Loneliness and Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey

Abstract

Objectives: To examine the relationship between loneliness and cognitive function and to explore the mediating role of physical health on the loneliness-cognition relationship in Chinese older adults (OAs). Method: Data came from a nationally representative sample of 14,199 Chinese OAs (aged 65+) from 2002, 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. A latent variable cross-lagged panel model combined with mediation analysis was used to determine the relationship between loneliness and cognitive function and the mediating effect of increase in the number of chronic conditions (ΔNCCs) on the ascertained loneliness-cognition relationship. Results: Severe loneliness at prior assessment points was significantly associated with poorer cognitive function at subsequent assessments, and vice versa. The ΔNCCs partially mediated this prospective reciprocal relationships, accounting for 2.58% of the total effect of loneliness on cognition and 4.44% of the total effect of cognition on loneliness, respectively. Discussion: Loneliness may predict subsequent cognitive decline, and vice versa. This loneliness-cognition relationship is partially explained by their impact on physical health. Multidisciplinary interventions aimed at reducing loneliness and cognitive decline per se and their associated risk factors as well as improving chronic illness management would be beneficial for emotional well-being and cognitive health in OAs.

Loneliness in Chinese older adults in primary care: prevalence and correlates

“…Subjects were asked whether they regularly participate in physical exercise. Respondents who gave an affirmative answer were regarded as regular exercisers …”

“…The outcome measure of this study, loneliness, was assessed with a single question asking how often the interviewee feels lonely on a five‐point Likert scale: 1 = always, 2 = often, 3 = sometimes, 4 = seldom, 5 = never. This single‐item measure of loneliness has been commonly used in prior studies and is well accepted by the oldest age group . As a result of the stigma associated with loneliness, this direct measure may lead to an underestimate of the actual prevalence or degree of loneliness .…”

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“…Loneliness is defined as ‘the unpleasant experience that occurs when a person's network of social relations is deficient in some important way, either quantitatively or qualitatively’ . There is accumulating evidence that loneliness is an important risk factor for many negative physical and mental health outcomes in OA, including elevated all‐cause mortality, increased systolic blood pressure, coronary heart disease and stroke, physical inactivity, daytime dysfunction, dementia and cognitive impairment, depression, suicidal behaviors, poor quality of life, and increased health‐care utilization . A cross‐temporal meta‐analysis has reported a higher level of loneliness among more recent birth cohorts of Chinese OA as compared with earlier birth cohorts .…”

Elderly suicide trends in the context of transforming China, 1987–2014

“…In parallel with China’s rapid development of a market-oriented economy in the last 30 years, many sociocultural changes have occurred: rapid urbanization and economic development, massive rural-to-urban migration, improved standards of living and healthcare, the significant shift in value from Confucian collectivism to individualism, and diminished traditions of filial piety and respect for elders1115161718. Because suicide is often linked to complex social, economic and cultural factors1920, it is expected that the ES pattern should have changed over time.…”