration number: CRD42016043089.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, NSW, Australia; Centre for Ageing, Cognition and Wellbeing, Macquarie University, NSW, Australia.
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, NSW, Australia.
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, NSW, Australia.
| | - Mikaela Jorgensen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, NSW, Australia.
| | | | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, NSW, Australia.
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Arafa A, Eshak ES, Shirai K, Cadar D, Iso H, Tsuji T, Kanamori S, Kondo K. Impact of various intensities and frequencies of non-occupational physical activity on the risk of dementia among physically independent older adults: the Japan Gerontological Evaluation Study. Public Health 2021; 196:204-210. [PMID: 34274694 DOI: 10.1016/j.puhe.2021.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association between different intensities and frequencies of non-occupational physical activity (PA) and the risk of dementia among Japanese older adults. STUDY DESIGN This was a prospective cohort study. METHODS A total of 2194 participants aged ≥65 years from the Japan Gerontological Evaluation Study were followed up between 2010 and 2016. The standardised dementia scale of the long-term care insurance system was used to identify incident dementia, whereas non-occupational PA (<2 or ≥2 times/week on each intensity: light, moderate and vigorous) was assessed using a questionnaire. Cox regression was used to compute the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident dementia. RESULTS After adjustment for sociodemographic and medical characteristics, the following frequencies and intensities of non-occupational PA, compared with no non-occupational PA at all, were associated with a reduced risk of dementia: light PA ≥2 times/week (HR = 0.61, 95% CI: 0.38-0.97), moderate PA <2 times/week (HR = 0.46, 95% CI: 0.28-0.76), moderate PA ≥2 times/week (HR = 0.57, 95% CI: 0.36-0.91), vigorous PA <2 times/week (HR = 0.40, 95% CI: 0.21-0.74) and vigorous PA ≥2 times/week (HR = 0.29, 95% CI: 0.15-0.57). In the sex-specific analysis, moderate PA <2 times/week and vigorous PA ≥2 times/week were associated with a reduced risk of dementia in men, whereas light and moderate PA ≥2 times/week and all frequencies of vigorous PA were associated with a reduced risk of dementia in women. CONCLUSIONS Practicing non-occupational PA was associated with a reduced risk of dementia among Japanese older adults.
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Affiliation(s)
- A Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - E S Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - K Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - D Cadar
- Department of Behavioral Science and Health, University College London, London, UK
| | - H Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - T Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - S Kanamori
- Teikyo University Graduate School of Public Health, Tokyo, Japan; Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
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.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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20
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Miyaguni Y, Tabuchi T, Aida J, Saito M, Tsuji T, Sasaki Y, Kondo K. Community social support and onset of dementia in older Japanese individuals: a multilevel analysis using the JAGES cohort data. BMJ Open 2021; 11:e044631. [PMID: 34083332 PMCID: PMC8183266 DOI: 10.1136/bmjopen-2020-044631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Recently, there has been an increase in the number of people with dementia. However, no study has examined the association between community-level social support and the onset of incident dementia using multilevel survival analysis. DESIGN A prospective cohort study. PARTICIPANTS AND SETTING We analysed data pertaining to 15 313 (7381 men and 7932 women) community-dwelling adults aged 65 years or older who had not accessed long-term care insurance and were living in Aichi Prefecture (seven municipalities) in Japan. PRIMARY AND SECONDARY OUTCOME MEASURES The association between community-level social support and onset of incident dementia was examined using the Japan Gerontological Evaluation Study, a prospective cohort study introduced in Japan in 2003. Incident dementia was assessed using Long-term Care Insurance records spanning 3436 days from the baseline survey. RESULTS During the 10-year follow-up, the onset of incident dementia occurred in 1776 adults. Among older people, a 1% increase in community-level social support (in the form of receiving emotional support) was associated with an approximately 4% reduction in the risk of developing dementia, regardless of socio-demographic variables and health conditions (HR=0.96; 95% CI=0.94 to 0.99). CONCLUSIONS Receiving community-level social support in the form of emotional support is associated with a lower risk of developing incident dementia.
