Important for preventing but also living well with cognitive impairment – The associations between social relationships, well-being, and cognition in very old adults

Int Psychogeriatr. 2025 Jul 5:100109. doi: 10.1016/j.inpsyc.2025.100109. Online ahead of print.

ABSTRACT

OBJECTIVES: Social relationships are well-researched as protective factors against cognitive impairment, but their role for individuals experiencing cognitive impairment is less clear. The present study examined the associations between cognitive impairment, social relationships, and well-being in very old adults (80 + years), a high-risk group for cognitive impairment.

DESIGN: Using representative data from the Study on Quality of Life and Well-Being in North-Rhine Westphalia (NRW80+ Study), we analyzed three social factors (close network, leisure activity, loneliness) and two well-being measures (depressiveness, positive affect) across very old individuals with and without cognitive impairment. We also investigated whether cognitive impairment affected the associations between social factors and well-being.

SETTING: Computer-assisted interviews were conducted with target persons or proxies in private housing and care facilities.

PARTICIPANTS: The final sample included 1516 participants: 66.80 % without cognitive impairment, 15.00 % with mild impairment, and 18.20 % with major impairment.

MEASUREMENTS: Social and well-being measures were assessed through standardized interviews.

RESULTS: Cognitive impairment was associated with poorer social outcomes and lower well-being. Meanwhile, stronger social connections were linked to higher well-being. The associations were partially influenced by cognitive impairment. Notably, low leisure engagement was more strongly associated with increased depressiveness in individuals with major cognitive impairment than in those without (B = -0.53 [-0.83, -0.23], p < .001).

CONCLUSIONS: Our findings emphasize the importance of social integration in preserving well-being for individuals with cognitive impairment. As the incidence of cognitive impairment rises, future research should not only focus on prevention but also on improving the situation for those affected.

PMID:40619313 | DOI:10.1016/j.inpsyc.2025.100109