Objectives Previous studies have shown that participation in social activities (SA) can prevent cognitive decline (CD) and that living arrangements (LA) can affect cognitive function. This study aimed to evaluate the effects of SA and LA on CD, as well as their interactions, using longitudinal data.
Methods Data were used from the 2006-2018 Korean Longitudinal Study for Aging, which followed 10 254 adults older than 45 years over a 12-year period. CD was defined as a ≥4-point score decrease in the Mini-Mental Status Exam over 2 years. We developed an extended Cox proportional hazards model for time-dependent covariates to estimate the hazard ratio (HR) of CD in 4 groups: (1) socially active and living with others, (2) socially active and living alone, (3) socially inactive and living with others (SILO), and (4) socially inactive and living alone (SILA). The model was stratified by gender and adjusted for important confounders.
Results The HR of CD was significantly higher in the SILO group in men (HR,1.36; 95% confidence interval [CI], 1.08 to 1.78) and in the SILA group in women (HR, 1.72; 95% CI, 1.08 to 2.75). However, the interaction term for gender was not significant.
Conclusions Among socially inactive elderly adults, the HR of CD was elevated in men who lived with others and in women who lived alone, although the interaction term for gender was not significant. Socially inactive men who live with others and socially inactive women who live alone are particularly encouraged to participate in SA to prevent CD.
Summary
Korean summary
고령화연구패널조사(KLoSA)(2006-2018)에 참여한 10,254명의 45세 이상 성인을 2년마다 추척하여 생존분석을 이용하여, 사회활동 참여여부와 독거 여부가 인지기능 저하에 미치는 영향을 분석하였다. 인지기능 저하는 2년동안 Mini-Mental Status Exam이 4점 이상 감소한 경우로 정의하였다. 그 결과 사회활동에 참여하지 않으면서 가족과 함께 사는 남성과, 사회활동에 참여하지 않으면서 혼자 사는 여성에서 인지기능 저하의 위험이 증가했다.
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