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Affiliation(s)
- Yasuhiro Miyaguni
- Department of Social Welfare, Nihon Fukushi University, Aichi, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Aichi, Japan
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
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21
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Amanollahi M, Amanollahi S, Anjomshoa A, Dolatshahi M. Mitigating the negative impacts of aging on cognitive function; modifiable factors associated with increasing cognitive reserve. Eur J Neurosci 2021; 53:3109-3124. [PMID: 33715252 DOI: 10.1111/ejn.15183] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/21/2022]
Abstract
Research suggests that social, physical, and cognitively challenging activities during lifetime, could mitigate the negative effects of aging on cognitive function. This effect is explained by the increased cognitive reserve (CR) resulting from such factors; in fact, such activities, by altering structural and functional properties of the human brain, equip one with more effective compensatory mechanisms to resist brain damage before the presentation of severe clinical symptoms. Therefore, applying appropriate modifications in one's lifestyle and activities may be effective in lowering the risk of developing dementia and cognitive dysfunction in old age, especially in brain areas that are susceptible to aging. In this paper, we are going to review relevant studies discussing the association between important modifiable factors, known as CR proxies (i.e., educational attainment, occupational complexity, physical activity, social engagement, bilingualism, leisure activities, and Mediterranean diet), and different domains of cognitive function, which are affected either in the process of healthy aging or neurodegenerative diseases.
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Affiliation(s)
- Mobina Amanollahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Saba Amanollahi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Ali Anjomshoa
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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22
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van der Velpen IF, Melis RJF, Perry M, Vernooij-Dassen MJF, Ikram MA, Vernooij MW. Social Health Is Associated With Structural Brain Changes in Older Adults: The Rotterdam Study. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:659-668. [PMID: 33549803 DOI: 10.1016/j.bpsc.2021.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Social health markers have been linked to the development of dementia. We hypothesize that social health affects brain structure and consequently influences cognitive function. We aim to elucidate the cross-sectional and longitudinal associations between social health markers and structural brain changes in older adults in the general population. METHODS Social health markers (loneliness, perceived social support, marital status) were assessed in the Rotterdam Study from 2002 to 2008. Magnetic resonance imaging of the brain was performed repeatedly between 2005 and 2015 for 3737 participants to obtain brain volumetrics, cerebral small vessel disease markers, and white matter microstructural integrity as measures of brain structure. Cross-sectional associations between social health and brain structure were studied using multivariable linear and logistic regression models. Longitudinal associations between baseline social health and changes in brain structure were examined using linear mixed models and generalized estimating equations. RESULTS Loneliness was associated with smaller white matter volume at baseline (mean difference = -4.63 mL, 95% confidence interval = -8.46 to -0.81). Better perceived social support was associated with larger total brain volume and gray matter volume at baseline and a less steep decrease in total brain volume over time. Better social support was associated with higher global fractional anisotropy and lower mean diffusivity at baseline. Participants who had never been married had a smaller total brain volume (mean difference = -8.27 mL, 95% confidence interval = -13.16 to -3.39) at baseline than married peers. CONCLUSIONS Social health is associated with brain structure. Better perceived social support at baseline was associated with better brain structure over time.
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Affiliation(s)
- Isabelle F van der Velpen
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - René J F Melis
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marieke Perry
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
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23
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Kim S, Choe K, Lee K. Depression, Loneliness, Social Support, Activities of Daily Living, and Life Satisfaction in Older Adults at High-Risk of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249448. [PMID: 33348548 PMCID: PMC7767125 DOI: 10.3390/ijerph17249448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
As the number of older adults with dementia increases, early diagnosis and intervention are crucially important. The purpose of this study was to conduct dementia screening on older adults to determine whether there are differences in depression, loneliness, social support, daily activities of living, and life satisfaction between older adults at high-risk for dementia compared with low-risk older adults. We hypothesized a negative relationship between high-risk older adults and these factors. This study also hypothesized a moderating effect for social support on the relationship between daily living activities and life satisfaction. This study used a cross-sectional design with survey data. Participants were recruited at 15 public community health centers in South Korea. A total of 609 older adults (male 208, female 401) living in the community were screened for early dementia, and 113 participants (18.9%) were assigned to the high-risk group. As hypothesized, participants in the high-risk group showed significantly more negative results in terms of activities of daily living, depression, loneliness, social support, and life satisfaction compared with participants in the low-risk group. The findings of this study provide a theoretical basis for the importance of early screening for dementia and policies for effective dementia prevention.
