Social relationships and the rate of cognitive decline among older adults in Lebanon: Differences by gender

Abstract

AbstractBackgroundCognitive decline is an increasing public health problem with ageing of populations worldwide. Evidence from developed countries is accumulating on the role of social relationship on cognitive decline. No such studies in the Middle East. The aim of this study was to assess the effect of social network and social engagement on cognitive decline and explore differences by gender among older adults in Lebanon.MethodData were derived from the COLDS’ study (Cohort of Older Adults in Lebanon: A Dementia Study). Out of a cohort of 508 older adults, 273 participants did not have cognitive decline at baseline and these constitute the sample of current study. Cognitive decline was estimated using the Arabic version of the IQCODE. The social network dimension consisted of the participant’s marital status and his /her contact with relatives, friends, and neighbors. Social engagement included attending religious meetings, engaging in any community activities, and involvement in any kind of paid work. Simple and multiple logistic regression analyses were performed adjusting for cluster effect. To explore the effect of Gender on the association between exposure variables and cognitive decline, stratification by gender was done at the bivariate and multivariate level. Interaction terms were added to logistic regression models to check for statistical significance of the interaction with gender.ResultAdjusting for age, gender, educational level, depression, difficulties in performing daily activities, and other social factors, only frequent contact with children or other relatives was significantly associated with lower odds of cognitive decline after 3 years of follow‐up (adjusted OR= 0.37, 95 % CI 0.14‐0.97). No evidence of difference by gender was found.ConclusionThe findings highlight the importance of support received from children and close relatives particularly in a country like Lebanon where the social life of elderly is centered on the family, while friends and neighbors play a lesser role. Children and close relatives may influence older people’s health by motivating positive healthy behaviors. Future longitudinal studies should explore in a comprehensive framework how social interactions and cognitive status would change throughout the follow‐up period and the dynamics through which they would influence each other.