A Study On The Correlation Between Social Isolation,Ability Of Daily Living Activities And Cognitive Weakness In The Elderly In Community

Objective:To study the current situation and influential factors of cognitive frailty in community aged people,and to analyze the relationship between cognitive frailty,social isolation,and the ability to carry out everyday activities,Apart from the mediating role of the ability to carry out everyday activities in the period of social isolation and cognitive frailty,as well as the effect of the combined interaction of social isolation and the ability to perform activities of daily living on cognitive frailty among the elderly in community.Try to find an effective way to reduce the incidence of cognitive frailty of the elderly in the community,and provide theoretical basis and guidance for the elderly care in the community.To study the current situation and influential factors of cognitive weakness in community aged people,and to analyze the relationship between cognitive weakness,social isolation and the ability to carry out everyday activities.And to explore the mediating role of the ability to perform daily life activities between social isolation and cognitive frailty,as well as the effect of the combined interaction of Social isolation and daily life skills on cognitive weakness of older people in the community.Try to find an effective method to reduce the incidence of cognitive weakness among older people,and provide theoretical basis and guidance for the elderly care in the community.Methods:A total of 260 elderly people from five communities in Shandong Province were selected by convenience sampling method from February 2022 to July 2022.The General Information Questionnaire,Fragile Phenotype,Montreal Cognitive Assessment Scale,the Clinical Dementia Rating Scale,the Berkman Social Network Index,and the Ability to Perform Activities of Daily Living Scale.Excel 2021,SPSS 26.0 and Mplus 8.0 and R were used for data analysis.Descriptive analysis,T test,Chi-Square test,Logistic regression analysis,and so on were used general data such as frequency,component ratio,mean and standard difference.The mediating effect of ADL on social isolation and CF was tested by Z test.The additive interaction between social isolation and activities of daily living on the elderly in the community was analyzed using R software to calculate the excess risk of interaction（RERI）,attributable proportion（AP）and interaction index（S）.Results:1.In this study,there were 49 cases of social isolation（18.8%）,154 cases of impaired ability of daily living activities（59.2%）,25 cases of cognitive decline,and the incidence of cognitive decline of the elderly in the community was 9.6%.2.Univariate analysis showed that social isolation and impaired ability of daily living accounted for a larger proportion of elderly CF patients in the community.Among the elderly in the community,older,female,less educated,and more chronic diseases had a higher probability of cognitive decline（P<0.05）.No statistically significant difference was found in residence and monthly income between the elderly with cognitive frailty and those without（P>0.05）.3.Multiple Logistic Regression Analysis Reveals Social Isolation（OR=2.10,P<0.001）and the ability of daily living activities（OR=4.72,P<0.05）could lead to the occurrence of cognitive decline in the elderly in the community.Older people with social isolation were more likely to have reduced ability to perform daily activities.（OR=0.31,P<0.001）.Education level,marriage,the number of chronic diseases are also significant factors affecting the cognitive decline of the elderly community.4.The mediating effect analysis showed that social isolation was closely related to cognitive decline(c^std=0.65,P<0.001).When the relationship between social isolation and cognitive frailty was incorporated into the ability to do activities of daily living,the corresponding standardized regression coefficient of social isolation on cognitive frailty decreased,but the relationship was still significant(c’^std=0.389,P<0.001),and the relationship between social isolation and the ability to do activities of daily living was significant(a^std=-0.54,P<0.001).The relationship between the ability to perform activities of daily living and cognitive decline was significant(b^std=-0.42,P<0.001).The Z-test showed that the ability to perform activities of daily living had a significant mediating effect between social isolation and cognitive decline（z=2.80,P<0.001）.5.According to the analysis of additive interaction,the OR value of cognitive decline of the elderly in the community with only social isolation was 7.25（P<0.001）,and that of the elderly in the community with only ADL impairment was 3.56（P<0.05）.The OR value of cognitive decline in community elderly with social isolation and ADL impairment was21.28（P<0.01）.The results showed that RERI=27.25（13.95,54.11）,AP=9.80（6.94,23.68）,S=0.13（0.02,0.23）,which proved that the additive interaction of social isolation and the ability of daily living activities on cognitive decline was valid.Conclusions:1.The incidence of cognitive frailty among the elderly in the community is high.Age,marital status,educational attainment and number of chronic diseases are the factors affecting cognitive frailty among the elderly in the community.2.The social isolation of the elderly in the community is significantly correlated with cognitive decline,and the elderly with a high degree of social isolation are more likely to suffer from cognitive decline.3.The ability of daily living activities has a significant mediating effect between social isolation and cognitive decline of the elderly in community.4.The social isolation of the elderly in the community and the ability of daily living activities have a additive interaction effect on cognitive decline.