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24
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Rockwood K, Andrew MK, Aubertin‐Leheudre M, Belleville S, Bherer L, Bowles SK, Kehler DS, Lim A, Middleton L, Phillips N, Wallace LM. CCCDTD5: Reducing the risk of later-life dementia. Evidence informing the Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5). ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12083. [PMID: 33204818 PMCID: PMC7656906 DOI: 10.1002/trc2.12083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
The Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5) was a year-long process to synthesize the best available evidence on several topics. Our group undertook evaluation of risk reduction, in eight domains: nutrition; physical activity; hearing; sleep; cognitive training and stimulation; social engagement and education; frailty; and medications. Here we describe the rationale for the undertaking and summarize the background evidence-this is also tabulated in the Appendix. We further comment specifically on the relationship between age and dementia, and offer some suggestions for how reducing the risk of dementia in the seventh decade and beyond might be considered if we are to improve prospects for prevention in the near term. We draw to attention that a well-specified model of success in dementia prevention need not equate to the elimination of cognitive impairment in late life.
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Affiliation(s)
- Kenneth Rockwood
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Melissa K. Andrew
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Sylvie Belleville
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontréalQuebecCanada
- Psychology DepartmentUniversité de MontréalMontréalCanada
| | - Louis Bherer
- Département de Médecine, Faculté de médecine, Université de Montréal, Centre de recherche, Institut de cardiologie de Montréal, Centre de rechercheInstitut universitaire de gériatrie de MontréalMontréalQuébecCanada
| | - Susan K. Bowles
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
- College of PharmacyDalhousie UniversityHalifaxNova ScotiaCanada
| | - D Scott Kehler
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Andrew Lim
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Laura Middleton
- Department of KinesiologyUniversity of WaterlooWaterlooOntarioCanada
| | - Natalie Phillips
- Department of PsychologyConcordia UniversityMontréalQuébecCanada
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25
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Association of Late Life Depression, (Non-) Modifiable Risk and Protective Factors with Dementia and Alzheimer's Disease: Literature Review on Current Evidences, Preventive Interventions and Possible Future Trends in Prevention and Treatment of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207475. [PMID: 33066592 PMCID: PMC7602449 DOI: 10.3390/ijerph17207475] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
The number of people living with dementia and Alzheimer’s disease is growing rapidly, making dementia one of the biggest challenges for this century. Many studies have indicated that depression plays an important role in development of dementia, including Alzheimer’s disease; depression, especially, during the late life may either increase the risk of dementia or even being its prodromal stage. Despite a notably large number of carried observational studies and/or clinical trials, the association between the late life depression and dementia remains, due to the complexity of their relationship, still unclear. Moreover, during past two decades multiple other (non-)modifiable risk and possibly protective factors such as the hypertension, social engagement, obesity, level of education or physical (in)activity have been identified and their relationship with the risk for development of dementia and Alzheimer’s disease has been extensively studied. It has been proposed that to understand mechanisms of dementia and Alzheimer’s disease pathogeneses require their multifactorial nature represented by these multiple factors to be considered. In this review, we first summarize the recent literature findings on roles of the late life depression and the other known (non-)modifiable risk and possibly protective factors in development of dementia and Alzheimer’s disease. Then, we provide evidences supporting hypotheses that (i) depressive syndromes in late life may indicate the prodromal stage of dementia (Alzheimer’s disease) and, (ii) the interplay among the multiple (non-)modifiable risk and protective factors should be considered to gain a better understanding of dementia and Alzheimer’s disease pathogeneses. We also discuss the evidences of recently established interventions considered to prevent or delay the prodromes of dementia and provide the prospective future directions in prevention and treatment of dementia and Alzheimer’s disease using both the single-domain and multidomain interventions.
