Evaluation of facilitative factors for preventing cognitive decline: A 3-year cohort study of community intervention

Association between frequency of going out and mild cognitive impairment in community-dwelling older adults: a pilot study in frailty prevention groups

BACKGROUND

Clarifying the role of physical limitations in the relationship between frequency of going out and mild cognitive impairment (MCI) may be useful in supporting early detection and prevention of MCI. However, few studies have explored relatively active populations that are continuously active throughout the year. This study aimed to determine the relationship between frequency of going out and MCI among non-homebound older adults who participated in group activities to prevent frailty.

METHODS

This prospective cohort study used frequency of going out as the exposure and MCI as the outcome. The Touch Panel-type Dementia Assessment Scale and questionnaires about daily life were completed by 153 community-dwelling older adults aged ≥65 years participating in frailty prevention groups in a rural town. The baseline survey was conducted from December 2017 to March 2018 and analysed cross-sectionally. Follow-up surveys were conducted at 1- and 2-years and analysed longitudinally.

RESULTS

Univariate and binomial logistic regression analyses at baseline showed no association between MCI and frequency of going out in older adults with physical limitations. However, there was a significant association in older adults without physical limitations. A binomial logistic regression analysis of the frequency of going out at baseline and cognitive function at the 2-year follow-up showed no association between MCI and frequency of going out in older adults with physical limitations, but there was a significant association in those without physical limitations.

CONCLUSION

Our results suggest that frequency of going out may not be a useful indicator of MCI in older adults with physical limitations, although low frequency of going out may be an indicator of MCI in older adults without physical limitations.

Social isolation, social support, and loneliness and their relationship with cognitive health and dementia

BACKGROUND

Poor social health is prevalent in older adults and may be associated with worse cognition, and increased dementia risk. The aim of this study was to determine whether social isolation, social support and loneliness are independently associated with cognitive function and incident dementia over 5 years in older adults, and to investigate potential gender differences.

METHODS

Participants were 11,498 community-dwelling relatively healthy Australians aged 70-94, in the ASPREE Longitudinal Study of Older Persons (ALSOP). Social isolation, social support, loneliness and cognitive function were assessed through self-report. Outcomes examined were cognitive decline (>1.5 SD decline in cognitive performance since baseline) and incident dementia (adjudicated according to DSM-IV criteria).

RESULTS

Most participants self-reported good social health (92%) with very few socially isolated (2%), with low social support (2%) or lonely (5%). Among women, social isolation and low social support were consistently associated with lower cognitive function (e.g., social support and cognition β = -1.17, p < 0.001). No consistent longitudinal associations were observed between baseline social health and cognitive decline (over median 3.1 years) or incident dementia (over median 4.4 years; social isolation: HR = 1.00, p = 0.99; low social support: HR = 1.79, p = 0.11; loneliness: HR = 0.72, p = 0.34 among women and men).

CONCLUSION

Our study provides evidence that social isolation and a low social support are associated with worse cognitive function in women, but not men. Social health did not predict incident cognitive decline or dementia, but we lacked power to stratify dementia analyses by gender.

Social Networks as A Predictive Factor in Preserving Cognitive Functioning During Aging: A Systematic Review

This study presents a review of the existing literature concerning the relationship between types of social network and cognitive functioning during aging. The primary intent of the study was to identify the nature of this relationship. The study examined relevant literature published between 2008 and 2019 using searches of 4 scientific databases: PubMed, CINAHL, Embase, and PsycINFO. This study identified the relationship between social-network types and cognitive decline. The relationship is influenced by quantitative rather than qualitative variables of social networks, and it was found that associated with cognitive changes in episodic memory, working memory, and processing speed. The mechanism by which social networks influence cognitive function has been unclear. This study identified cognitive-ability variables related to social-network variables that have a major impact on cognitive function.

Social capital and cognitive decline: Does sleep duration mediate the association?

Background

Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults.

Methods

A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model.

Results

After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance).

Conclusions

Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.

