Living arrangements and cognitive abilities of community‐dwelling older adults in Singapore

Abstract

Aim: Dementia is a growing public health concern. It is necessary to focus on factors that may help preserve cognitive function in late life. Limited research has examined how living arrangements are associated with cognitive function in older adults. This study aims to further our understanding of this association in community-dwelling older adults in a multi-ethnic Asian population. Methods: Data were obtained from a cross-sectional population survey of 2548 adults aged 60 and older with standardized instruments. Living arrangements were classified as living with adult children and grandchildren, living with adult children only, living with a spouse/partner only, living alone, living with other relatives, and living with non-relatives. Results: Cognitive function was significantly predicted by living arrangements among community-dwelling older adults. Multivariate linear regression analyses revealed that older adults in multigenerational family households had significantly poorer cognitive function than those living with a spouse/partner (β = 0.54, P < 0.02) and those living with non-relatives (β = 1.08, P < 0.02). This association was independent of the influence of age, gender, ethnicity, education, employment status, marital status, depression, disability, chronic health conditions, and self-reported health. Conclusion: Older adults living in multigenerational households seem to be disadvantaged in their cognitive function. However, we cannot conclude this based on the evidence because of the cross-sectional nature of the data. Further research is needed to reasonably determine the relationship between living arrangements and cognitive function. Regardless, these findings add to the growing understanding of the complex relationship between living arrangements and cognition in older adults and could provide a basis to design effective strategies to delay cognitive decline in communitydwelling older adults.

Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated?

“…Moreover, people with higher socioeconomic status and higher physical and cognitive function would be more likely to live alone; this might explain why older adults living alone had higher MMSE scores than those living with other household members [ 38 , 39 ]. On the other hand, older adults living with other household members had poorer cognitive function and a lower level of independence [ 11 , 13 ] because their household members provided most of the support for them [ 22 ].…”

“…Cognitive impairment and living arrangement transition are associated with increased risk of mortality in later life [ 8 , 9 ]. To delay or slow the progression of cognitive impairment, it is important to unpack the complex relationship between living arrangement transition and cognitive health [ 10 , 11 , 12 , 13 , 14 ]. Older adults living with a spouse, children, unrelated persons, or alone after having a family represent various types of living arrangement transition [ 15 ].…”

“…For instance, some studies have shown that older adults who live with adult children or within multigenerational households are more likely to be disabled [ 21 , 22 ]. Furthermore, older adults living in multigenerational households had significantly poorer cognitive function [ 13 ], decreased independence, and faster age-related loss of physical ability. At the same time, conflicts between older adults and other household members were shown to lead to increased risk of poor health and mortality [ 23 , 24 , 25 ].…”

“…Research on the long-term relationship between living arrangement transition and cognitive impairment remains limited, reflecting in part the lack of reliable longitudinal data. In addition, endogeneity may pose an inevitable challenge with cross-sectional study designs [ 13 ]. Moreover, previous research did not evaluate changes in living arrangement during the follow-up period [ 11 ].…”

“…Finally, there have been few studies connecting changes of cognitive function with living arrangement transitions. Previous research studies have focused primarily on Singapore [ 13 ], Europe [ 10 , 12 ], and Japan [ 11 ], where living arrangements may differ from those in China and other emerging economies.…”