Cognitive Impairment and the Trajectory of Loneliness in Older Adulthood: Evidence from the Health and Retirement Study
Abstract
Emotional and Social Loneliness
The Effect of Cognitive Impairment on Loneliness
Method
Sample
Measures
Loneliness
Cognitive impairment
Sociodemographic covariates
Health and social covariates
Analytic Plan
Results
Sample Characteristics
Range | M (SD) or % | Bivariate correlations at Wave 1 | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Wave 1 | Wave 2 | Wave 3 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | ||
1. Age | 50–101 | 66.59 (9.85) | — | |||||||||||||||||
2. Female | 59.2% | −.01 | — | |||||||||||||||||
3. Education | 0–17 | 12.83 (3.07) | −.11** | −.05** | — | |||||||||||||||
4. Race (Black) | 15.6% | −.13** | .05** | −.07** | — | |||||||||||||||
5. Race (other) | 5.8% | −.13** | .00 | −.11** | −.11** | — | ||||||||||||||
6. Latinx | 10% | −.12** | .01 | −.34** | −.12** | .38** | — | |||||||||||||
7. CIND | 16% | 17.4% | 18% | .17** | −.03** | −.29** | .15** | .06** | .10** | — | ||||||||||
8. Dementia | 3% | 4.5% | 4.5% | .13** | .00 | −.21** | .09** | .03** | .05** | — | — | |||||||||
9. Functional limitation | 0–5 | 1.99 (1.35) | 2.19 (1.37) | 2.33 (1.36) | .34** | .00 | −.13** | .04** | −.05** | −.07** | .12** | .08** | — | |||||||
10. Disease burden | 0–7 | 0.18 (0.61) | 0.24 (0.70) | 0.29 (0.80) | .08** | .02* | −.14** | .06** | .04** | .05** | .16** | .15** | .21** | — | ||||||
11. Married | 65.1% | 61.3% | 56% | −.17** | −.24** | .10** | −.17** | .01 | .01 | −.08** | −.08** | −.10** | −.10** | — | ||||||
12. Social contact | 1–6 | 3.73 (0.86) | 3.70 (0.86) | 3.68 (0.87) | −.07** | .20** | .17** | −.02 | −.04** | −.06** | −.12** | −.07** | −.08** | −.10** | −.03** | — | ||||
13. Depressive symptoms | 0–7 | 1.25 (1.73) | 1.25 (1.74) | 1.18 (1.68) | −.05** | .09** | −.20** | .08** | .06** | .10** | .14** | .11** | .19** | .31** | −.15** | −.11** | — | |||
14. Overall loneliness | 1–3 | 1.52 (0.43) | 1.52 (0.43) | 1.52 (0.43) | −.04** | −.05** | −.15** | .05** | .04** | .07** | .11** | .05** | .10** | .16** | −.15** | −.29** | .37** | — | ||
15. Emotional loneliness | 1–3 | 1.50 (0.54) | 1.48 (0.53) | 1.47 (0.53) | −.04** | .07** | −.10** | .06** | .02* | .03** | .08** | .06** | .11** | .17** | −.27** | −.16** | .40** | .78** | — | |
16. Social loneliness | 1–3 | 1.48 (0.51) | 1.49 (0.52) | 1.49 (0.53) | −.03** | −.10** | −.13** | .03** | .03** | .07** | .11** | .04** | .07** | .11** | −.04** | −.31** | .25** | .88** | .45** | — |
Loneliness Trajectories by Cognitive Impairment Status
Overall loneliness | ||||
---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | |
Fixed effects | ||||
Intercept | 1.49 [1.48, 1.51], <.001 | 1.51 [1.49, 1.52], <.001 | 1.60 [1.58, 1.61], <.001 | 1.52 [1.51, 1.54], <.001 |
Time | .01 [.01, .02], <.001 | .00 [.00, .01], .135 | −.01 [−.01, .00], .004 | .00 [−.01, .00], .387 |
Age | .00 [−.01, .00], <.001 | −.01 [−.01, −.01], <.001 | −.01 [−.01, −.01], <.001 | −.01 [−.01, .00], <.001 |
Age2 | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 |
Female | −.04 [−.06, −.03], <.001 | −.04 [−.06, −.03], <.001 | −.03 [−.05, −.02], <.001 | −.05 [−.06, −.03], <.001 |
Education | −02 [−.02, −.01], <.001 | −.01 [−.02, −.01], <.001 | −.01 [−.01, −.01], <.001 | .00 [−.01, .00], <.001 |
Black | .01 [.00, .03], .117 | .00 [−.01, .02], .677 | −.02 [−.04, −.01], .008 | −.02 [−.04, −.01], .004 |
Other | .00 [−.03, .03], .812 | .00 [−.03, .03], .959 | −.01 [−.04, .02], .452 | −.02 [−.04, .01], .174 |
Latinx | −.01 [−.03, .02], .680 | .00 [−.02, .02], .975 | .00 [−.02, .03], .765 | −.01 [−.03, .01], .475 |
Ever CIND | .08 [.07, .10], <.001 | .07 [.06, .09], <.001 | .06 [.04, .08], <.001 | .04 [.03, .06], <.001 |
Ever dementia | .10 [.08, .13], <.001 | .09 [.06, .12], <.001 | .07 [.04, .10], <.001 | .04 [.01, .07], .002 |
Functional limitations | .03 [.03, .03], <.001 | .03 [.02, .03], <.001 | .02 [.01, .02], <.001 | |
Disease burden | .05 [.05, .06], <.001 | .02 [.01, .02], <.001 | .02 [.01, .02], <.001 | |
Married | −.12 [−.13, −.11], <.001 | −.10 [−.11, −.09], <.001 | ||
Social contact | −.11 [−.11, −.10], <.001 | −.10 [−.11, −.10], <.001 | ||
Depressive symptoms | .06 [.06, .06], <.001 | |||
Age × time | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 | .00 [.00, .00], <.001 |
Ever CIND × time | .00 [−.01, .01], .969 | .00 [−.01, .01], .676 | .00 [−.01, .01], .557 | .00 [−.01, .01], .524 |
Ever dementia × time | −.01 [−.03, .01], .298 | −.02 [−.04, .00], .079 | −.02 [−.04, .00], .029 | −.01 [−.03, .00], .130 |
Random effects | ||||
Residual var. | .06 [.06, .07], <.001 | .06 [.06, .07], <.001 | .06 [.06, .07], <.001 | .06 [.06, .07], <.001 |
Intercept var. | .12 [.11, .12], <.001 | .11 [.11, .12], <.001 | .10 [.09, .10], <.001 | .08 [.08, .09], <.001 |
Time var. | .00 [−.01, .00], <.001 | .00 [−.01, .00], <.001 | .00 [−.01, .00], <.001 | .00 [−.01, .00], .001 |
Intercept and time covar. | .01 [.00, .01], <.001 | .01 [.00, .01], <.001 | .00 [.00, .01], <.001 | .00 [.00, .01], <.001 |
2 log-likelihood | 26,581.318 | 26,128.580 | 24,270.106 | 22,477.756 |
Age, Gender, Race/Ethnicity, and Education Differences in the Association between Cognitive Impairment and Loneliness
Discussion
Clinical and Practical Implications
Strengths and Limitations
Declaration of Conflicting Interests
Funding
ORCID iDs
References
Supplementary Material
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