The Effect of Perceived Social Support on Cognitive Function and Incident Mild Cognitive Impairment Status Among Older Adults
Pillemer, Sarah C.
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Objective: Research has extensively examined the relationship between social support and health outcomes in older adults. Little is known, however, about the longitudinal associations between distinct dimensions of perceived social support and incident cognitive decline and risk of mild cognitive impairment (MCI). The current study examined whether four empirically validated dimensions of perceived social support (emotional/informational, tangible, affectionate, and positive social interaction) were associated with increased risk of cognitive decline (as measured by 1 standard deviation [SD] decrease below the baseline mean on measures of overall cognition, memory, and executive functioning) and MCI, and whether this association was moderated by gender. Participants and Methods: The sample included 493 community-residing non-demented older adults (mean age=76.58yrs; %female=57.2) enrolled in a longitudinal cohort study. Social support was assessed using the Medical Outcomes Study-Social Support Survey (MOS-SSS). Cognitive decline was defined as 1 SD below the baseline mean assessed by: the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for a global cognitive score. List Learning test, Story Memory test, Trail Making Test-B, and phonemic fluency (FAS). Incident risk of cognitive decline and MCI was assessed with Cox proportional-hazard models. Results: Higher levels of perceived tangible support (hazard ratio (HR), 1.748; 95% confidence interval [CI], 1.124-2.718), affectionate support (HR, 1.870; 95%CI, 1.002-3.490), positive social interaction (HR, 1.696; 95%CI, 1.067-2.697), and overall support (HR, 2.059; 95%CI, 1.163- 3.645) were associated with increased risk of incident cognitive decline on the RBANS. Further analyses revealed an effect of gender on the relationship between 3 dimensions of social support (tangible, positive social interaction, and overall levels) and incident cognitive decline, demonstrating that higher levels of perceived support at baseline were associated with increased risk of cognitive decline in males but not females. Conclusion: Higher levels of perceived social support are associated with increased risk of cognitive decline in men 65 years and older. Men who seek more support may do it in order to compensate for abilities or skills that are gradually being lost. Higher levels of social support are a general risk factor for overall cognitive decline, but there were no specific associations with more defined cognitive outcomes (e.g., memory, executive functioning). Results from this study could potentially be used in assessment and intervention procedures for older men at risk of cognitive decline (e.g., support groups and social interventions for men who do not have a confidant).