Investigating Biological Pathways Underpinning the Longitudinal Association Between Loneliness and Cognitive Impairment.
Investigating Biological Pathways Underpinning the Longitudinal Association Between Loneliness and Cognitive Impairment.
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研究支持孤独感和认知障碍之间纵向关联的生物途径。
DOI：
10.1093/gerona/glac213
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
SiangNg,TedKheng
中科院分区：
文献类型：
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作者：
Yu,Kexin;SiangNg,TedKheng
研究背景孤独症是老年人认知功能损害（CI）的先兆。尽管人们已经在概念上提出了孤独感“深入皮肤”影响CI风险的机制，但很少进行经验检验。孤独症的进化理论认为，孤独作为一种应激源，可能导致多个生理系统的失调。目前的研究调查是否炎症，心血管和肾脏生物标志物介导的纵向关联孤独和CI. MethodsCross-laged面板模型被用来检查假设的关系，使用2006年，2010年和2014年波的数据从健康和退休研究（N= 7,037）。孤独感用3项UCLA孤独量表测量。CI采用改良的电话访谈进行认知状态评估。生物标志物包括HbA 1C、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、C反应蛋白和胱抑素C。使用逐步建模的方法，首先，该模型只包括孤独，CI和生物标志物变量，然后，社会人口统计学协变量被添加，最后，健康状况进行了控制为.ResultsIn未调整和部分调整模型，孤独与更高的几率更差的认知状态，在8年的随访。只有HbA 1C介导孤独感与CI之间的纵向关联。然而，在进一步控制健康状况，所有协会成为nonsignificant.ConclusionsExamining大量的参与者和有限数量的生物标志物与认知和孤独纵向联系，我们的实证数据并不支持理论命题，突出控制混杂因素在未来的研究中的重要性纵向中介关系的孤独和CI。
BackgroundLoneliness precedes the onset of cognitive impairment (CI) in older adults. Although the mechanisms through which loneliness “gets under the skin” to influence the risk of developing CI have been conceptually proposed, they are rarely empirically examined. The Evolutionary Theory of Loneliness posits that loneliness as a stressor could cause dysregulations in multiple physiological systems. The current study investigated whether inflammatory, cardiovascular, and kidney biomarkers mediate the longitudinal association between loneliness and CI.MethodsCross-lagged panel models were used to examine the hypothesized relationships, using 2006, 2010, and 2014 waves of data from the Health and Retirement Study (N= 7,037). Loneliness was measured with the 3-item UCLA loneliness scale. CI was assessed with the modified telephone interview for cognitive status. Biomarkers included HbA1C, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, and Cystatin C. Using a stepwise model-building approach, first, the model included only loneliness, CI, and biomarker variables; then, sociodemographic covariates were added; lastly, health status were controlled for.ResultsIn unadjusted and partially adjusted models, loneliness was associated with higher odds of worse cognitive status in an 8-year follow-up. Only HbA1C mediated the longitudinal association between loneliness and CI. However, after further controlling for health status, all associations became nonsignificant.ConclusionsExamining a large number of participants and linking a limited number of biological markers with cognition and loneliness longitudinally, our empirical data did not support theoretical propositions, highlighting the critical importance of controlling for confounders in future studies examining longitudinal mediational relationships underlying loneliness and CI.