Social support factors and cognitive outcomes in mid‐life

Abstract

AbstractBackgroundA growing body of evidence suggests that social support is associated with cognitive outcomes including dementia in late‐life. Yet few studies have examined the association between social support and cognition in mid‐life, a critical time of transition to aging. Furthermore, little is known about the effects of other aspects of social function such as emotional support, social strain and loneliness on cognition. Our goal was to investigate the association between several social support factors and cognitive performance in mid‐life.MethodWe studied 2,732 Black and White adults from the Coronary Artery Risk Development in Young Adults (CARDIA) Study who completed a social support questionnaire at baseline (CARDIA Year 20, mean age 45.2 years, 57% female, 45% Black) which assessed aspects of emotional support, social strain, and loneliness. At the 10‐year follow‐up, cognitive performance was evaluated with a battery of five tests: Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, Verbal Fluency (category and letter fluency), and the Montreal Cognitive Assessment (MOCA) and standardized to z‐scores. We used linear regression to determine the association between emotional support, social strain, and loneliness, categorized as tertiles (comparing high to low), with mid‐life cognition.ResultIn unadjusted models, all three social support factors were associated with cognition 10 years later. After adjusting for age, sex, race, education, marital status, income, and depression, participants reporting higher levels of emotional support performed better on all cognitive tests (DSST High vs. Low (z‐score)=0.13 [95%CI 0.03, 0.23]; RAVLT=0.17 [95%CI 0.07, 0.27]; reverse Stroop=0.15 [95%CI 0.05, 0.26]; Verbal Fluency=0.12 [95%CI 0.01, 0.23]; MOCA=0.19 [95%CI 0.09, 0.28]). Less social strain was associated with higher scores on most tests (DSST Low vs. High=0.16 [95%CI 0.06, 0.26]; RAVLT=0.11 [95%CI 0.01, 0.21]; and MOCA=0.13 [95%CI 0.04, 0.23]). Loneliness was not associated with mid‐life cognition.ConclusionGreater level of social support, particularly emotional support, was associated with better mid‐life cognitive outcomes 10 years later. To better inform risk and prevention efforts, more research should be conducted to investigate the associations between various dimensions of social support and cognitive outcomes across the life course.