Impact of a Cognitive Decline on Older Adults' Informal Social Contact: Evidence from Korean Longitudinal Study of Ageing

Background and Purpose: Although Alzheimer’s disease is the sixth cause of death and dementia is affecting more than 5 million older adults in the U.S., few studies have examined the longitudinal effects of a cognitive decline on older adults’ social functioning. This study examined: (1) the longitudinal effects of a cognitive decline on older adults’ informal social contact and (2) the extent to which the effects of a cognitive decline on older adults’ social contact differ by the level of educational attainment.

Methods: Our data are from the 2006 (Time 1; T1) and 2010 (Time 2; T2) waves of Korean Longitudinal Study of Ageing (KLoSA). The level of cognitive functioning was assessed with the Korean version of the Mini-Mental Status Exam (MMSE-K). A participant with an MMSE score of 24 or above was considered as having a normal cognitive functioning (Group 1), a score of 18-23 as having a mild cognitive impairment (Group 2), and a score of 17 or less as having serious cognitive problems (Group 3). The analytic sample includes only those who showed normal cognitive functioning at T1. We examined how transitioning from Group 1 at T1 to either Group 2 or 3 at T2 influenced older adults’ informal social contact at T2, controlling for social contact at T1. Informal social contact was measured by the frequency of contacts with friends, relatives, or neighbors. Also we examined whether educational attainment of participants moderated the effect of a cognitive decline.

Results: The study showed that both groups with a mild cognitive impairment and serious cognitive problems showed lower levels of informal social contact compared to those who maintained normal cognitive functioning. The negative effect of a severe cognitive decline (Group 1 to Group 3) on informal social contact was significantly moderated by educational attainment. Older adults with education attainment equal to or above high school education were more negatively affected by the severe cognitive decline than those with lower educational attainment.

Conclusions and Implications: The findings suggest that older adults’ interactions with their close social networks, which are important determinants of older adults’ health and well-being, can be significantly harmed by their cognitive decline. It is particularly alarming that such negative effect of a cognitive decline is more pronounced among older adults with higher educational attainment. Developing social service programs that help older adults maintain their social relationships despite their cognitive impairments will be essential in order to address the needs of a growing population with dementia.