Social contact, social support, and cognitive health in a population-based study of middle-aged and older men and women in rural South Africa
Social contact, social support, and cognitive health in a population-based study of middle-aged and older men and women in rural South Africa
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DOI：
10.1016/j.socscimed.2020.113167
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发表时间：
2020-09-01
影响因子：
5.4
通讯作者：
Berkman, Lisa
中科院分区：
文献类型：
--
作者：
Harling, Guy;Kobayashi, Lindsay C.;Berkman, Lisa
背景：有几种理论试图解释在老年阶段社会联系和认知功能是如何相互关联的。这些理论包括社会交往能防止认知能力下降，认知能力下降会导致社会联系减少，以及认知能力下降会导致工具性支持增加。我们研究了南非农村地区的社会交往模式、社会支持和认知健康状况如何符合这三种理论。
方法：我们使用了来自“非洲健康与老龄化：南非一个国际人口动态监测系统社区的纵向研究”（HAALSI）基线的数据，这是一项针对5059名年龄≥40岁个体的基于人群的研究。我们评估了一系列以自我为中心的社会联系指标如何因受访者的认知功能而有所不同。
结果：我们发现认知功能较低的受访者拥有更小、更紧密的社交网络，这些网络比同龄人更具本地性且更基于亲属关系。认知功能较低通常与获得较少的社会支持有关，但这种差异在情感和信息支持方面比在经济和物质支持方面更为显著。在40 - 59岁人群以及有（相对于无）教育程度的人群中，认知障碍与更大的差异相关。
结论：我们发现的模式表明，在这种环境下认知受损的老年人依靠其核心社交网络获取支持，并且在高收入和高教育水平环境中发展起来的与社会联系和认知功能相关的理论可能也适用于其他资源匮乏的环境。
Background: Several theories seek to explain how social connections and cognitive function are interconnected in older age. These include that social interaction protects against cognitive decline, that cognitive decline leads to shedding of social connections and that cognitive decline leads to increased instrumental support. We investigated how patterns of social contact, social support and cognitive health in rural South Africa fit with these three theories.Method: We used data from the baseline of "Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa" (HAALSI), a population-based study of 5059 individuals aged >= 40 years. We evaluated how a range of egocentric social connectedness measures varied by respondents' cognitive function.Results: We found that respondents with lower cognitive function had smaller, denser social networks that were more local and more kin-based than their peers. Lower cognitive function was associated with receipt of less social support generally, but this difference was stronger for emotional and informational support than for financial and physical support. Impairment was associated with greater differences among those aged 40-59 and those with any (versus no) educational attainment.Conclusions: The patterns we found suggest that cognitively impaired older adults in this setting rely on their core social networks for support, and that theories relating to social connectedness and cognitive function developed in higher-income and higher-education settings may also apply in lower-resource settings elsewhere.