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The Effects of Social Activities and Living Arrangements on Cognitive Functions in Middle-aged and Elderly Adults: A Panel Study Using the 2006-2018 Korean Longitudinal Study of Aging

  • Choi, Yoon-Jung (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Hong, Yun-Chul (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Do, Young-Kyung (Department of Health Policy and Management, Seoul National University College of Medicine)
  • 투고 : 2021.07.08
  • 심사 : 2021.08.25
  • 발행 : 2021.11.30

초록

Objectives: Previous studies have shown that participation in social activities (SA) can prevent cognitive decline (CD) and that living arrangements (LA) can affect cognitive function. This study aimed to evaluate the effects of SA and LA on CD, as well as their interactions, using longitudinal data. Methods: Data were used from the 2006-2018 Korean Longitudinal Study for Aging, which followed 10 254 adults older than 45 years over a 12-year period. CD was defined as a ≥4-point score decrease in the Mini-Mental Status Exam over 2 years. We developed an extended Cox proportional hazards model for time-dependent covariates to estimate the hazard ratio (HR) of CD in 4 groups: (1) socially active and living with others, (2) socially active and living alone, (3) socially inactive and living with others (SILO), and (4) socially inactive and living alone (SILA). The model was stratified by gender and adjusted for important confounders. Results: The HR of CD was significantly higher in the SILO group in men (HR,1.36; 95% confidence interval [CI], 1.08 to 1.78) and in the SILA group in women (HR, 1.72; 95% CI, 1.08 to 2.75). However, the interaction term for gender was not significant. Conclusions: Among socially inactive elderly adults, the HR of CD was elevated in men who lived with others and in women who lived alone, although the interaction term for gender was not significant. Socially inactive men who live with others and socially inactive women who live alone are particularly encouraged to participate in SA to prevent CD.

