Modelling the impact of social isolation on the rate of cognitive decline of dementia patients

Abstract

AbstractBackgroundThe current study looked to model the impact of social isolation (SI), using marital status as a proxy, on the rate of cognitive decline of dementia patients. It was hypothesised that patients with higher levels of SI (whose marital statuses reflected less socially connected living conditions) would exhibit steeper rates of cognitive decline over time than patients with lower levels of SI, and patients with higher levels of SI would have lower intercept cognitive scores compared to patients with lower levels of SI.MethodPatient demographic, diagnosis, cognitive assessment (Mini‐Mental State Examination [MMSE]/Montreal Cognitive Assessment [MoCA]) and marital status data were collated from electronic health records. Linear mixed‐effects models were used to explore the main effects and interaction effects of SI on the rate of cognitive decline of 4,137 patients from date of diagnosis to up to five years after (17,131 total observations).ResultComparisons for the MMSE and MoCA models showed the main effect models significantly outperformed null models testing the fixed effect of only diagnosis duration. The models revealed a similar rate of cognitive decline across all marital statuses. Excluding divorced patients, average intercept scores for less isolated marital statuses (married, civil‐partnership cohabiting) were higher than more isolated marital statuses (single, separated, widowed) for the MMSE models, but not the MoCA models. Interestingly, divorced patients had the highest average intercept scores in both the MMSE and MoCA models.ConclusionFuture research should look to develop the SI proxy using data from the COVID‐19 pandemic to explore the implications of isolation through enforced social restrictions on cognitive decline in dementia patients.