Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States

Abstract Aims Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race–ethnicity and dementia. Methods We analyzed 11...

Full description

Saved in:
Bibliographic Details
Main Authors: J. Grullon, D. Soong, R. Wong
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:Epidemiology and Psychiatric Sciences
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S204579602400060X/type/journal_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850202945867481088
author J. Grullon
D. Soong
R. Wong
author_facet J. Grullon
D. Soong
R. Wong
author_sort J. Grullon
collection DOAJ
description Abstract Aims Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race–ethnicity and dementia. Methods We analyzed 11 years (2011–2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race–ethnicity was associated with incident dementia risk. Results Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period (t = −7.35, p < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], p < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], p = .11). Race–ethnicity was not a significant moderator in the association between social isolation and dementia. Conclusions Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race–ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk.
format Article
id doaj-art-d2f1de57f9fc42308230c5071de61276
institution OA Journals
issn 2045-7960
2045-7979
language English
publishDate 2024-01-01
publisher Cambridge University Press
record_format Article
series Epidemiology and Psychiatric Sciences
spelling doaj-art-d2f1de57f9fc42308230c5071de612762025-08-20T02:11:38ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792024-01-013310.1017/S204579602400060XRacial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United StatesJ. Grullon0https://orcid.org/0000-0003-4310-3571D. Soong1https://orcid.org/0009-0001-5689-3747R. Wong2https://orcid.org/0000-0002-2243-1990Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USANorton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USADepartment of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA Department of Geriatrics, SUNY Upstate Medical University, Syracuse, NY, USAAbstract Aims Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race–ethnicity and dementia. Methods We analyzed 11 years (2011–2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race–ethnicity was associated with incident dementia risk. Results Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period (t = −7.35, p < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], p < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], p = .11). Race–ethnicity was not a significant moderator in the association between social isolation and dementia. Conclusions Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race–ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk. https://www.cambridge.org/core/product/identifier/S204579602400060X/type/journal_articlecognitive impairmentdementiaelderlyhealth disparitiesminority issues and cross cultural psychiatrysocial environmentsocial network
spellingShingle J. Grullon
D. Soong
R. Wong
Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
Epidemiology and Psychiatric Sciences
cognitive impairment
dementia
elderly
health disparities
minority issues and cross cultural psychiatry
social environment
social network
title Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
title_full Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
title_fullStr Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
title_full_unstemmed Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
title_short Racial and ethnic disparities in social isolation and 11-year dementia risk among older adults in the United States
title_sort racial and ethnic disparities in social isolation and 11 year dementia risk among older adults in the united states
topic cognitive impairment
dementia
elderly
health disparities
minority issues and cross cultural psychiatry
social environment
social network
url https://www.cambridge.org/core/product/identifier/S204579602400060X/type/journal_article
work_keys_str_mv AT jgrullon racialandethnicdisparitiesinsocialisolationand11yeardementiariskamongolderadultsintheunitedstates
AT dsoong racialandethnicdisparitiesinsocialisolationand11yeardementiariskamongolderadultsintheunitedstates
AT rwong racialandethnicdisparitiesinsocialisolationand11yeardementiariskamongolderadultsintheunitedstates