Loneliness in Chinese older adults: Association with inflammation and cognitive decline. A 2-year longitudinal study.

  • 馮慧東, Ada (PI)
  • Lam, Chiu Wa Linda (External CoI)
  • Livingston, Gill (External CoI)
  • Ma, Suk Ling (External CoI)
  • Marcus, Richards (External CoI)
  • Shum, Ho Keung David (External CoI)

Project: Research project

Project Details


Background: Evidence shows that loneliness is a major risk factor for cognitive decline in older adults. Both are associated with increased inflammation, but no study has comprehensively investigated the relationships between loneliness, inflammation, and cognition in older adults. Relatively few studies have examined how social and emotional loneliness are associated with cognitive health. The impact of subdimensions of loneliness on inflammation and cognition has not been evaluated before.

Objectives: This study aims to assess the longitudinal association between loneliness and cognitive functions in older people. Specifically, we will examine how social and emotional loneliness associate with global and specific cognitive functions. We will also explore the role of inflammation in the association between social and emotional loneliness and cognitive function.

Design and Participants: This will be a 2-year longitudinal study on 337 non-demented older adults over the age of 60 years. Loneliness will be measured by the Chinese version of the 6-item De Jong Gierverg Loneliness Scale, which comprises social and emotional dimensions of loneliness. Level of inflammation will be quantified by the expression of selected inflammatory genes relating to neurodegeneration. Primary cognitive outcomes will be measured by the Hong Kong Montreal Cognitive Assessment and tests of episodic memory, attention, and executive function. Secondary outcomes will include mental health symptoms, vascular risks and sleep quality. Linear regression will be used to
examine how associations between social and emotional loneliness and global and specific cognitive functions are explained by inflammation and other potential mechanisms, with adjustments for physical burdens and sociodemographic variables.

Implications: The proposed study will elucidate possible mechanisms by which loneliness affects cognition. The distinction between social and emotional loneliness will offer insights to determine precisely which interpersonal network is corresponding to cognitive decline in specific domains. Our results will inform future model testing to investigate whether specific aspects in different interpersonal networks relevant to inflammatory-related mechanisms to further explain or modify the association between loneliness and cognitive decline. It will provide a clear framework for medical and social care workers to co-create personalized interventions to mitigate the risk of dementia in lonely older people with different social needs. The approach will allow a multidisciplinary team
working together to provide a comprehensive care to lonely older adults. At the same time, working in partnership will empower more frontline workers through capacity-building to work with lonely older people in the context of cognitive decline.
Effective start/end date1/01/2431/12/26


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