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참고문헌

  1. Handels RL, Wolfs CA, Aalten P, Joore MA, Verhey FR, Severens JL. Diagnosing Alzheimer's disease: a systematic review of economic evaluations. Alzheimers Dement 2014;10(2):225-237. https://doi.org/10.1016/j.jalz.2013.02.005
  2. Kim YJ, Han JW, So YS, Seo JY, Kim KY, Kim KW. Prevalence and trends of dementia in Korea: a systematic review and meta-analysis. J Korean Med Sci 2014;29(7):903-912. https://doi.org/10.3346/jkms.2014.29.7.903
  3. Park JH, Eum JH, Bold B, Cheong HK. Burden of disease due to dementia in the elderly population of Korea: present and future. BMC Public Health 2013;13:293. https://doi.org/10.1186/1471-2458-13-293
  4. Fiest KM, Roberts JI, Maxwell CJ, Hogan DB, Smith EE, Frolkis A, et al. The prevalence and incidence of dementia due to Alzheimer's disease: a systematic review and meta-analysis. Can J Neurol Sci 2016;43 Suppl 1:S51-S82.
  5. Choi Y, Park S, Cho KH, Chun SY, Park EC. A change in social activity affect cognitive function in middle-aged and older Koreans: analysis of a Korean longitudinal study on aging (2006-2012). Int J Geriatr Psychiatry 2016;31(8):912-919. https://doi.org/10.1002/gps.4408
  6. Cummings J, Lee G, Ritter A, Zhong K. Alzheimer's disease drug development pipeline: 2018. Alzheimers Dement (N Y) 2018;4:195-214. https://doi.org/10.1016/j.trci.2018.03.009
  7. Hersi M, Irvine B, Gupta P, Gomes J, Birkett N, Krewski D. Risk factors associated with the onset and progression of Alzheimer's disease: a systematic review of the evidence. Neurotoxicology 2017;61:143-187. https://doi.org/10.1016/j.neuro.2017.03.006
  8. Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004;3(6):343-353. https://doi.org/10.1016/S1474-4422(04)00767-7
  9. Saito T, Murata C, Saito M, Takeda T, Kondo K. Influence of social relationship domains and their combinations on incident dementia: a prospective cohort study. J Epidemiol Community Health 2018;72(1):7-12. https://doi.org/10.1136/jech-2017-209811
  10. Hsiao YH, Chang CH, Gean PW. Impact of social relationships on Alzheimer's memory impairment: mechanistic studies. J Biomed Sci 2018;25(1):3. https://doi.org/10.1186/s12929-018-0404-x
  11. Pillai JA, Verghese J. Social networks and their role in preventing dementia. Indian J Psychiatry 2009;51(Suppl1):S22-S28.
  12. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry 2007;64(2):234-240. https://doi.org/10.1001/archpsyc.64.2.234
  13. Boss L, Kang DH, Branson S. Loneliness and cognitive function in the older adult: a systematic review. Int Psychogeriatr 2015;27(4):541-553. https://doi.org/10.1017/s1041610214002749
  14. Park JH. Dying alone is increased 40% over 3 years as living alone increased. Newsis; 2020 Oct 1 [cited 2021 Jul 1]. Available from: https://newsis.com/view/?id=NISX20201001_00011-84646 (Korean).
  15. Shin JK, Ahn JK, Kim KH, Kim EY, Kwon YS. 2014 Korean Longitudinal Study of Ageing (KLoSA) basic analysis report [cited 2021 Jul 1]. Available from: https://survey.keis.or.kr/cmm/fms/asaproFileDown.do?atchFileId=FILE_000000000013912&fileSn=0&browser=Opera (Korean).
  16. Hwang J, Park S, Kim S. Effects of participation in social activities on cognitive function among middle-aged and older adults in Korea. Int J Environ Res Public Health 2018;15(10):2315. https://doi.org/10.3390/ijerph15102315
  17. Kim D, Arai H, Kim S. Social activities are associated with cognitive decline in older Koreans. Geriatr Gerontol Int 2017;17(8):1191-1196. https://doi.org/10.1111/ggi.12861
  18. Jeong HG, Han C. Diagnosis and treatment of dementia in primary care. J Korean Med Assoc 2013;56(12):1104-1112 (Korean). https://doi.org/10.5124/jkma.2013.56.12.1104
  19. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189-198. https://doi.org/10.1016/0022-3956(75)90026-6
  20. Jongstra S, van Gool WA, Moll van Charante EP, van Dalen JW, Eurelings LS, Richard E, et al. Improving prediction of dementia in primary care. Ann Fam Med 2018;16(3):206-210. https://doi.org/10.1370/afm.2224
  21. Hensel A, Angermeyer MC, Riedel-Heller SG. Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination. J Neurol Neurosurg Psychiatry 2007;78(12):1298-1303. https://doi.org/10.1136/jnnp.2006.109074
  22. Evans IE, Llewellyn DJ, Matthews FE, Woods RT, Brayne C, Clare L, et al. Living alone and cognitive function in later life. Arch Gerontol Geriatr 2019;81:222-233. https://doi.org/10.1016/j.archger.2018.12.014
  23. Mazzuco S, Meggiolaro S, Ongaro F, Toffolutti V. Living arrangement and cognitive decline among older people in Europe. Ageing Soc 2017;37(6):1111-1133. https://doi.org/10.1017/S0144686X16000374
  24. Jekel K, Damian M, Wattmo C, Hausner L, Bullock R, Connelly PJ, et al. Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimers Res Ther 2015;7(1):17. https://doi.org/10.1186/s13195-015-0099-0
  25. Cornelis E, Gorus E, Beyer I, Bautmans I, De Vriendt P. Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: development of a new evaluation tool. PLoS Med 2017;14(3):e1002250. https://doi.org/10.1371/journal.pmed.1002250
  26. Jang SN, Kawachi I, Chang J, Boo K, Shin HG, Lee H, et al. Marital status, gender, and depression: analysis of the baseline survey of the Korean Longitudinal Study of Ageing (KLoSA). Soc Sci Med 2009;69(11):1608-1615. https://doi.org/10.1016/j.socscimed.2009.09.007
  27. Jack CR Jr, Vemuri P. Amyloid-β - a reflection of risk or a preclinical marker? Nat Rev Neurol 2018;14(6):319-320. https://doi.org/10.1038/s41582-018-0008-9