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Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

Published online by Cambridge University Press:  22 January 2021

Bin Yu Open the ORCID record for Bin Yu [Opens in a new window] ,
Andrew Steptoe ,
Yongjie Chen  and
Xiaohua Jia
Bin Yu*
Affiliation:
Institute of Psychology, Tianjin Medical University, Tianjin, China
Andrew Steptoe
Affiliation:
Department of Behavioural Science and Health, University College London, London, UK
Yongjie Chen
Affiliation:
Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
Xiaohua Jia
Affiliation:
Department of Ultrasound, General Hospital of People's Liberation Army, Beijing, China Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China
*
Author for correspondence: Bin Yu, E-mail: yubin80@tmu.edu.cn
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Abstract

Background

Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults.

Methods

This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up.

Results

Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables.

Conclusions

Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

Keywords

Cognitive functionlonelinessolder adultssocial isolation
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 8
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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