Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults

  • Eunji Kim (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kiho Sung (Department of Sociology, Yonsei University Graduate School) ;
  • Chang Oh Kim (Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Yoosik Youm (Department of Sociology, Yonsei University Graduate School) ;
  • Hyeon Chang Kim (Department of Preventive Medicine, Yonsei University College of Medicine)
  • Received : 2022.08.10
  • Accepted : 2022.10.21
  • Published : 2023.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults. Methods: This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults' complete network maps across an entire village in 2011-2012. Participants' deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment. Results: In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively. Conclusions: The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.

Keywords

Acknowledgement

This work used data from the KSHAP study, which was supported by the Ministry of Education of the Republic of Korea, the National Research Foundation of Korea (grant No. NRF-2017S1A3A2067165).

References

  1. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med 2012;74(6):907-914. https://doi.org/10.1016/j.socscimed.2011.11.028
  2. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med 2010;40(2):218-227. https://doi.org/10.1007/s12160-010-9210-8
  3. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med 2006;160(8):805-811. https://doi.org/10.1001/archpedi.160.8.805
  4. Holt-Lunstad J, Smith TB. Social relationships and mortality. Soc Personal Psychol Compass 2012;6(1):41-53. https://doi.org/10.1111/j.1751-9004.2011.00406.x
  5. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med 2010;7(7):e1000316.
  6. Gale CR, Martyn CN, Cooper C. Cognitive impairment and mortality in a cohort of elderly people. BMJ 1996;312(7031): 608-611. https://doi.org/10.1136/bmj.312.7031.608
  7. An J, Li H, Tang Z, Zheng D, Guo J, Liu Y, et al. Cognitive impairment and risk of all-cause and cardiovascular disease mortality over 20-year follow-up: results from the BLSA. J Am Heart Assoc 2018;7(15):e008252.
  8. Palmer K, Fratiglioni L, Winblad B. What is mild cognitive impairment? Variations in definitions and evolution of nondemented persons with cognitive impairment. Acta Neurol Scand Suppl 2003;179:14-20. https://doi.org/10.1034/j.1600-0404.107.s179.2.x
  9. Youm Y, Laumann EO, Ferraro KF, Waite LJ, Kim HC, Park YR, et al. Social network properties and self-rated health in later life: comparisons from the Korean social life, health, and aging project and the national social life, health and aging project. BMC Geriatr 2014;14:102.
  10. Lee JM, Lee WJ, Kim HC, Choi W, Lee J, Sung K, et al. The Korean social life, health and aging project-health examination cohort. Epidemiol Health 2014;36:e2014003.
  11. Scott J. Social network analysis. 3rd ed. Los Angeles: SAGE; 2013, p. 117-119.
  12. Jeong SK, Cho KH, Kim JM. The usefulness of the Korean version of modified Mini-Mental State Examination (K-mMMSE) for dementia screening in community dwelling elderly people. BMC Public Health 2004;4:31.
  13. Kim S, Kim Y, Park SM. Association between alcohol drinking behaviour and cognitive function: results from a nationwide longitudinal study of South Korea. BMJ Open 2016;6(4):e010494.
  14. Choi YJ, Hong YC, Do YK. 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. J Prev Med Public Health 2021;54(6):395-403. https://doi.org/10.3961/jpmph.21.384
  15. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992;40(9):922-935. https://doi.org/10.1111/j.1532-5415.1992.tb01992.x
  16. Fillenbaum GG, Pieper CF, Cohen HJ, Cornoni-Huntley JC, Guralnik JM. Comorbidity of five chronic health conditions in elderly community residents: determinants and impact on mortality. J Gerontol A Biol Sci Med Sci 2000;55(2):M84-M89. https://doi.org/10.1093/gerona/55.2.M84
  17. Youm Y, Baldina E, Baek J. All-cause mortality and three aspects of social relationships: an eight-year follow-up of older adults from one entire Korean village. Sci Rep 2021;11(1):465.
  18. Becofsky KM, Shook RP, Sui X, Wilcox S, Lavie CJ, Blair SN. Influence of the source of social support and size of social network on all-cause mortality. Mayo Clin Proc 2015;90(7):895-902. https://doi.org/10.1016/j.mayocp.2015.04.007
  19. Kauppi M, Kawachi I, Batty GD, Oksanen T, Elovainio M, Pentti J, et al. Characteristics of social networks and mortality risk: evidence from 2 prospective cohort studies. Am J Epidemiol 2018; 187(4):746-753. https://doi.org/10.1093/aje/kwx301
  20. Minagawa Y, Saito Y. Active social participation and mortality risk among older people in Japan: results from a nationally representative sample. Res Aging 2015;37(5):481-499. https://doi.org/10.1177/0164027514545238
  21. Ishikawa Y, Kondo N, Kondo K, Saito T, Hayashi H, Kawachi I, et al. Social participation and mortality: does social position in civic groups matter? BMC Public Health 2016;16:394.
  22. Lynch JW, Smith GD, Kaplan GA, House JS. Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ 2000; 320(7243):1200-1204. https://doi.org/10.1136/bmj.320.7243.1200
  23. Lyyra TM, Heikkinen RL. Perceived social support and mortality in older people. J Gerontol B Psychol Sci Soc Sci 2006;61(3): S147-S152. https://doi.org/10.1093/geronb/61.3.S147
  24. Blazer DG. Social support and mortality in an elderly community population. Am J Epidemiol 1982;115(5):684-694. https://doi.org/10.1093/oxfordjournals.aje.a113351
  25. Pettigrew KE. Lay information provision in community settings: how community health nurses disseminate human services information to the elderly. Libr Q 2000;70(1):47-85. https://doi.org/10.1086/603154
  26. Young AF, Russell A, Powers JR. The sense of belonging to a neighbourhood: can it be measured and is it related to health and well being in older women? Soc Sci Med 2004;59(12): 2627-2637. https://doi.org/10.1016/j.socscimed.2004.05.001
  27. Guehne U, Luck T, Busse A, Angermeyer MC, Riedel-Heller SG. Mortality in individuals with mild cognitive impairment. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). Neuroepidemiology 2007;29(3-4):226-234. https://doi.org/10.1159/000112479
  28. Obisesan TO, Gillum RF. Cognitive function, social integration and mortality in a U.S. national cohort study of older adults. BMC Geriatr 2009;9:33.
  29. Poulin MJ, Brown SL, Dillard AJ, Smith DM. Giving to others and the association between stress and mortality. Am J Public Health 2013;103(9):1649-1655. https://doi.org/10.2105/AJPH.2012.300876
  30. Serper M, Patzer RE, Curtis LM, Smith SG, O'Conor R, Baker DW, et al. Health literacy, cognitive ability, and functional health status among older adults. Health Serv Res 2014;49(4):1249-1267. https://doi.org/10.1111/1475-6773.12154
  31. Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, et al. Screening for cognitive impairment in older adults: an evidence update for the U.S. Preventive Services Task Force. Rockville: Agency for Healthcare Research and Quality; 2013. Report No. 14-05198-EF-1.
  32. Gussekloo J, Westendorp RG, Remarque EJ, Lagaay AM, Heeren TJ, Knook DL. Impact of mild cognitive impairment on survival in very elderly people: cohort study. BMJ 1997;315(7115): 1053-1054. https://doi.org/10.1136/bmj.315.7115.1053
  33. Latkin CA, Edwards C, Davey-Rothwell MA, Tobin KE. The relationship between social desirability bias and self-reports of health, substance use, and social network factors among urban substance users in Baltimore, Maryland. Addict Behav 2017;73:133-136. https://doi.org/10.1016/j.addbeh.2017.05.005