Association of Social Support with Mild Cognitive Impairment and Dementia Among Older Women: The Women’s Health Initiative Memory Study

Article type: Research Article

Authors: Posis, Alexander Ivan B.^{a; b; *} | Yarish, Natalie M.^c | McEvoy, Linda K.^{a; d} | Jain, Purva^{a; b} | Kroenke, Candyce H.^e | Saquib, Nazmus^f | Ikramuddin, Farha^g | Schnatz, Peter F.^{h; i} | Bellettiere, John^a | Rapp, Stephen R.^j | Espeland, Mark A.^k | Shadyab, Aladdin H.^a

Affiliations: [a] Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA | [b] School of Public Health, San Diego State University, San Diego, CA, USA | [c] School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA | [d] Department of Radiology, University of California, San Diego, La Jolla, CA, USA | [e] Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA | [f] Department of Epidemiology, College of Medicine at Sulaiman, Al Rajhi University, Saudi Arabia | [g] Division of Physical Medicine and Rehabilitation, Department of Rehabilitation Medicine, Medical School, University of Minnesota, MN, USA | [h] Reading Hospital/Tower Health, West Reading, PA, USA | [i] Drexel University, Philadelphia, PA, USA | [j] Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA | [k] Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA

Correspondence: [*] Correspondence to: Alexander Ivan B. Posis, MPH, 9500 Gilman Drive, University of California, San Diego, La Jolla, CA, USA. Tel.: +1 858 534 2230; E-mail: [email protected].

Abstract: Background:Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and dementia. Objective:To examine associations of perceived social support with incident MCI and dementia among community-dwelling older women. Methods:This prospective cohort study included 6,670 women from the Women’s Health Initiative Memory Study who were cognitively unimpaired at enrollment. We used Cox proportional hazards models to assess associations between perceived social support with incident MCI, dementia, or either MCI/dementia during an average 10.7 (SD = 6.1)-year follow-up. Modelling was repeated for emotional/information support, affection support, tangible support, and positive social interaction subscales of social support. Results:Among 6,670 women (average age = 70 years [SD = 3.8]; 97.0% non-Hispanic/Latina; 89.8% White), greater perceived social support was associated with lower risk of MCI/dementia after adjustment for age, ethnicity, race, hormone therapy, education, income, diabetes, hypertension, and body mass index (Tertile [T]3 versus T1: HR = 0.85, 95% CI 0.74–0.99; ptrend = 0.08). Associations were significant for emotional/information support (T3 versus T1: HR = 0.84, 95% CI 0.72–0.97; ptrend = 0.04) and positive social interaction (T3 versus T1: HR = 0.85, 95% CI 0.73–0.99; ptrend = 0.06) subscales. Associations were attenuated and not significant after adjustment for depressive symptom severity. Objective:Perceived social support, emotional/information support, and positive social interaction were associated with incident MCI/dementia among older women. Results were not significant after adjustment for depressive symptom severity. Improving social support may reduce risk of MCI and dementia in older women.

Keywords: Cognitive aging, epidemiology, psychosocial, women’s health

DOI: 10.3233/JAD-220967

Journal: Journal of Alzheimer's Disease, vol. 91, no. 3, pp. 1107-1119, 2023