Association of Family Support With Lower Modifiable Risk Factors for Dementia Among Cognitively Impaired Older Adults.

• What is the primary question addressed by this study? Are varying levels of access to family support, measured based on spousal presence and residential proximity to children, associated with key modifiable risk factors for dementia, among older adults with cognitive impairment? • What is the main finding of this study? In this longitudinal study of Americans aged 50 and older who were living with cognitive impairment, those with limited family support, characterized by distant children and no spouse, displayed a significantly higher percentage of smoking, depressive symptoms, and social isolation. Importantly, a consistent gradient relationship was observed, showing that as family support became more distant, the percentage of dementia risk factors increased. • What is the meaning of the finding? Policies that support family caregivers and encourage the maintenance of close family ties and social support should be promoted to improve the health and well-being of this vulnerable population with cognitive impairment. Cognitive impairment poses considerable challenges among older adults, with the role of family support becoming increasingly crucial. This study examines the association of children's residential proximity and spousal presence with key modifiable risk factors for dementia in cognitively impaired older adults. We analyzed 14,600 individuals (35,165 observations) aged 50 and older with cognitive impairment from the Health and Retirement Study (1995–2018). Family support was categorized by spousal presence and children's residential proximity. Modifiable risk factors, including smoking, depressive symptoms, and social isolation, were assessed. Associations between family support and the modifiable risk factors were determined using mixed-effects logistic regressions. A significant proportion of older adults with cognitive impairment lacked access to family support, with either no spouse (46.9%) or all children living over 10 miles away (25.3%). Those with less available family support, characterized by distant-residing children and the absence of a spouse, had a significantly higher percentage of smoking, depressive symptoms, and social isolation. Moreover, we revealed a consistent gradient in the percentage of the risk factors by the degree of family support. Relative to older adults with a spouse and co-resident children, those without a spouse and with all children residing further than 10 miles displayed the highest percentage of the risk factors. These findings were robust to various sensitivity analyses. Family support from spouses and nearby children serves as a protective factor against modifiable dementia risk factors in cognitively impaired older adults. Policies that strengthen family and social support may benefit this population. [ABSTRACT FROM AUTHOR]