Occupational performance issues in older adults with subjective cognitive decline

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The longitudinal relation between social reserve and smaller subsequent decline in executive functioning in old age is mediated via cognitive reserve

OBJECTIVES

Social reserve such as having close friends helps promoting activity engagement in old age. Activity engagement in turn contributes to the accumulation of cognitive reserve and is a key predictor for maintaining executive functioning in aging. We investigated the mediating role of leisure activity engagement in the longitudinal relation between close friends and subsequent change in executive functioning as measured through performance changes in the Trail Making Test (TMT).

DESIGN, SETTING, AND PARTICIPANTS

Longitudinal study with 897 older adults tested in two waves 6 years apart, analyzed using latent change score modeling.

MEASUREMENTS

TMT parts A and B, leisure activity engagement, and close friends.

RESULTS

A larger number of close friends in the first wave of data collection was related to a higher frequency of leisure activities in the first wave. A higher frequency of leisure activities in the first wave significantly predicted a smaller subsequent increase in TMT completion time from the first to the second wave (i.e. a smaller decline in executive functioning). Importantly, 41.3% of the longitudinal relation between a larger number of close friends in the first wave and a smaller subsequent increase in TMT completion time (i.e. a smaller decline in executive functioning) was mediated via a higher frequency of leisure activities in the first wave.

CONCLUSIONS

Social reserve such as having close friends may help promoting activity engagement in old age. By enhancing individuals' cognitive reserve, this activity engagement may finally result in smaller subsequent decline in executive functioning in aging.

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

Objectives: The composition of one's social network has been associated with cognition such that a greater proportion of family is associated with worse cognition compared to a greater proportion of friends. It is not clear whether this association between network composition and cognitive aging is driven by potential negative effects of family interactions or positive effects of friend interactions.Methods: Using the Health and Retirement Study (T1: 2006/2008, T2: 2010/2012, T3: 2012/2014), a longitudinal mediation model was conducted to test the effects of composition on episodic memory and latent change in memory through contact frequency with friends and family.Results: Analyses revealed indirect effects of composition on both T2 memory and latent change in memory through contact frequency with friends. A greater proportion of family in one's network was associated with lower contact frequency with friends and in turn lower memory. Composition was also associated with higher contact frequency with family; however, contact frequency with family was not associated with memory.Conclusions: These findings suggest that spending time with family may not affect episodic memory in older adulthood, but spending time with friends may be beneficial. Potential mechanisms and implications regarding the importance of friendships in later life are discussed.

The relation of low cognitive abilities to low well-being in old age is attenuated in individuals with greater cognitive reserve and greater social capital accumulated over the life course

Objectives: The present study sets out to investigate the relation of cognitive abilities to well-being and its interplay with key life course proxies of cognitive reserve and social capital in a large sample of older adults.Method: Three thousand eighty older adults served as sample for the present study. Physical well-being (EuroQoL-5D questionnaire) and psychological well-being (Satisfaction with Life Scale) as well as cognitive performance in terms of verbal abilities (Mill Hill vocabulary scale), processing speed (Trail Making Test part A), and cognitive flexibility (Trail Making Test part B) were assessed. Participants reported information on education, occupation, cognitively stimulating leisure activities, the different languages regularly spoken as well as family and close friends.Results: Moderation analyses showed that the relation of cognitive performance to physical and psychological well-being was significantly attenuated in individuals with a higher cognitive level of the first job after education, a larger number of midlife and current cognitively stimulating leisure activities, a larger number of languages regularly spoken, a larger number of significant family members and friends, and more frequent contact with and more confidence in significant family members.Conclusion: Present data suggest that the relation of low cognitive abilities to low well-being in old age is attenuated in individuals with greater cognitive reserve and greater social capital accumulated over the life course.

Changes in Activity Participation Among Older Adults With Subjective Cognitive Decline or Objective Cognitive Deficits

