Literature DB >> 32574350

Loneliness Interacts With Cognition in Relation to Healthcare and Financial Decision Making Among Community-Dwelling Older Adults.

Christopher C Stewart1, Lei Yu2,3, Crystal M Glover2,4, Gary Mottola5, David A Bennett2,3, Robert S Wilson2,4, Patricia A Boyle2,4.   

Abstract

BACKGROUND AND OBJECTIVES: Cognition is a known determinant of healthcare and financial decision making in old age. Social vulnerabilities also might play a role in such decisions; however, the evidence for this is less clear. Here, we examined the association of loneliness with decision making and tested the hypothesis that loneliness is associated with decision making via its interaction with global cognition. RESEARCH DESIGN AND METHODS: Participants were 1,121 nondemented older adults from the Rush Memory and Aging Project. Healthcare and financial decision making was assessed via a performance-based measure; loneliness was assessed via the De Jong Gierveld Loneliness Scale; and cognition was assessed via a 19-test neuropsychological battery.
RESULTS: In a regression model adjusted for age, sex, and education, global cognition was associated with decision making (B = 2.43, SE = 0.14, p < .001) but loneliness was not (B = -0.04, SE = 0.11, p = .72). However, in a model including the interaction of loneliness with global cognition, the interaction was significant (B = 0.44, SE = 0.20, p = .03), such that the detrimental effect of loneliness on decision making was stronger when cognition was low. In secondary analyses examining the interaction of loneliness with 5 specific cognitive domains, the interaction between loneliness and working memory with decision making was significant (B = 0.35, SE = 0.15, p = .02). DISCUSSION AND IMPLICATIONS: Our results suggest that loneliness compromises healthcare and financial decision making among older adults with lower global cognition and, more specifically, lower working memory.
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Entities:  

Keywords:  Dual-processing theory; Reserve; Social vulnerability; Working memory

Mesh:

Year:  2020        PMID: 32574350      PMCID: PMC7681217          DOI: 10.1093/geront/gnaa078

Source DB:  PubMed          Journal:  Gerontologist        ISSN: 0016-9013


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