Longitudinal Associations of Social Isolation, Systemic Inflammation, and Cognitive Function Among Older Adults With Diabetes: Cross-Lagged Examination.

Abstract

Purpose: The purpose of the study was to examine the cross-lagged longitudinal associations between social isolation and cognitive function among older adults with diabetes and to investigate the mediating role of systemic inflammation in these associations.

Methods: Secondary data from the Health and Retirement Study were utilized across 3 waves (2006, 2010, and 2014). To examine the longitudinal relationships between social isolation and cognitive function, a cross-lagged panel modeling approach was employed, with particular attention to the mediating role of C-reactive protein. A sequential predictor procedure was used; initially, only social isolation and cognitive function were analyzed; subsequently, sociodemographic covariates were controlled for; and finally, health-related covariates were added.

Results: Data from 1336 older adults with diabetes in the United States were analyzed. In the partially adjusted model, reciprocal negative associations between social isolation and cognitive function were identified. However, these reciprocal negative associations were no longer statistically significant after accounting for health-related covariates. C-reactive protein did not serve as a mediator in the link between social isolation and cognitive function regardless of adjustments for covariates.

Conclusion: Given the reciprocal associations between social isolation and poorer cognitive function, a feedback loop may exist between these 2 factors. It is crucial to identify mediating mechanisms to disrupt this vicious cycle.