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ObjectiveThis study aims to elucidate the heterogeneous cognitive trajectories among older adults in China through a comprehensive, nationally representative longitudinal study. Furthermore, it seeks to investigate the impact of multidimensional social isolation on heterogeneous cognitive trajectories among older adults in China.MethodsUtilizing data from three successive waves of the Chinese Longitudinal Aging Social Survey (CLASS) spanning 2016 to 2020, this investigation quantified baseline social isolation across three dimensions—family isolation, friend isolation, and subjective isolation—alongside cognitive function scores of older adults, measured across all three waves. Through latent class growth models, heterogeneous cognitive trajectories were delineated. The influence of family isolation, friend isolation, and subjective isolation on these cognitive trajectories was examined employing multinomial logistic regression analysis.ResultsThe study included 6,378 participants aged 60 and above, revealing three primary cognitive trajectories: High baseline stable group (68.8%), High baseline but declining group (21.7%), and Low baseline deteriorating group (9.5%). Adjusting for variables such as personal physical characteristics, social networks, living and working conditions, and the surrounding policy environment, the findings indicated that family isolation did not significantly affect cognitive function’s high-level decline or low-level deterioration. Conversely, friend isolation markedly increased the risk of high-level cognitive decline (OR = 1.289) and low-level cognitive deterioration (OR = 1.592). Similarly, subjective isolation significantly heightened the risk for both high-level decline (OR = 1.254) and low-level deterioration (OR = 1.29) in cognitive function.ConclusionMitigating friend and subjective isolation among older adults appears to be a more effective strategy in preventing or delaying cognitive decline, potentially reducing the strain on healthcare and social welfare systems.

Loneliness is recognised as a 'grand challenge' for social work, given its negative impact on health and well-being. But there has been limited progress on how social workers should respond. We aimed to characterise social work research on loneliness from 2016 to 2021, to inform policy, practice and training. We utilised the Joanna Briggs Institute methodology for scoping reviews with a narrative synthesis of results. Data were extracted on study characteristics, assessment and intervention strategies, the role of social workers in this literature and limitations in the research. The final review consisted of 366 studies. Results showed a steady growth in research outputs on loneliness over time, predominantly (40 per cent) aimed at improving social work practice. Qualitative research methods (45 per cent) and cross-sectional study designs (61 per cent) were most common. Fewer than one-third of studies (32 per cent) used a formal assessment tool to identify loneliness. The most common intervention strategies examined were enhancing social relationships (30 per cent) and person-centred solutions (21 per cent). A slight majority (57 per cent) of peer-reviewed journal articles had a social work lead author. The review indicates social workers are engaged in research and action on loneliness, but ensuring this expertise is visible, led by social workers and accessible, remains a challenge. [ABSTRACT FROM AUTHOR]

Objectives Social isolation and loneliness are two different aspects of social connections. Whether social isolation and loneliness precede depressive symptoms, or depressive symptoms precede feelings of loneliness and social isolation, or both, has not been fully established. This study aims to examine the possible reciprocity in the relationship between the two aspects of social connections and depressive symptoms among middle-aged and older adults. Method This study analyzed four waves of data (2008–2016) from the Health and Retirement Study (N = 5,393 individuals) and investigated within-person level cross-lagged associations of social isolation and loneliness with depressive symptoms using random intercept cross-lagged panel models. Results This study revealed a unidirectional relationship between social isolation and depressive symptoms and a bidirectional relationship between loneliness and depressive symptoms at the within-person level. Specifically, net of trait levels and prior states, earlier state depressive symptoms predicted future state social isolation. That is, when adults feel depressed more frequently than they usually do, they are more likely to be socially disconnected than usual at a later time. In the reverse direction, earlier state social isolation did not predict future state depressive symptoms. Within-person deviation in prior expected depressive symptoms predicted deviation in expected loneliness 4 years later and vice versa. Moreover, the strength of the two cross-lagged effects did not differ. Discussion Social isolation and loneliness are linked to depressive symptoms differently. Though depressive symptoms might be a potential antecedent of social isolation, they might be both a potential antecedent and an outcome of loneliness. [ABSTRACT FROM AUTHOR]

Objective: This study aims to elucidate the heterogeneous cognitive trajectories among older adults in China through a comprehensive, nationally representative longitudinal study. Furthermore, it seeks to investigate the impact of multidimensional social isolation on heterogeneous cognitive trajectories among older adults in China., Methods: Utilizing data from three successive waves of the Chinese Longitudinal Aging Social Survey (CLASS) spanning 2016 to 2020, this investigation quantified baseline social isolation across three dimensions-family isolation, friend isolation, and subjective isolation-alongside cognitive function scores of older adults, measured across all three waves. Through latent class growth models, heterogeneous cognitive trajectories were delineated. The influence of family isolation, friend isolation, and subjective isolation on these cognitive trajectories was examined employing multinomial logistic regression analysis., Results: The study included 6,378 participants aged 60 and above, revealing three primary cognitive trajectories: High baseline stable group (68.8%), High baseline but declining group (21.7%), and Low baseline deteriorating group (9.5%). Adjusting for variables such as personal physical characteristics, social networks, living and working conditions, and the surrounding policy environment, the findings indicated that family isolation did not significantly affect cognitive function's high-level decline or low-level deterioration. Conversely, friend isolation markedly increased the risk of high-level cognitive decline (OR = 1.289) and low-level cognitive deterioration (OR = 1.592). Similarly, subjective isolation significantly heightened the risk for both high-level decline (OR = 1.254) and low-level deterioration (OR = 1.29) in cognitive function., Conclusion: Mitigating friend and subjective isolation among older adults appears to be a more effective strategy in preventing or delaying cognitive decline, potentially reducing the strain on healthcare and social welfare systems., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Lyu, Wu, Zong, Zhuang and Xu.)