Social relationships and the rate of cognitive decline among older adults in Lebanon : differences by gender

Abstract

Introduction: Dementia is an increasing public health problem worldwide. Cognitive decline is a defining feature of the disease. The aim of this study was to assess the effect of social network and social engagement on cognitive decline and to explore differences by gender among older adults in Lebanon. Methods: Data were derived from the COLDS’ study (Cohort of Older Adults in Lebanon: A Dementia Study). Out of 508 older adults, the eligible sample for this longitudinal study was 273 participants who were at risk of cognitive decline at baseline. The outcome variable, cognitive decline, was estimated using the Arabic version of the IQCODE (A-IQCODE). The social network dimension consisted of the participant’s marital status and his -her contact with relatives, friends, and neighbors. The following variables were used to evaluate social engagement: attending religious meetings, engaging in any community activities, and involvement in any kind of paid work. Social network score and social engagement score were generated by adding up the responses of items comprising each concept. Simple and multiple logistic regression models were performed adjusting for cluster effect. To explore the effect of Gender on the association between exposure variables and cognitive decline, stratification by gender was done at the bivariate and multivariate level. Interaction terms were added to logistic regression models to check for statistical significance of the interaction with gender. The same analyses was run on the baseline sample (502 participants) to check for any significant association between social relations variables and cognitive decline at baseline. Results: Adjusting for age, gender, educational level, depression, difficulties in performing daily activities, and other social factors, only frequent contact with children or other relatives was significantly associated with lower odds of cognitive decline after 3 years of follow-up. No evidence of difference by gender was found. Conclusion: Frequent cont