Trajectories of social health, cognitive, and daily functioning in community-dwelling older adults

INTRODUCTION: Cognitive and functional impairments can both influence and stem from deteriorating social health). However, the interplay between these dimensions while aging remains poorly understood. This study investigated the concordance and discordance of SH, cognitive, and daily functioning trajectories.

METHODS: We analyzed 15-year follow-up data (2001-2015) from 2848 initially dementia-free older adults in the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Cognition and daily functioning were assessed with the MMSE and ADL/IADLs. Social health encompassed indices of social participation, connections, and support. Longitudinal trajectories across these five dimensions were identified using latent growth curve analysis, latent class growth analysis, and growth mixture models.

RESULTS: Two cognitive trajectories—relatively preserved (91%) and fast decline (9%)—and two daily functioning trajectories—stable (95%) and declining (5%)—were identified. For SH, alongside the stable groups, further subgroups included gradually declining social participation (70%) and low initial social connections (29%). Social support showed stable (95%), declining (2%), and increasing (3%) trajectories. Females were more likely to be in the initially low-stable social connections group, whereas higher education was linked to favorable trajectories across almost all dimensions but support. Membership in the lowest class for cognition, daily functioning, social connections and participation showed strong concordance. Yet, increasing social support was associated with low cognition but high daily functioning (pseudo-class’s OR 4.2, 95%CI 2.3–7.6).

DISCUSSION: Our findings highlight the crucial role of social health in influencing cognitive and daily functioning, offering new insights into the dynamic interplay between social participation, connections, and support in aging.