The effects of loneliness, social isolation, and associated gender differences on the risk of developing cognitive impairment for Chinese oldest old

Abstract

Objectives

To investigate whether loneliness and social isolation could independently predict subsequent risk of cognitive impairment in Chinese oldest old, and to examine possible gender differences.

Methods

The sample included 2,732 older adults aged 80 years and above with intact cognitive function from the Chinese Longitudinal Healthy Longevity Survey 2002–2018 waves, with an average follow-up of 4.24 years. Loneliness was measured by a single-item question about how often the participant felt lonely. Social isolation was defined by marital status, frequent visits by family members, and social activity engagement. Cognitive impairment was defined based on Mini-Mental State Examination scores.

Results

Cox regression showed that social isolation independently predicted a higher risk of developing cognitive impairment at follow-up (HR = 1.14, 95% CI [1.03, 1.27], p = 0.014). Importantly, although there was no main effect of loneliness, a significant interaction between gender and loneliness (p = 0.013) suggested that increased loneliness was associated with a higher risk of developing cognitive impairment for men but not for women.

Conclusion

To prevent cognitive impairment and promote healthy longevity, socially isolated adults in their oldest old age should receive more attention, and men who often feel lonely should be offered with more emotional support.

Keywords:

• Loneliness
• social isolation
• cognitive impairment
• oldest-old
• social connections
• cognitive function
• Chinese Longitudinal Healthy Longevity Survey (CLHLS)

Acknowledgement

We thank the staff and the participants of the CLHLS.

Disclosure statement

The authors have no conflicts of interest to declare.

Author contributions

All authors designed the study. Yan Huang contributed the central idea, analyzed most of the data, and wrote the initial draft of the manuscript. Xinyi Zhu, Xiaomei Liu, and Juan Li contributed to refining the ideas, carrying out additional analyses and revising the manuscript.

Data availability statement

The data that support the findings of this study are from the publicly available CLHLS dataset, which is available from the Peking University Open Research Data Platform (https://opendata.pku.edu.cn/dataverse/CHADS).

Additional information

Funding

This work was supported by National Key Research and Development Program of China under Grant number 2020YFC2003000, 2018YFC2001701, and 2018YFC2000300; the National Natural Science Foundation of China under Grant number 32071079, 31861133011, 31671157, and 31711530157; Scientific Foundation of Institute of Psychology, Chinese Academy of Sciences under Grant number Y9CX191005; and China Postdoctoral Science Foundation under Grant number 2021M703468. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency.