Elderly people in SG with larger social ties less likely to develop dementia
Most of older adults in Singapore maintain close relationships with family and/or relative and connect less with friends and neighbours, as reported in a recent study. However, having a larger social support network confers greater protection against the risk of developing dementia as compared with being in the family-dependent social support network type. Meanwhile, there is no significant association between social support network typology and depression.
“We infer from our findings that the social support network is not a good enough predictor for depression; rather, it is the older adults’ perception of the quality of social interaction that will influence the likelihood of depression,” according to the study authors.
“In this regard, future research is essential to measure the quality of social interaction and establish its associated factors in older adults in order to develop effective preventive measures against depression,” they added.
The current analysis included 2,421 older adults aged ≥60 years from the Well-being of the Singapore Elderly study, the majority of whom were women (57 percent), of Chinese ethnicity (82.6 percent) and currently married (65.4 percent). A total of 89.3 percent received some form of income (eg, salary, benefits, pensions or allowances), while 51.7 percent had one or two physical impairments.
Five social support network types emerged based on the Practitioner Assessment of Network Type, as follows: (1) the family-dependent social support network type (close family ties, little contact with friends/neighbours; 44.4 percent), (2) the locally integrated social support network type (close relationships with family/relatives/friends/neighbours, high involvement in religious/community activities; 27.1 percent), (3) the locally self-contained social support network type (arm’s-length relationships with family/relatives, little involvement in the community, relies primarily on neighbours; 4.6 percent), (4) the wider community-focused social support network type (absence of local family, active relationships with distant relatives, numerous friends, high community involvement; 0.8 percent) and (5) the private social support network type (absence of local family, little contact with neighbours/friends, low community involvement; 2.6 percent). [BMJ Open 2019;9:e025303]
Logistic regression analysis revealed dementia to be negatively associated with the locally integrated social support network type as opposed to the family dependent social support network type (odds ratio [OR], 0.34, 95 percent CI, 0.15–0.79). The brain disease was also negatively associated with Indian ethnicity and higher education level, but positively associated with older age (≥75 years), absence of income and disability. There were no dementia cases identified in the wider community-focused social support network type.
None of the social support network typologies was linked to depression. Depression and subsyndromal depression were positively associated with the Malay and Indian ethnicities, physical impairments and disability.
“We observed that the nature of social interaction among the older adults in Singapore was unlike other countries… [wherein seniors] mostly belonged to the locally integrated social network type,” the authors noted.
They pointed out that the disparity might be explained by cultural influences on support seeking, such that older adults might not be comfortable being close or divulging too much information to others apart from family members, resulting in generally minimal interaction with other people.
Furthermore, as Singapore has a small geographical size and convent transportation, older adults might not feel the need to maintain social relationships because they could easily get in touch and depend on family members for help and support in times of need.
“The social support network typology presents knowledge about the older adults’ social network profile and their cognitive functioning-ability which would help stakeholders better identify older adults who might be at risk of cognitive decline or experiencing delay in diagnosis of dementia,” the authors said.
“Appropriate interventions could then be implemented to ensure that the group of older adults will be cared for and promote the importance of social interaction among them,” they added.