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Objective: To evaluate the relationship between loneliness and cognitive functioning, and whether depressive and anxiety symptoms have intermediate roles therein. Methods: Information about 7,433 participants of the Irish Longitudinal Study on Ageing (a prospective, representative cohort study), aged over 50, was collected at three time-points two years apart, and analysed using Structural Equation Modelling to assess whether depressive and anxiety symptoms mediate the relationship between loneliness and cognitive functioning. Cognitive functioning was measured as a latent factor, with four indicators: measures of immediate and delayed word recall, verbal fluency, and a global measure (the MMSE). Loneliness was measured using the UCLA Loneliness scale, depressive symptoms using the CES-D-ML scale, and anxiety symptoms using the HADS-A scale. Results: Loneliness at time-point 1 predicted cognitive functioning at time-point 3, β = −0.103, p < 0.001, and depressive (β = 0.426, p < 0.001) and anxiety (β = 0.410, p < 0.001) symptoms at time-point 2. Depressive (β = −0.020, p = 0.001) but not anxiety (β = −0.000, p = 0.658) symptoms mediated the relationship between loneliness and cognitive functioning, total effect: β = −0.123, p < 0.001. Conclusion: The relationship between loneliness and cognitive functioning is in part explained by its relationship with depressive symptoms. Statistically, the mediation model helps us understand possible mechanisms through which loneliness impacts cognitive functioning. Results have implications for cognitive functioning interventions for older adults, and imply that loneliness is also a worthwhile target for intervention. [ABSTRACT FROM AUTHOR]

Based on biologically plausible mechanisms and previous research, it is possible to hypothesize a reciprocal association between sustained attention and loneliness. We investigated this association using a cross-lagged modeling approach. Using data from 6,239 participants aged over 50 in TILDA, a nationally representative study of aging, we used structural equation models to investigate potential cross-lagged associations between sustained attention and loneliness, measured at baseline and again after four years. Sustained attention at baseline had a small association with loneliness four years later, but loneliness at baseline was not associated with sustained attention at follow-up. Auto-regressive associations were strong for both loneliness over time and sustained attention over time. Sustained attention may account for a small proportion of the variance in loneliness over time among older adults, and may constitute a risk factor in the development of loneliness. Implications for the identification of at-risk individuals and the prevention of loneliness are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Loneliness may have different cultural meanings in different countries. This may manifest as differing levels of Social Asymmetry-the discrepancy between loneliness and social isolation. Since loneliness is thought to be low in Sweden relative to more southerly countries, we hypothesised that more number of individuals would also fall into the "discordant robust" category of Social Asymmetry, i.e. that more individuals in Sweden would have lower loneliness levels relative to social isolation than in Ireland. We also explored the clinical relevance of Social Asymmetry in both countries, by examining its association with cognitive functioning.Methods: We derived Social Asymmetry metrics in two representative cohort studies: the Irish Longitudinal Study on Ageing (TILDA) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Data pertaining to a dementia-free sample of 4565 Irish participants and 3042 Swedish participants, all aged over 60 years, were analysed using a multilevel modelling approach, with country as a higher-order variable.Results: Contrary to the expected, more individuals in Ireland were "discordant robust" than in Sweden. We also found evidence for superior performance in global cognitive functioning among those in the "discordant robust" category relative to those in the discordant susceptible (i.e. those with higher levels of loneliness than social isolation) category, β = 0.61, p < .001, across both countries.Conclusions: Irish older adults may be more robust to the impact of social isolation on loneliness than those in the Swedish cohort. Social Asymmetry was related to cognitive functioning in both countries, suggesting that Social Asymmetry is a clinically relevant construct. [ABSTRACT FROM AUTHOR]

Objective to examine the associations of cardiovascular disease (CVD) and cardiovascular risk factors with frailty. Design a cross-sectional study. Setting the Irish Longitudinal Study on Ageing (TILDA). Participants frailty measures were obtained on 5,618 participants and a subset of 4,330 participants with no prior history of CVD. Exposures for observational study cardiovascular risk factors were combined in three composite CVD risk scores (Systematic Coronary Risk Evaluation [SCORE], Ideal Cardiovascular Health [ICH] and Cardiovascular Health Metrics [CHM]). Main outcome measures a frailty index (40-items) was used to screen for frailty. Methods the associations of CVD risk factors with frailty were examined using logistic regression. Results overall, 16.4% of participants had frailty (7.6% at 50–59 years to 42.5% at 80+ years), and the prevalence was higher in those with versus those without prior CVD (43.0% vs. 10.7%). Among those without prior CVD, mean levels of CVD risk factors were closely correlated with higher frailty index scores. Combined CVD risk factors, assessed using SCORE, were linearly and positively associated with frailty. Compared to low-to-moderate SCOREs, the odds ratio (OR) (95% confidence interval, CI) of frailty for those with very high risk was 3.18 (2.38–4.25). Conversely, ICH was linearly and inversely associated with frailty, with an OR for optimal health of 0.29 (0.21–0.40) compared with inadequate health. Conclusions the concordant positive associations of SCORE and inverse associations of ICH and CHM with frailty highlight the potential importance of optimum levels of CVD risk factors for prevention of disability in frail older people. [ABSTRACT FROM AUTHOR]

Objective: Evidence points to an association between social and leisure activity (SLA) engagement and cognitive outcomes, but the mechanisms underlying this link remain unknown. We aimed to investigate three potential mechanisms: Vascular function, Perceived Stress, and Cognitive Reserve. Methods: With data from 8163 adults aged over 50 in the Irish Longitudinal Study of Ageing, we used a structural equation model to evaluate Vascular Function and Perceived Stress as potential mediators, and Cognitive Reserve as a potential antecedent in the relationship between SLA at baseline (2009), and cognitive outcomes collected at a two-year follow-up point (2011). Results: Cognitive Reserve was strongly associated both with cognitive outcomes (β = 0.306; p < 0.001) and with SLA (β = 0.694; p < 0.001). Perceived stress (β = 0.018) acted as a significant mediator in the relationships between SLA and cognitive outcomes (p < 0.001), although Vascular Function did not (β = 0.000). Conclusion: These results indicate that SLA may protect cognitive function partly because of its association with cognitive reserve, and partly through its impact on perceived stress. Results have policy implications for those interested in facilitating SLA to protect cognitive outcomes among older adults. [ABSTRACT FROM AUTHOR]