Abstract
BackgroundAs the population ages, cognitive decline and dementia have become major health concerns in the UK. Loneliness has been linked to cognitive decline, but the reverse causality of this association remains unclear. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50 years and over) over a 10-year follow-up.MethodsData came from a nationally representative sample of 5885 participants in the English Longitudinal Study of Ageing (ELSA), free of stroke or dementia and followed every 2 years up to wave 7 (2014–15). At each wave, cognitive function was measured with word recall and verbal fluency tests, and loneliness was measured with the abridged version of the revised UCLA Loneliness Scale. Bivariate dual change score models were used to assess the multivariate associations between loneliness and cognitive function, used interchangeably as exposures and outcomes.ResultsGreater loneliness at baseline was associated with poorer memory [β intercept = −0.03, standard error (SE) = 0.01, P = 0.016] and verbal fluency (β intercept = −0.01, SE = 001, P = 0.027) at baseline, and with a stronger linear rate of decline in both memory (β linear slope = −0.07, SE = 001, P ≤ 0.001) and verbal fluency (β linear slope = −0.09, SE = 0.03, P = 0.003) over a 10-year follow-up period, although the performance on verbal fluency did not change substantially on average over this period. We also found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (β linear slope = −0.01, SE = 001, P = 0.004) and that a linear decline in memory was associated with an acceleration in loneliness (β quadratic slope = −0.02, SE = 001, P ≤ 0.001) during follow-up.ConclusionsHigher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade. These factors seem, however, to be partially intertwined, since baseline memory and its rate of decline also contribute to an increase in loneliness over time.
Highlights
Life expectancy in the UK is increasing rapidly.[1]
Higher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade
These factors seem, to be partially intertwined, since baseline memory and its rate of decline contribute to an increase in loneliness over time
Summary
Life expectancy in the UK is increasing rapidly.[1]. The male life expectancy was projected to increase from 89 years for an individual born in 2007 to years for a man born in 2030 and, if female, the corresponding figures are years in 2007 and 95 in 2030.2 increased life expectancy is not necessarily equivalent to healthy extra years of life,[2] meaning that population ageing and age-related health problems are increasingly becoming a public health priority.[3]Brain ageing leads to a decline in cognitive function, which is a slow, gradual process over time.[4]. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50 years and over) over a 10-year follow-up. Results: Greater loneliness at baseline was associated with poorer memory [b intercept 1⁄4 À0.03, standard error (SE) 1⁄4 0.01, P 1⁄4 0.016] and verbal fluency (b intercept 1⁄4 À0.01, SE 1⁄4 001, P 1⁄4 0.027) at baseline, and with a stronger linear rate of decline in both memory (b linear slope 1⁄4 À0.07, SE 1⁄4 001, P 0.001) and verbal fluency (b linear slope 1⁄4 À0.09, SE 1⁄4 0.03, P 1⁄4 0.003) over a 10-year follow-up period, the performance on verbal fluency did not change substantially on average over this period. We found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (b linear slope 1⁄4 À0.01, SE 1⁄4 001, P 1⁄4 0.004) and that a linear decline in memory was associated with an acceleration in loneliness (b quadratic slope 1⁄4 À0.02, SE 1⁄4 001, P 0.001) during follow-up
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