Association of social support with mild cognitive impairment and dementia among older women: the Women’s Health Initiative Memory Study

Abstract

AbstractBackgroundWomen comprise approximately two‐thirds of older adults with Alzheimer’s disease in the United States. Social support may be a modifiable risk factor for cognitive impairment. However, few long‐term, large prospective studies have examined associations of various forms of social support with cognitive impairment. Therefore, we examined the association of perceived social support with incident mild cognitive impairment (MCI) and dementia among older women.MethodThis prospective cohort study included 6,670 older women from the Women’s Health Initiative (WHI) Memory Study (WHIMS), a sub‐cohort of the WHI hormone therapy (HT) trials, who were free of dementia upon enrollment. Perceived social support was assessed at baseline using nine items from the Medical Outcomes Study Social Support Survey. All item ratings were summed to generate a summary score (range = 9‐45), with higher scores indicating greater perceived social support. Incident MCI and dementia were ascertained using a comprehensive neuropsychological battery and central adjudication by a panel of specialists with expertise in dementia diagnosis during up to 25 years of follow‐up. Cox proportional hazards models were used to assess associations of perceived social support with incident MCI, dementia, and overall cognitive impairment (MCI or dementia). We also examined associations of four types of social support (emotional/informational, affection, tangible, and positive social interaction) with MCI/dementia.ResultOverall, (mean age at baseline = 70.0 [SD 3.8] years; 97.0% non‐Hispanic/Latina; 89.8% White) 753 women had incident MCI, 697 had incident dementia, and 1,197 had incident overall cognitive impairment. There were no significant associations of social support with MCI (HR = 0.99; 95%CI = 0.98‐1.00), dementia (HR = 0.99; 95% CI = 0.98‐1.01), or overall cognitive impairment (HR = 0.99; 95% CI = 0.98‐1.00) after adjusting for age, education, income, race, ethnicity, marital status, smoking, alcohol intake, body mass index, history of diabetes, hormone therapy trial assignment, history of hormone therapy use, history of hypertension, and depressive symptom severity. There were no significant associations between the four types of social support and MCI/dementia.ConclusionPerceived social support was not significantly associated with incident cognitive impairment among older women. Future studies should explore other social factors, such as social isolation and loneliness, particularly in larger and racially/ethnically diverse populations.