Individual differences among older adults with mild and moderate dementia in social and emotional loneliness and their associations with cognitive and psychological functioning

Abstract

Background Loneliness is a major health issue among older adults. The aim of this study was to assess the relationship between loneliness, in its social and emotional facets, and the cognitive (language), and behavioral/psychological functioning as well as quality of life (QoL) in people with mild and moderate dementia, i.e., considering dementia severity as an individual characteristic. Methods This cross-sectional study involved 58 people with mild dementia and 55 people with moderate dementia. Participants completed the Social and Emotional Loneliness scale, along with measures assessing their language skills, the frequency and severity of their behavioral and psychological symptoms, and their QoL. Results Socio-demographic characteristics and depression, but not loneliness or its social and emotional facets, contributed to explain participants’ behavioral and psychological symptoms, regardless of dementia severity. Loneliness explained, though to a small extent (8% of variance), language skills in people with moderate dementia, with social loneliness only accounting for language skills (18% of variance) in this group. Loneliness also modestly accounted for dysphoria symptoms in both the mildly and moderately impaired (6% and 5% of variance, respectively) individuals with social loneliness predicting dysphoric mood in the former group only (7% of variance). Loneliness also explained, to a larger extent, QoL in both the mildly impaired and moderately impaired individuals (27% and 20% of variance, respectively), its social facet predicting QoL in the mildly impaired (30% of variance), and its emotional facet in the moderately impaired (21% of variance) group. Conclusion These findings suggest that loneliness and its facets have a clear impact on perceived QoL, and influence the language skills and dysphoria symptoms of people with dementia, to a degree that depends on dementia severity. The assessment of loneliness and its facets in people with dementia considering dementia severity, and the promotion of social inclusion to reduce it should be considered by professionals.

Decomposition and comparative analysis of depressive symptoms between older adults living alone and with others in China

“…The prevalence was recorded to be higher among older adults living alone (15.76%) than among older adults living not alone (11.15%), which was aligned with the data acquired through prior investigation of depressive symptoms among older adults in China (26,27). This is mainly because living alone makes it easier to experience social isolation, and cognitive decline, which are risk factors for depression according to previous research (28)(29)(30).…”

“…The prevalence was recorded to be higher among older adults living alone (15.76%) than among older adults living not alone (11.15%), which was aligned with the data acquired through prior investigation of depressive symptoms among older adults in China ( 26 , 27 ). This is mainly because living alone makes it easier to experience social isolation, and cognitive decline, which are risk factors for depression according to previous research ( 28–30 ). Additionally, the 4.61%-point difference in the prevalence of depressive symptoms between alone and not alone suggested that medical personnel must pay attention to older adults living alone and provide them with more professional support to alleviate any anxiety or depression.…”

Mental Fatigue Is Associated with Subjective Cognitive Decline among Older Adults

“…Stable marital relationships can ensure daily care and emotional sustenance for older adults, while those who are separated, divorces, windowed, or never married may suffer from loneliness, insecurity, feeling a lack or loss of relationships, making them more vulnerable to cognitive decline [ 39 , 47 , 48 , 49 ]. The current literature supports the importance of marital/living status—Nerobkova et al suggests that the status of being unmarried, divorced, or widowed was associated with the risk of cognitive decline [ 50 ], and Liu et al found evidence that, compared to married counterparts, divorced and widowed elders had higher odds of dementia and cognitive impairment in the United States, but that the results did not vary by gender [ 51 ].…”

The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment

“…Emotional functioning is influenced by both normal aging and changes in the brain due to dementia and other neurodegenerative diseases (Carbone et al, 2022; Depp et al, 2010; Fan et al, 2023). With the normal aging process, older adults generally can maintain similar, if not higher, affective well-being and emotional stability because they engage more in positivity-seeking emotional regulation strategies (Isaacowitz, 2022; Scheibe & Carstensen, 2010).…”