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...
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Cambridge University Press
2024-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S204579602400060X/type/journal_article |
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| 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.
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| 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 |
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