Family and Community Support, Brain-Derived Neurotrophic Factor, and Cognitive Performance in Older Adults: Findings From the Health, Wellbeing and Aging Study Population-Based Cohort

Family dysfunction and cognitive decline in aging: the "Health, Wellbeing, and Aging" (SABE) longitudinal population-based study

Stress during aging is not uncommon and dysfunctional family relationships are important sources of stress in the elderly. Considering the potential stressor that family dysfunction represents, it is questioned whether prolonged exposure to dysfunctional family arrangements can contribute to cognitive decline in aging.

Objective

To verify whether family dysfunction is a predictive factor of cognitive decline in aging.

Methods

Secondary study with analysis of existing data from the longitudinal, population-based study "Health, Wellbeing and Aging" (SABE). Data from 791 elderly people from two cohorts of the SABE study between 2006 and 2015 were analyzed. Family dysfunction was assessed using the Apgar family instrument, while cognitive performance was assessed using the Mini-Mental State Examination (MMSE), verbal fluency (animals) and digit length in reverse order. Cognitive decline was measured by the difference in scores in the period between 2006 and 2015.

Results

Approximately 10% of the sample had family dysfunction. The familial Apgar score was not associated with decline on MMSE (p=0.732), verbal fluency (p=0.852) and digit span scores (p=0.718). Scores related to cognition and family functionality, such as age, education, living alone, depression and family Apgar, do not explain cognitive decline.

Conclusion

The findings indicate that family functioning is not associated with cognitive decline in community-dwelling elderly. New studies will be needed to analyze the qualitative characteristics of family relationships in the cognitive performance of the elderly.

Community support and promoting cognitive function for the elderly

Proper cognitive functions are critical to the life of the elderly. With the rapid aging of the population, community support plays an important role in cognitive functioning. This study examines the association between community support and the level of cognitive functioning in the elderly, and the mediating effect of social participation in the relationship. Based on the panel data of China Longitudinal Healthy Longevity Survey (CLHLS) in 2005, 2008, 2011, 2014, and 2018, people aged 65 and over are selected as the research object (N = 35,479). The panel Logit model is used to analyze the influence of community support on their cognitive functioning. In addition, the stepwise regression and KHB decomposition methods are used to test the influence mechanism of community support on their cognitive function. The benchmark regression results show that there is a significant correlation between community support and cognitive function in the elderly (OR: 1.64, 95% CI: 1.41–1.91, p < 0.01). Daily care (OR: 1.75, 95% CI: 1.33–2.29, p < 0.01) has the strongest impact on the cognitive function of the elderly, followed by health care (OR: 1.70, 95% CI: 1.43–2.01, p < 0.01) and legal support (OR: 1.64, 95% CI: 1.37–1.95, p < 0.01), while psychological care (OR: 1.62, 95% CI: 1.31–2.01, p < 0.01) has the weakest impact on the cognitive function of the elderly. The results of the mediation effect test show that social participation plays a significant intermediary role in the impact of community support on the cognitive function of the elderly (mediation percentage: 16.89%), demonstrating that community support can improve the cognitive function of the elderly by promoting the social participation of the elderly. In classified community support, social participation plays a significant intermediary role in the impact of psychological care on cognition (mediation percentage: 46.10%).