The Association Between Social Isolation and Memory Loss Among Older Adults

David M. Mosen; Matthew P. Banegas; Erin M. Keast; Briar L. Ertz-Berger

doi:10.3122/jabfm.2022.AP.210497

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Table 1.

Population Characteristics of Study Population¹

	Social Isolation
	Never/Rarely	Sometimes	Often/Always	All
	n = 36048 (78.0%)	n = 7791 (16.8%)	n = 2401 (5.2%)	n = 46240 (100.0%)
	mean ± SD, N (%)	Mean ± SD, N (%)	Mean ± SD, N (%)	Mean ± SD, N (%)
Age (mean, standard deviation)	73.1 ± 7.8	73.6 ± 9.1	73.0 ± 10.6	73.2 ± 8.2
Female	19474 (54.0)	4918 (63.1)	1587 (66.1)	25979 (56.2)
Race/Ethnicity
White	32709 (90.7)	6945 (89.1)	2136 (89.0)	41790 (90.4)
Black/African-American	478 (1.3)	132 (1.7)	38 (1.6)	648 (1.4)
Hispanic/Latinx	786 (2.2)	223 (2.9)	83 (3.5)	1092 (2.4)
Asian-American	820 (2.3)	165 (2.1)	36 (1.5)	1021 (2.2)
Native American/Alaska Native	47 (0.1)	10 (0.1)	7 (0.3)	64 (0.1)
Hawaiian / Pacific Islander	37 (0.1)	11 (0.1)	3 (0.1)	51 (0.1)
More than one race	991 (2.8)	254 (3.3)	81 (3.4)	1326 (2.9)
Unknown/other	180 (0.5)	51 (0.7)	17 (0.7)	248 (0.5)
Area Deprivation Index (ADI)
1 to 3 (least disadvantaged)	13683 (38.0)	2613 (33.5)	725 (30.2)	17021 (36.8)
4 to 6	12190 (33.8)	2618 (33.6)	799 (33.3)	15607 (33.8)
7 to 10 (most disadvantaged)	9591 (26.6)	2442 (31.3)	847 (35.3)	12880 (27.9)
Unknown	584 (1.6)	118 (1.5)	30 (1.3)	732 (1.6)
Charlson Comorbidity Index (CCI)
0	19066 (52.9)	3504 (45.0)	858 (35.7)	23428 (50.7)
1	5510 (15.3)	1241 (15.9)	412 (17.2)	7163 (15.5)
2+	11472 (31.8)	3046 (39.1)	1131 (47.1)	15649 (33.8)
1+ hospital admissions	3717 (10.3)	1141 (14.6)	500 (20.8)	5358 (11.6)
1+ ED visits	6921 (19.2)	2144 (27.5)	945 (39.4)	10010 (21.6)
1+ primary care visits	28342 (78.6)	6438 (82.6)	2070 (86.2)	36850 (79.7)
COVID-19 Era
2/28/13- 2/28/20: Before Pandemic Era	34102 (94.6)	7196 (92.4)	2173 (90.5)	43471 (94.0)
3/1/2020 – 2/28/21: During Pandemic Era	1946 (5.4)	595 (7.6)	228 (9.5)	2769 (6.0)

Abbreviations: ED, Emergency department; SD, Standard deviation.
↵1 Results based on 46,240 Medicare members (aged 65 years or older) of Kaiser Permanente Northwest (KPNW) who completed an index Medicare Total Health Assessment (MTHA) survey between March 1, 2013, and February 28, 2021, (8 years) and had KPNW insurance in the 12 months before survey completion.

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Table 2.

Logistic Regression Results: Association of Social Isolation with Memory Loss. Unadjusted and Adjusted for Covariates

	Memory Loss (vs. no Memory Loss)
Total Population (Unadjusted for Study Covariates)¹^,²	OR (Unadjusted)	95% CI		p-value
Social Isolation
Never/Rarely	Reference
Sometimes	*2.56*	*2.42*	*2.70*	*0.0076*
Often/Always	*5.50*	*5.06*	*5.99*	*<0.0001*

Total Population (Adjusted for Study Covariates)¹^,³^,⁴	Memory Loss (vs. no Memory Loss)
Total Population (Adjusted for Study Covariates)¹^,³^,⁴	OR (Adjusted)¹	95% CI		p-value
Social Isolation
Never/Rarely	Reference
Sometimes	*2.45*	*2.32*	*2.60*	*0.0298*
Often/Always	*5.20*	*4.75*	*5.68*	*<0.0001*

Abbreviations: ED, Emergency department; SD, Standard deviation; OR, Odds ratio; CI, Confidence interval.
↵1 Results based on 46,240 Medicare members (aged 65 years or older) of Kaiser Permanente Northwest (KPNW) who completed an index MTHA survey between March 1, 2013, and February 28, 2021, (8 years) and had KPNW insurance in the 12 months before survey completion. Significant results are displayed in bold, italicized font.
↵2 ROC (Area Under the Curve, unadjusted for study covariates) = 0.615.
↵3 Model adjusted for age, sex, race/ethnicity, Area Deprivation Index (ADI), Charlson Comorbidity Index (CCI), prior hospital admissions, ED visits, primary care visits and COVID-19 Era.
↵4 ROC (Area Under the Curve, adjusted for study covariates) = 0.696.