Loneliness and the rate of motor decline in old age: the Rush Memory and Aging Project, a community-based cohort study

Aron S Buchman, Patricia A Boyle, Robert S Wilson, Bryan D James, Sue E Leurgans, Steven E Arnold, David A Bennett, Aron S Buchman, Patricia A Boyle, Robert S Wilson, Bryan D James, Sue E Leurgans, Steven E Arnold, David A Bennett

Abstract

Background: Being alone, as measured by less frequent social interactions, has been reported to be associated with a more rapid rate of motor decline in older persons. We tested the hypothesis that feeling alone is associated with the rate of motor decline in community-dwelling older persons.

Methods: At baseline, loneliness was assessed with a 5-item scale in 985 persons without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Annual detailed assessment of 9 measures of muscle strength and 9 motor performances were summarized in a composite measure of global motor function.

Results: Linear mixed-effects models which controlled for age, sex and education, showed that the level of loneliness at baseline was associated with the rate of motor decline (Estimate, -0.016; S.E. 0.006, p = 0.005). For each 1-point higher level of loneliness at baseline, motor decline was 40% more rapid; this effect was similar to the rate of motor decline observed in an average participant 4 years older at baseline. Furthermore, this amount of motor decline per year was associated with about a 50% increased risk of death. When terms for both feeling alone (loneliness) and being alone were considered together in a single model, both were relatively independent predictors of motor decline. The association between loneliness and motor decline persisted even after controlling for depressive symptoms, cognition, physical and cognitive activities, chronic conditions, as well as baseline disability or a history of stroke or Parkinson's disease.

Conclusions: Among community-dwelling older persons, both feeling alone and being alone are associated with more rapid motor decline, underscoring the importance of psychosocial factors and motor decline in old age.

Figures

Figure 1
Figure 1
Loneliness and the Rate of Motor Decline. This model derived (Model A, Table 3) figure illustrates the rate of motor decline in two participants one who is lonely (solid line: 90th percentile, score = 3.2) and the second not lonely (dotted line: 10th percentile, score = 1.4).