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26
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Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open 2020; 10:e037301. [PMID: 32265252 PMCID: PMC7245373 DOI: 10.1136/bmjopen-2020-037301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Maintenance of cognitive function into old age is important for ageing populations. Researchers seek to identify modifiable risk and protective factors for cognitive function. One such modifiable factor is functional social support, that is, one's perception of whether their social network can provide resources such as material help, companionship, information and emotional contact, if needed. While the literature generally reports positive associations between functional social support and cognitive function, results vary according to study methods such as the tool used to measure functional social support or the specific cognitive domain under investigation. Our review will summarise the association between functional social support and cognitive function in middle-aged and older-aged adults who reside in any setting (eg, community dwelling, long-term care facilities). We will also identify sources of discrepant findings between studies. METHODS AND ANALYSIS This protocol was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline. PubMed, PsycINFO, Sociological Abstracts, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus will be searched from inception to the present using a search strategy developed with a medical librarian's help. We will supplement the database searches with a grey literature search. English-language or French-language studies with a comparison group will be subject to inclusion, regardless of the measures used to assess functional social support or cognitive function. We will assess risk of bias with the Cochrane Risk of Bias Tool-Version 2 or the Newcastle-Ottawa Scale, narratively synthesise the extracted data and conduct a meta-analysis of studies with similar characteristics (eg, sample age and sex, cognitive function outcomes). Two independent raters will screen articles and assess risk of bias. ETHICS AND DISSEMINATION This review is timely given the push toward early diagnosis and treatment of dementia/major neurocognitive disorder and other types of cognitive impairment. This protocol does not require a formal ethics review. We will publish our findings in a peer-reviewed journal.
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Affiliation(s)
- Emily C Rutter
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterlo, Ontario, Canada
| | - Jane Law
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Candace A Konnert
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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27
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Liu Y, Zhang S, Tomata Y, Otsuka T, Nurrika D, Sugawara Y, Tsuji I. Emotional support (giving or receiving) and risk of incident dementia: The Ohsaki Cohort 2006 Study. Arch Gerontol Geriatr 2019; 86:103964. [PMID: 31683175 DOI: 10.1016/j.archger.2019.103964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/26/2019] [Accepted: 10/11/2019] [Indexed: 11/25/2022]
Abstract
Previous studies have suggested that emotional support may promote cognition; however, the effects of giving or receiving emotional support on incident dementia remain unclear. Therefore, we sought to investigate the relationship between emotional support (giving or receiving) and incident dementia. In December 2006, we conducted a prospective cohort study of 31,694 Japanese individuals aged ≥65 years who lived in Ohsaki City, Miyagi Prefecture, Japan. A self-reported questionnaire including items on emotional support and lifestyle factors was distributed. After excluding those who did not provide consent or responses to all items, 13,636 eligible responses were analyzed for this study. According to responses of "yes" or "no" for emotional support, we made two categories for both giving (gave or did not give) and receiving (received or did not receive) emotional support. Furthermore, we combined giving and receiving emotional support into four categories ("giving = no & receiving = no", "giving = no & receiving = yes", "giving = yes & receiving = no", "giving = yes & receiving = yes"). Data on incident dementia were retrieved from the Long-term Care Insurance Database in which participants were followed up for 5.7 years. Using multivariate Cox proportional hazards models, we found that compared with participants who did not give emotional support to others, those who did give had a lower risk of dementia (multivariate-adjusted hazard ratio [HR]: 0.61 (95% confidence interval [CI]: 0.52, 0.71)). However, a nonsignificant relationship was observed for receiving emotional support. Additionally, compared to "giving = no & receiving = no" for emotional support, "giving = no & receiving = yes" showed a higher risk of dementia (multivariate-adjusted HR: 1.51 [95% CI: 1.07, 2.14]).
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Affiliation(s)
- Yingxu Liu
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Shu Zhang
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine.
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Tatsui Otsuka
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Dieta Nurrika
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine
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28
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Noguchi T, Nojima I, Inoue-Hirakawa T, Sugiura H. The Association between Social Support Sources and Cognitive Function among Community-Dwelling Older Adults: A One-Year Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4228. [PMID: 31683571 PMCID: PMC6862477 DOI: 10.3390/ijerph16214228] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/30/2019] [Accepted: 10/30/2019] [Indexed: 11/16/2022]
Abstract
There is evidence that social relationships may modify cognitive decline in older people. We examined the prospective association between social support and cognitive function among community-dwelling older people. Japanese adults recruited at health checkups in suburban towns were surveyed at baseline and one-year follow-up. Cognitive function was assessed using the Montreal Cognitive Assessment, Japanese version (MoCA-J). Social support from coresiding family, non-coresiding family, and neighbors/friends was assessed using self-administered questionnaires. Multivariable linear regression analysis was conducted to examine the effects of social support on MoCA-J scores at follow-up. Data were analyzed from 121 older people (mean age (standard deviation): 73.86 (4.95) years). There was a positive association between social support exchanges with neighbors and friends and MoCA-J scores at follow-up after covariate adjustment (unstandardized β = 1.23, p = 0.006). Social support exchanges with coresiding family and non-coresiding family and relatives were not associated with MoCA-J scores at follow-up (coresiding family: Unstandardized β = 0.28, p = 0.813, non-coresiding family and relatives: Unstandardized β = 0.51, p = 0.238). The provision of emotional support to neighbors and friends had the largest effect on MoCA-J scores. Our findings suggest that social support exchanges with neighbors and friends are protective against cognitive decline.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi 467-8601, Japan.
| | - Ippei Nojima
- Department of Health Sciences, Shinshu University Graduate School, Nagano 390-8621, Japan.
| | - Tomoe Inoue-Hirakawa
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Aichi 461-8673, Japan.
| | - Hideshi Sugiura
- Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Aichi 461-8673, Japan.
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Lee HJ, Lee DK, Song W. Relationships between Social Capital, Social Capital Satisfaction, Self-Esteem, and Depression among Elderly Urban Residents: Analysis of Secondary Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081445. [PMID: 31018623 PMCID: PMC6517880 DOI: 10.3390/ijerph16081445] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 12/11/2022]
Abstract
The role that psychological variables play in depression among elderly urban residents has received little research attention. Therefore, the purpose of this study was to examine the relationships between social capital, social capital satisfaction, self-esteem, and depression among elderly urban residents. We used the responses provided by 701 elderly persons to scales assessing social capital (i.e., network, trust), social capital satisfaction, self-esteem, and depression, as part of the Korea Welfare Panel Study (KOWEPS). We conducted a confirmatory factor analysis and tested the validity of a proposed statistical model using structural equation modeling (SEM). The results showed that trust in social capital, social capital satisfaction, and self-esteem were significantly related to depression. Further, social capital satisfaction and self-esteem fully and partially mediated the relationship between trust and depression, respectively. These findings serve as an empirical base upon which social welfare policies can be founded that benefit elderly urban residents with weak social capital, low social capital satisfaction, and poor self-esteem.
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Affiliation(s)
- Hyun Jin Lee
- Interdisciplinary Program in Landscape Architecture, Seoul National University, Seoul 08826, Korea.
| | - Dong Kun Lee
- Department of Landscape Architecture and Rural System Engineering, Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Korea.
| | - Wonkyong Song
- Department of Landscape Architecture, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan, Chungnam 330-714, Korea.
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Sant’Ana LAJD, Elboux MJD. Comparison of social support network and expectation of care among elderly persons with different home arrangements. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To compare the social support network and expectation of care among elderly persons who live alone and those who live with others. Method: A cross-sectional study with 348 elderly people living in the community in the municipal region of Várzea Grande, Mato Grosso, Brazil was performed. The elderly were interviewed using a questionnaire composed of socio-demographic issues; evaluation tools of basic and instrumental activities of daily living; and care expectation and perceived social support network. The data were submitted to descriptive and comparative statistical analysis, the chi-squared test or Fisher’s exact test at a significance level of 5%. Results: Most of the interviewees were younger elderly women. Of these,14.66% lived alone and 85.34% lived with other people, with mainly bi-generation family arrangements. The majority stated that they had fair health, had up to two diseases, were dependent in instrumental activities of daily living and independent in self-care activities. Elderly persons who lived with others relied on their family, and the expectation of care was aimed at a daughter or daughter-in-law; while those who lived alone expected to rely on neighbors or friends to help with their tasks, if needed. Conclusion: Family members are the greatest providers of support and care, and the elderly hope to count on them when they need help in carrying out basic and instrumental activities of daily living.
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