The relationship between social isolation and anxiety in people with cognitive impairment in the United States

Objectives

Social isolation among older adults with cognitive impairment is understudied. The purpose of this study is to examine the relationship between social isolation and anxiety in people with cognitive impairment in the United States.

Methods

/Design: Secondary data analyses were conducted using the National Social Life, Health, and Aging Project Wave 2 (2010-2011) dataset which includes a nationally representative sample of American older adults living at home. A total of 1,343 people who had probable cognitive impairment measured by a Montreal Cognitive Assessment score of 22 or less were selected. Anxiety was measured using the anxiety measure of Hospital Anxiety and Depression Scale (HADS-A) and social isolation was measured using Perceived Social Isolation Scale. A weighted multivariable linear regression analysis and weighted F tests were used to examine the relationship between social isolation and anxiety.

Results

We observed that greater social isolation was related to increased anxiety in people with cognitive impairment (Coefficients=0.7242, t=2.51, p=0.015), adjusting for severity of cognitive impairment, race, pain, depression, activities of daily living, and instrumental activities of daily living. Weighted F tests showed that persons with clinically significant anxiety (HADS-A≥8) had higher levels of loneliness, including feeling a lack of companionship, feeling left out, and greater social isolation.

Conclusions

The results of our study suggest that people with cognitive impairment can feel social isolation and it may contribute to their anxiety. Health care professionals, family, and friends of people with cognitive impairment should pay greater attention to social isolation of their loved ones.

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