References

    1. Buchman AS, Wilson RS, Bienias JL, Bennett DA. Change in frailty and risk of death in older persons. Exp Aging Res. 2009;35(1):61–82. doi: 10.1080/03610730802545051.
    1. Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB. Alternative Definitions of Sarcopenia, Lower Extremity Performance, and Functional Impairment with Aging in Older Men and Women. Journal of the American Geriatrics Society. 2007;55(5):769–774. doi: 10.1111/j.1532-5415.2007.01140.x.
    1. Louis ED, Schupf N, Marder K, Tang MX. Functional correlates of mild parkinsonian signs in the community-dwelling elderly: poor balance and inability to ambulate independently. Mov Disord. 2006;21(3):411–416. doi: 10.1002/mds.20735.
    1. Onder G, Penninx BW, Ferrucci L, Fried LP, Guralnik JM, Pahor M. Measures of physical performance and risk for progressive and catastrophic disability: results from the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci. 2005;60(1):74–79.
    1. Louis ED, Tang MX, Schupf N, Mayeux R. Functional correlates and prevalence of mild parkinsonian signs in a community population of older people. Arch Neurol. 2005;62(2):297–302. doi: 10.1001/archneur.62.2.297.
    1. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, Garry PJ, Lindeman RD. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147(8):755–763.
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G. et al.Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–156.
    1. Louis ED, Schupf N, Manly J, Marder K, Tang MX, Mayeux R. Association between mild parkinsonian signs and mild cognitive impairment in a community. Neurology. 2005;64(7):1157–1161.
    1. US Census BNR. Dramatic Changes in U.S. Aging. Washington, DC: Department of Commerce; 2006.
    1. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2004;59(3):M255–263.
    1. Visser M, Pluijm SM, Stel VS, Bosscher RJ, Deeg DJ. Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam. J Am Geriatr Soc. 2002;50(11):1774–1781. doi: 10.1046/j.1532-5415.2002.50504.x.
    1. Brach JS, FitzGerald S, Newman AB, Kelsey S, Kuller L, VanSwearingen JM, Kriska AM. Physical activity and functional status in community-dwelling older women: a 14-year prospective study. Arch Intern Med. 2003;163(21):2565–2571. doi: 10.1001/archinte.163.21.2565.
    1. Buchman AS, Boyle PA, Wilson RS, Bienias JL, Bennett DA. Physical Activity and Motor Decline in Older Persons. Muscle Nerve. 2007;35:354–362. doi: 10.1002/mus.20702.
    1. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Canadian Medical Association Journal. 2006;174(6):801–809. doi: 10.1503/cmaj.051351.
    1. Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology. 2004;3(6):343–353. doi: 10.1016/S1474-4422(04)00767-7.
    1. Menec VH. The Relation Between Everyday Activities and Successful Aging: A 6-Year Longitudinal Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2003;58(2):S74–82.
    1. Agahi N, Parker MG. Leisure Activities and Mortality: Does Gender Matter? J Aging Health. 2008;20(7):855–871. doi: 10.1177/0898264308324631.
    1. Buchman AS, Boyle PA, Wilson RS, Fleischman DA, Leurgans S, Bennett DA. Association Between Late-Life Social Activity and Motor Decline in Older Adults. Archives of Internal Medicine. 2009;169(12):1139–1146. doi: 10.1001/archinternmed.2009.135.
    1. Cacioppo JT, Hawkley LC. Perceived social isolation and cognition. Trends Cogn Sci. 2009;13(10):447–454. doi: 10.1016/j.tics.2009.06.005.
    1. Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA. Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychol Aging. 2006;21(1):140–151. doi: 10.1037/0882-7974.21.1.140.
    1. Hawkley LC, Masi CM, Berry JD, Cacioppo JT. Loneliness is a unique predictor of age-related differences in systolic blood pressure. Psychol Aging. 2006;21(1):152–164. doi: 10.1037/0882-7974.21.1.152.
    1. McDade TW, Hawkley LC, Cacioppo JT. Psychosocial and behavioral predictors of inflammation in middle-aged and older adults: the Chicago health, aging, and social relations study. Psychosom Med. 2006;68(3):376–381. doi: 10.1097/01.psy.0000221371.43607.64.
    1. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, Tang Y, Bennett DA. Loneliness and Risk of Alzheimer Disease. Archives of General Psychiatry. 2007;64(2):234–240. doi: 10.1001/archpsyc.64.2.234.
    1. Hawkley LC, Thisted RA, Cacioppo JT. Loneliness predicts reduced physical activity: cross-sectional & longitudinal analyses. Health Psychol. 2009;28(3):354–363. doi: 10.1037/a0014400.
    1. Dishman RK, Berthoud HR, Booth FW, Cotman CW, Edgerton VR, Fleshner MR, Gandevia SC, Gomez-Pinilla F, Greenwood BN, Hillman CH. et al.Neurobiology of exercise. Obesity. 2006;14(3):345–356. doi: 10.1038/oby.2006.46.
    1. Berkman LF. Which influences cognitive function: living alone or being alone? Lancet. 2000;355(9212):1291–1292. doi: 10.1016/S0140-6736(00)02107-3.
    1. Bennett DA, Schneider JA, Buchman AS, Mendes de Leon C, Bienias JL, Wilson RS. The Rush Memory and Aging Project: study design and baseline characteristics of the study cohort. Neuroepidemiology. 2005;25(4):163–175. doi: 10.1159/000087446.
    1. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984;34(7):939–944.
    1. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35–41.
    1. Langston JW, Widner H, Goetz CG, Brooks D, Fahn S, Freeman T, Watts R. Core assessment program for intracerebral transplantations (CAPIT) Mov Disord. 1992;7(1):2–13. doi: 10.1002/mds.870070103.
    1. Mendes de Leon CF, Glass TA, Berkman LF. Social Engagement and Disability in a Community Population of Older Adults: The New Haven EPESE. American Journal of Epidemiology. 2003;157(7):633–642. doi: 10.1093/aje/kwg028.
    1. Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS. The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. The Lancet Neurology. 2006;5(5):406–412. doi: 10.1016/S1474-4422(06)70417-3.
    1. Wilson RS, Barnes LL, Krueger KR, Hoganson G, Bienias JL, Bennett DA. Early and late life cognitive activity and cognitive systems in old age. J Int Neuropsychol Soc. 2005;11(4):400–407. doi: 10.1017/S1355617705050599.
    1. Katz S, Akpom CA. A measure of primary sociobiological functions. Int J Health Serv. 1976;6(3):493–508.
    1. Wilson RS, Schneider JA, Boyle PA, Arnold SE, Tang Y, Bennett DA. Chronic distress and incidence of mild cognitive impairment. Neurology. 2007;68(24):2085–2092. doi: 10.1212/01.wnl.0000264930.97061.82.
    1. Boyle PA, Wilson RS, Aggarwal NT, Arvanitakis Z, Kelly J, Bienias JL, Bennett DA. Parkinsonian signs in subjects with mild cognitive impairment. Neurology. 2005;65(12):1901–1906. doi: 10.1212/01.wnl.0000188878.81385.73.
    1. Zeger SL, Liang KY, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988;44(4):1049–1060. doi: 10.2307/2531734.
    1. SAS Institute Inc. SAS/STAT® Software for Unix, Version (9.18) Cary, NC: SAS Institute Inc; 2002.
    1. Wilson RS, Bennett DA, Bienias JL, Aggarwal NT, Mendes De Leon CF, Morris MC, Schneider JA, Evans DA. Cognitive activity and incident AD in a population-based sample of older persons. Neurology. 2002;59(12):1910–1914.
    1. Adolphs R. The Social Brain: Neural Basis of Social Knowledge. Annual Review of Psychology. 2009;60(1):693–716. doi: 10.1146/annurev.psych.60.110707.163514.
    1. Rizzolatti G, Sinigaglia C. Mirrors in the Brain: How Our Minds Share Actions, Emotions, and Experience. New York: Oxford University Press; 2008.
    1. Cacioppo JT, Hawkley LC. Perceived social isolation and cognition. Trends in Cognitive Sciences. 2009;13(10):447–454. doi: 10.1016/j.tics.2009.06.005.
    1. Doane LD, Adam EK. Loneliness and cortisol: Momentary, day-to-day, and trait associations. Psychoneuroendocrinology. in press Corrected Proof.
    1. Cole S, Hawkley L, Arevalo J, Sung C, Rose R, Cacioppo J. Social regulation of gene expression in human leukocytes. Genome Biology. 2007;8(9):R189. doi: 10.1186/gb-2007-8-9-r189.
    1. McDade TW, Hawkley LC, Cacioppo JT. Psychosocial and Behavioral Predictors of Inflammation in Middle-Aged and Older Adults: The Chicago Health, Aging, and Social Relations Study. Psychosomatic Medicine. 2006;68(3):376–381. doi: 10.1097/01.psy.0000221371.43607.64.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel