Social isolation, cognitive reserve, and cognition in older people with depression and anxiety

Abstract

Objectives: Poor social connections may be associated with poor cognition in older people who are not experiencing mental health problems, and the trajectory of this association may be moderated by cognitive reserve. However, it is unclear whether this relationship is the same for older people with symptoms of depression and anxiety. This paper aims to explore social relationships and cognitive function in older people with depression and anxiety.

Method: Baseline and two-year follow-up data were analysed from the Cognitive Function and Ageing Study–Wales (CFAS-Wales). We compared levels of social isolation, loneliness, social contact, cognitive function, and cognitive reserve at baseline amongst older people with and without depression or anxiety. Linear regression was used to assess the relationship between isolation and cognition at baseline and two-year follow-up in a subgroup of older people meeting pre-defined criteria for depression or anxiety. A moderation analysis tested for the moderating effect of cognitive reserve.

Results: Older people with depression or anxiety perceived themselves as more isolated and lonely than those without depression or anxiety, despite having an equivalent level of social contact with friends and family. In people with depression or anxiety, social isolation was associated with poor cognitive function at baseline, but not with cognitive change at two-year follow-up. Cognitive reserve did not moderate this association.

Conclusion: Social isolation was associated with poor cognitive function at baseline, but not two-year follow-up. This may be attributed to a reduction in mood-related symptoms at follow-up, linked to improved cognitive function.

Keywords:

• Social isolation
• cognitive function
• cognitive reserve
• depression
• anxiety

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

The CFAS Wales study was funded by the ESRC (RES-060-25-0060) and HEFCW as ‘Maintaining function and well-being in later life: a longitudinal cohort study’, (Principal Investigators: R.T Woods, L.Clare, G.Windle, V. Burholt, J. Philips, C. Brayne, C. McCracken, K. Bennett, F. Matthews). We are grateful to the NISCHR Clinical Research Centre for their assistance in tracing participants and in interviewing, and to general practices in the study areas for their cooperation. We are also grateful to the Alzheimer’s Society for funding a PhD scholarship for Isobel Evans to complete this work through the following grant: Transdisciplinary training for dementia research in CFAS (The Alzheimer’s Society CFAS Doctoral Training Centre). 2015–2018. AS-DTC-2014-027.