Family dysfunction and cognitive decline in aging: the “Health, Wellbeing, and Aging” (SABE) longitudinal population-based study

Silva, Diego Ferreira; Souza-Talarico, Juliana Nery; Santos, Jair Licio Ferreira; Duarte, Yeda Aparecida Oliveira

doi:10.1590/1980-5764-DN-2022-0109

Acessibilidade / Reportar erro

Brasil

Dementia & Neuropsychologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Dement. neuropsychol. 17 • 2023 • https://doi.org/10.1590/1980-5764-DN-2022-0109 copy

Family dysfunction and cognitive decline in aging: the “Health, Wellbeing, and Aging” (SABE) longitudinal population-based study

Disfunção familiar e declínio cognitivo no envelhecimento: estudo longitudinal populacional “Saúde, Bem-Estar e Envelhecimento” (SABE)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Stress during aging is not uncommon and dysfunctional family relationships are important sources of stress in the elderly. Considering the potential stressor that family dysfunction represents, it is questioned whether prolonged exposure to dysfunctional family arrangements can contribute to cognitive decline in aging.

Objective:

To verify whether family dysfunction is a predictive factor of cognitive decline in aging.

Methods:

Secondary study with analysis of existing data from the longitudinal, population-based study “Health, Wellbeing and Aging” (SABE). Data from 791 elderly people from two cohorts of the SABE study between 2006 and 2015 were analyzed. Family dysfunction was assessed using the Apgar family instrument, while cognitive performance was assessed using the Mini-Mental State Examination (MMSE), verbal fluency (animals) and digit length in reverse order. Cognitive decline was measured by the difference in scores in the period between 2006 and 2015.

Results:

Approximately 10% of the sample had family dysfunction. The familial Apgar score was not associated with decline on MMSE (p=0.732), verbal fluency (p=0.852) and digit span scores (p=0.718). Scores related to cognition and family functionality, such as age, education, living alone, depression and family Apgar, do not explain cognitive decline.

Conclusion:

The findings indicate that family functioning is not associated with cognitive decline in community-dwelling elderly. New studies will be needed to analyze the qualitative characteristics of family relationships in the cognitive performance of the elderly.

Keywords:
Family; Aging; Cognitive Dysfunction; Nursing

		SABE sample 2006 n=1,413		Current study sample n=793	Exclusion/missing n=620	p-value^* * p≤0.05 statistical significance;
		Mean (±SD) n (%)	Min–Max	Mean (±SD) n (%)	Mean (±SD) n (%)	p-value^* * p≤0.05 statistical significance;
Age (years)		69.1	60–97	69.2	69.0	0.207^† † student t-test;
Education (years)		4.7	0–17	4.97	4.64	0.063^† † student t-test;
Gender (% female)		55.6	--	55.4	66.7	0.004^‡ ‡ chi-square.
Race (%)
	White	64.6	--	64.2	65.4	0.663^‡ ‡ chi-square.
	Brown	19.1	--	20.2	16.3
	Black	6.62	--	6.27	7.48
	Indigenous	0.57	--	0.62	0.45
	Yellow	3.05	--	3.13	2.87
	Not reported	6.03	--	5.48	7.40
Marital status (%)
	Divorced	2.26	--	1.67	3.71	0.105^‡ ‡ chi-square.
	Separated	5.50	--	5.96	4.38
	Widow(er)	27.9	--	25.8	33.2
	Married	55.6	--	57.5	50.8
	Cohabiting	4.44	--	4.33	4.70
	Single	4.13	--	4.54	3.12
	No response given	0.11	--	0.16	0.00
Income (%)
	No income	5.08	--	5.58	4.02	0.770^‡ ‡ chi-square.
	≤1 minimum wage	20.8	--	17.7	27.4
	1–2 minimum wages	24.7	--	27.0	19.9
	2–3 minimum wages	16.6	--	16.9	15.9
	3–5 minimum wages	17.1	--	17.5	16.2
	>5 minimum wages	15.6	--	15.2	16.4
	Retired (% yes)	730 (72.0)	--	522 (71.2)	208 (74.0)
Self-rated health
	Hypertension (% yes)	62.1	--	62.9	60.1	0.482^‡ ‡ chi-square.
	Heart disease (% yes)	21.1	--	22.4	17.9	0.160^‡ ‡ chi-square.
	Diabetes (% yes)	20.4	--	20.5	20.2	0.925^‡ ‡ chi-square.
	COPD (% yes)	11.9	--	12.2	11.2	0.692^‡ ‡ chi-square.
	Cerebrovascular stroke (% yes)	5.81	--	7.08	2.65	0.005^‡ ‡ chi-square.
	Use of medication (% yes)	90.4	--	91.3	88.1	0.254^‡ ‡ chi-square.
	Smoker (% yes)	48.4	--	52.4	39.3	0.176^‡ ‡ chi-square.
	Alcohol misuse (% yes)	1.42	--	1.85	0.35	0.087^‡ ‡ chi-square.
	Body mass index	26.7	15–51	26.4	27.3	0.080^‡ ‡ chi-square.
	Geriatric Depression Scale (GDS)	2.39	0–15	2.28	2.35	0.574^‡ ‡ chi-square.
Frailty
	Non-frail	54.9		52.9	59.8	0.152^‡ ‡ chi-square.
	Pre-frail	40.4		42.4	35.7
	Frail	4.58		4.63	4.47
Self-rated health (% yes)
	Excellent	47.9	--	46.4	51.7	0.263^‡ ‡ chi-square.
	Fair	45.0	--	45.7	43.1
	Poor	6.99	--	7.73	5.18
	Mini-mental state examination	26.1	21–30	26.0	26.3	0.100^† † student t-test;
	Verbal fluency (animals)	12.	1–29	12.1	12.2	0.995^† † student t-test;
	Backward digit span	4.1	0–5	4.1	4.3	0.085^† † student t-test;
	Number of people living with respondent	2.99	1–14	3.00	2.97	0.864^† † student t-test;
	Living alone (% yes)	100	--	86.9	13.4	0.888^‡ ‡ chi-square.
	Family apgar (score)	17.5	0–20	17.4	17.9	0.616^† † student t-test;
	Family dysfunction (% yes)	10.1	--	10.4	9.32	0.166^‡ ‡ chi-square.

Variables	MMSE (n=319)			Verbal fluency (n=568)			Digit span (n=330)
Variables	OR	p	95%CI Min–Max	OR	p	95%CI Min–Max.	OR	p	95%CI Min–Max.
Age	1.01	0.515	0.970–1.060	0.98	0.139	0.956–1.006	1.00	0.955	0.961–1.041
Education	1.04	0.199	0.976–1.116	1.05	0.034	1.004–1.117	1.02	0.536	0.953–1.094
Living alone	0.74	0.425	0.360–1.543	1.087	0.739	0.660–1.790	0.96	0.922	0.444–2.086
GDS score	0.96	0.4494	0.882–1.063	0.962	0.362	0.884–0.046	1.02	0.709	0.931–1.109
Apgar score	0.97	0.502	0.922–1.040	0.961	0.124	0.913–1.011	1.04	0.079	0.994–1.106

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Juliana Nery Souza-Talarico; Email: juliana-desouzatalarico@uiowa.edu.