Loneliness, Sense of Control, and Risk of Dementia in Healthy Older Adults: A Moderated Mediation Analysis

ABSTRACT

Objectives: Despite the rising prevalence of dementia, little research has been conducted to identify modifiable psychological factors that alleviate the risk of dementia in older adults and the underlying mechanisms. Given that loneliness is, in part, concomitant with a weakened sense of control, we examined whether sense of control would mediate the relation between loneliness and dementia risk. Further, considering that working -memory capacity is a critical cognitive resource that serves as a buffer against age-related cognitive decline, we examined a second-order moderated mediational model whereby working-memory capacity moderates the relation between control beliefs and dementia risk in older adults.

Methods

We administered a series of measures to older community-dwelling adults (ages 60–93; N = 69), including the participant-rated AD8 to assess the risk of dementia. Using the PROCESS macro, we examined the moderated mediation model for the relation between loneliness, sense of control, and dementia risk.

Results

We found that sense of control significantly mediated the relation between loneliness and risk of dementia. Moreover, the indirect effect of loneliness on dementia risk via lowered sense of control was significant only in individuals with poorer working-memory capacity. Notably, these findings held true when important covariates were controlled for.

Conclusions

Our findings underscore the critical role of control beliefs and working memory in protecting against dementia risk.

Clinical implications

Our findings have implications for intervention programs that target alleviating dementia risk and promoting healthy aging in older adults by improving socioemotional health and cognitive functioning.

KEYWORDS:

• control beliefs
• dementia
• loneliness
• perceived constraints
• working memory

Clinical implications

• Ensuring healthy socioemotional support for older persons would improve sense of control in facing constraints and challenges and in turn contribute to lowering the risk or slowing the onset of dementia, thus, promoting healthy aging.

• Evidence-based cognitive training of working memory and greater cognitive engagement for older adults could protect against cognitive decline and dementia risk in later life.

Acknowledgments

We thank our research assistants (Danish Ramlan, Geraldine Tng, Jeanette Cheong, Lim Pei Shan, Luqman Nur Hakim Bin Wahab, and Ng Rui Bing), who assisted with data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Data are available upon request.

Additional information

Funding

This work was supported by the the Ministry of Education Singapore (17-C242-SMU-008); the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2018S1A5A8027819).