Participation in daily activities is crucial for healthy aging. There is limited research on participation of older adults with subjective cognitive decline (SCD), defined as the experience of cognitive deficits with no evidence of objective cognitive deficits. Therefore, this study examined perceived changes in participation in this population, and compared it to perceived changes reported by individuals with objective cognitive deficits. The study aimed to: (1) examine the reported changes in activity participation of older with SCD; (2) investigate differences in the reported changes in participation between individuals with SCD and those with mild or severe objective cognitive deficits; (3) examine the relationship between activity participation, subjective memory, and objective cognitive status; and (4) explore whether subjective memory explains additional variance in activity participation after accounting for age and objective cognitive deficits. Participants were 115 older adults (60+), divided into three groups based on their Montreal Cognitive Assessment (MoCA) scores: (1) SCD (MoCA≥26; n = 66); (2) mild objective cognitive deficits (MoCA = 20-25; n = 34); and (3) severe objective cognitive deficits (MoCA ≤ 19; n = 15). The Activity Card Sort was used to measure participation in instrumental activities of daily living, social, and leisure activities. The Multifactorial Memory Questionnaire-Ability subscale was used to assess subjective memory. We found that individuals with SCD, mild cognitive deficits and severe cognitive deficits reported participation withdrawal to a level of 80, 70, and 58% of their past participation, respectively. A significant between group difference was found on participation [χ2(2) = 16.44, p < 0.01], with the SCD group reporting higher participation than the other two groups. Participation significantly correlated with both cognitive status (r = 0.40, p < 0.01) and subjective memory (r = 0.45, p < 0.05). A regression analysis revealed that subjective memory contributed significantly to the explained variance in participation, beyond that accounted for by objective cognitive deficits and age. Our findings demonstrate the important role of subjective memory problems in activity participation of older adults, even in the absence of objective cognitive deficits.

Actividades Recreativas Artístico-Culturales como Factor Protector de la Función Cognitiva en Adultos Mayores

<p class="p1"><strong>Introducción.</strong> Envejecer es un proceso que conlleva disminuciones en la función cognitiva, afectando al adulto mayor (AM). Murillo recomienda ejecutar actividades recreativas<span class="Apple-converted-space">  </span>porque contribuyen a un aporte intelectual, beneficio físico y mental en el AM. <strong>Objetivo. </strong>Conocer la asociación entre la alta ejecución de actividades recreativas y<span class="Apple-converted-space">  </span>la función cognitiva normal en AM de dos centros de atención en la ciudad de México. <strong>Metodología.</strong> Estudio observacional, transversal, prospectivo y analítico. El tamaño muestral fue de 50 sujetos del CASSAM<span class="Apple-converted-space">  </span>y 52 Sujetos del Jardín de los AM.<span class="Apple-converted-space">  </span>Se aplicó una escala Likert para medir la ejecución de las actividades recreativas realizadas y el test de Folstein para valorar la función cognitiva. Se estimó asociación estadística entre las variables de estudio a través de Chi cuadrada de Independencia y se compararon las medias de Función Cognitiva mediante ANOVA de Kruskal-Wallis. Nivel de significancia= 0.05. Resultados. La media de función cognitiva fue de 25.9 (IC 95%; 25.1 a 26.9) y 28.3 (IC95%; 28 a 28.7) en CASSAM<span class="Apple-converted-space">  </span>y Jardín de los AM respectivamente (p=0.000). No se encontró asociación significativa entre las variables de estudio (p=0.106). Las dimensiones de la variable Actividad Recreativa fueron homogéneas en ambas instituciones (p&gt;0.05). Se observaron diferencias significativas en dos aspectos de la función cognitiva. Atención y cálculo (p=0.001) y Recuerdo diferido (p=0.002). <strong>Conclusión.</strong> Una mejor función cognitiva se presentó en los sujetos del Jardín de los AM, lo que probablemente se deba a las distintas actividades artístico-culturales que allí se desarrollan.</p><p class="p2"> </p>

The relation of close friends to cognitive performance in old age: the mediating role of leisure activities

ABSTRACTBackground:From a conceptual point of view, close friends are an important resource for promoting activity engagement in old age. Leisure activity engagement in turn is a key predictor of cognitive performance. Empirically, it remains unclear so far whether leisure activity engagement mediates between having close friends on the one hand and cognitive performance on the other, which we investigated in a large sample of older adults.

METHODS

We assessed cognitive performance (Mill Hill vocabulary scale and Trail Making Test (TMT) parts A and B) in 2,812 older adults. Participants reported information on leisure activity engagement and close friends.

