Social interaction level modulates the impact of frailty on cognitive decline: a longitudinal study

Abstract

Objectives

This study evaluates whether social interaction level modifies the association between frailty and cognitive decline in older adults.

Methods

A total of 2701 adults aged ≥65 years enrolled in the Progetto Veneto Anziani (Pro.V.A.), participated in the study. At baseline, participants were classified as having low, moderate, or high social interactions based on: cohabiting status, frequency of contacts with relatives/friends or involvement in childcare activities, and frequency of participation in social or community activities. Baseline frailty was defined as the presence of ≥3 criteria among: weight loss, weakness, slowness, low physical activity, and exhaustion. Cognitive function was assessed through the Mini-Mental State Examination (MMSE) at baseline and after 4.4 and 7 years. The association between frailty and MMSE changes over time was evaluated through linear mixed models. Interaction and subgroup analyses explored the modifying effect of social interaction level on the above association.

Results

The mean age of participants was 76.1 years, and 59.1% were women. Frail individuals had a steeper annual MMSE decline than their non-frail counterparts (ß=-0.40, 95%CI: −0.59, −0.20). When stratifying participants by social interaction level, we found that the association between frailty and MMSE changes over time was stronger in those with low social interactions (ß=-0.74, 95%CI: −1.33, −0.15) while attenuated in those with moderate (ß=-0.42, 95%CI: −0.74, −0.11) or high social interaction level (ß=-0.29, 95%CI: −0.58, 0.01).

Conclusion

Maintaining frequent social interactions might mitigate the negative impact of frailty on older people’s cognitive functions.

Keywords:

• Social interaction
• frailty
• cognitive decline
• longitudinal study
• effect modification

Acknowledgments

We are grateful to all nurses, physicians, and participants who took part in this study. The data and analytic methods are available for replication purposes upon reasonable request to the corresponding author (CT) and the current scientific coordinator of the Pro.V.A. study (GS).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The data collection phase of the PRO.V.A. study was supported by the Fondazione Cassa di Risparmio di Padova e Rovigo, the University of Padua, the Local Health Units (Azienda Unità Locale Socio Sanitaria) nos. 15 and 18 of the Veneto Region, and a grant from the Veneto Regional Authority (Ricerca Sanitaria Finalizzata n. 156/03). The data analysis phase was financed by a grant from the University of Padua (Population Aging - Economics, Health, Retirement and the Welfare State - POPA_EHR). The sponsors had no involvement in the study design, methods, participant recruitment, data collection and analysis, nor in the drafting of this paper.