Social disengagement and incident cognitive decline in community-dwelling elderly persons.
BACKGROUND
Social engagement, which is defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. However, few longitudinal studies of this relation have been done.


OBJECTIVE
To determine the relation between social disengagement and incident cognitive decline in community-dwelling elderly persons.


METHODS
Cohort study.


METHODS
New Haven, Connecticut.


METHODS
2812 noninstitutionalized elderly persons (65 years of age or older) who were interviewed in their homes in 1982, 1985, 1988, and 1994.


METHODS
A global social disengagement scale was constructed from the following indicators: presence of a spouse, monthly visual contact with three or more relatives or friends, yearly nonvisual contact with 10 or more relatives or friends, attendance at religious services, group membership, and regular social activities. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. Response to the questionnaire was scored as high, medium, or low. Cognitive decline was defined as a transition to a lower category.


RESULTS
Compared with persons who had five or six social ties, those who had no social ties were at increased risk for incident cognitive decline after adjustment for age, initial cognitive performance, sex, ethnicity, education, income, housing type, physical disability, cardiovascular profile, sensory impairment, symptoms of depression, smoking, alcohol use, and level of physical activity. The 3-year odds ratio was 2.24 (95% CI, 1.40 to 3.58; P < 0.001), the 6-year odds ratio was 1.91 (CI, 1.14 to 3.18; P = 0.01), and the 12-year odds ratio was 2.37 (CI, 1.07 to 4.88; P = 0.03).


CONCLUSIONS
Social disengagement is a risk factor for cognitive impairment among elderly persons.
Bassuk
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SS
Department of Health and Social Behavior, Harvard School of Public Health, Boston, Massachusetts 02120, USA. sbassuk@hsph.harvard.edu
Glass
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TA
Berkman
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LF
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology*; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008137:Longitudinal Studies; D012044:Regression Analysis; D012934:Social Isolation; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires