Racial differences in the association between loneliness and cognitive impairment among older Black and White men

Abstract

Background Loneliness is a biopsychosocial stressor linked to poor health outcomes including dementia. Few studies have focused on this association among men and even fewer have examined racial disparities in loneliness and cognitive functioning among this group. The purpose of this study was to examine racial differences in the association between loneliness and cognitive functioning among men in the 2016 wave of the Health and Retirement Study (HRS). Methods This cross-sectional study included Black and White men who completed the core questionnaire and the Leave Behind Questionnaire (n=2227). Any cognitive impairment was the primary outcome and was measured by a dichotomous variable derived from a modified version of the Telephone Interview for Cognitive Status. Loneliness was the primary independent variable and was derived from the 3-item UCLA Loneliness Scale. Modified Poisson regression models with robust standard errors were estimated to generate prevalence ratios and corresponding 95% confidence intervals. Results Black men comprised 18.4% of the study sample; however, the proportion of this group with scores indicating cognitive impairment (35.9%) doubled the corresponding percentage of white men (17.6%). Findings from race-stratified modified Poisson regression models indicated that loneliness was associated with a higher prevalence of any cognitive impairment for White men (PR=1.24, CI:1.05-1.47), but not for Black men (PR=0.92, CI:0.73-1.16). Conclusions Our results underscore the complexity of race when investigating the association between loneliness and cognitive impairment among older men. Additional studies are needed to further examine how loneliness may have racially distinct implications for cognitive outcomes among the population.