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Title: Loneliness interacts with family relationship in relation to cognitive function in Chinese older adults
Authors: Fung, AWT 
Lee, ATC
Cheng, ST
Lam, LCW
Issue Date: Apr-2019
Source: International psychogeriatrics, Apr. 2019, v. 31, no. 4, p. 467-475
Abstract: Objectives: Loneliness and social networks have been extensively studied in relation to cognitive impairments, but how they interact with each other in relation to cognition is still unclear. This study aimed at exploring the interaction of loneliness and various types of social networks in relation to cognition in older adults.
Design: a cross-sectional study.
Setting: face-to-face interview.
Participants: 497 older adults with normal global cognition were interviewed.
Measurements: Loneliness was assessed with Chinese 6-item De Jong Gierverg's Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders.
Results: Significant interaction was found between loneliness and non-confiding network on cognitive performance (B =.002, β =.092, t = 2.099, p =.036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B =.021, β =.119, t = 2.775, p =.006).
Conclusions: Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.
Keywords: Close tie
Cognitive impairment
Confidante relationships
Dementia
Family estrangement
Loneliness
Older adults
Social network
Publisher: Cambridge University Press
Journal: International psychogeriatrics 
ISSN: 1041-6102
EISSN: 1741-203X
DOI: 10.1017/S1041610218001333
Rights: This article has been published in a revised form in International Psychogeriatrics http://doi.org/10.1017/S1041610218001333. This version is free to view and download for private research and study only. Not for re-distribution or re-use. © International Psychogeriatric Association 2018
When citing an Accepted Manuscript or an earlier version of an article, the Cambridge University Press requests that readers also cite the Version of Record with a DOI link. The article is subsequently published in revised form in International Psychogeriatrics https://dx.doi.org/10.1017/S1041610218001333
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