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.
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).