RESULTS

A larger number of leisure activities and a larger number of close friends were significantly related to better cognitive performance in the Mill Hill vocabulary scale and TMT parts A and B. A larger number of close friends were significantly related to a larger number of leisure activities. The number of leisure activities mediated more than half of the relation of the number of close friends to performance in all three cognitive measures.

CONCLUSIONS

Having close friends may be helpful to stimulate and promote activity participation in old age. By enhancing individuals' cognitive reserve, this may finally preserve their cognitive performance level in old age.

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

AIMS

The present study set out to investigate the relation of psychological stress to cognitive performance and its interplay with key life course markers of cognitive reserve and social capital in a large sample of older adults.

METHODS

We assessed cognitive performance (verbal abilities and processing speed) and psychological stress in 2,812 older adults. The Participants reported information on education, occupation, leisure activities, family, and close friends.

RESULTS

Greater psychological stress was significantly related to lower performance in verbal abilities and processing speed. Moderation analyses suggested that the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends.

CONCLUSION

Cognitive reserve and social capital accrued in early and midlife may reduce the detrimental influences of psychological stress on cognitive functioning in old age.

The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review

BACKGROUND

Social relationships, which are contingent on access to social networks, promote engagement in social activities and provide access to social support. These social factors have been shown to positively impact health outcomes. In the current systematic review, we offer a comprehensive overview of the impact of social activities, social networks and social support on the cognitive functioning of healthy older adults (50+) and examine the differential effects of aspects of social relationships on various cognitive domains.

METHODS

We followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, and collated data from randomised controlled trials (RCTs), genetic and observational studies. Independent variables of interest included subjective measures of social activities, social networks, and social support, and composite measures of social relationships (CMSR). The primary outcome of interest was cognitive function divided into domains of episodic memory, semantic memory, overall memory ability, working memory, verbal fluency, reasoning, attention, processing speed, visuospatial abilities, overall executive functioning and global cognition.

RESULTS

Thirty-nine studies were included in the review; three RCTs, 34 observational studies, and two genetic studies. Evidence suggests a relationship between (1) social activity and global cognition and overall executive functioning, working memory, visuospatial abilities and processing speed but not episodic memory, verbal fluency, reasoning or attention; (2) social networks and global cognition but not episodic memory, attention or processing speed; (3) social support and global cognition and episodic memory but not attention or processing speed; and (4) CMSR and episodic memory and verbal fluency but not global cognition.

CONCLUSIONS

The results support prior conclusions that there is an association between social relationships and cognitive function but the exact nature of this association remains unclear. Implications of the findings are discussed and suggestions for future research provided.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2012: CRD42012003248 .

Social interaction and cognitive decline: Results of a 7-year community intervention

INTRODUCTION

There are few intervention studies that demonstrated linking social participation to lower risk of cognitive decline. We examined prospectively the protective effect of a community intervention program promoting social participation on the incidence of cognitive disability.

METHODS

The baseline was established in a survey of community-dwelling older people aged 65 years old or more in July 2006 (2793 respondents, response rate 48.5%). The setting was Taketoyo town in Japan, where municipal authorities launched an intervention that was based on the establishment of community-based centers called "salons," where the town's senior residents could congregate and participate in social activities, ranging from arts and crafts, games, and interactive activities with preschool children. Three salons were established in May 2010, and a total of 10 salons were in operation by 2013. We recorded the frequency of salon participation among survey respondents till 2013 and conducted two follow-up surveys (in 2010 and 2013) to collect information about health status and behaviors. The onset of cognitive disability was followed from May 2007 to January 2014. We used the marginal structural models to evaluate the effect of program.

RESULTS

The range of prevalence of cognitive disability was from 0.2% to 2.5% during the observation period. The proportion of respondents who participates to salons increased over time to about 11.7%. The frequency of salon participation was protectively associated with cognitive decline, even after adjusting for time-dependent covariates and attrition (odds ratio = 0.73, 95% confidence interval: 0.54-0.99).

DISCUSSION

Our study suggests that operating community salons that encourage social interactions, light physical activity, and cognitive activities among older participants may be effective for preventing cognitive decline. In future studies, we need to understand what sorts of activities (e.g., those involving light physical activity vs. purely intellectual activities) are most effective in maintaining cognitive function.