Living Alone during Old Age and the Risk of Dementia: Assessing the Cumulative Risk of Living Alone

Authors

Benjamin A. Shaw, University of Illinois ChicagoFollow
Tse-Chuan Yang, University at Albany, State University of New YorkFollow
Seulki Kim, University of Nebraska-LincolnFollow

Document Type

Article

Date of this Version

2023

Citation

Journals of Gerontology: Social Sciences 78:2 (2023), pp. 293–301.

doi: 10.1093/geronb/gbac156

Comments

Copyright © 2022 Benjamin A. Shaw, Tse-Chuan Yang, and Seulki Kim. Published by Oxford University Press on behalf of the Gerontological Society of America. Used by permission.

Abstract

Objectives: This study examines the association between living alone during old age and dementia. Whereas most previous studies on this topic utilize measures of living alone status that were obtained at a single point in time, we compare this typical approach to one that measures long-term exposure to living alone among older adults and assesses whether dementia is more likely to occur within individuals with more accumulated time living alone. Methods: Data come from the Health and Retirement Study, with a follow-up period of 2000–2018. A total of 18,171 older adults were followed during this period, resulting in 78,490 person-waves analyzed in a series of multilevel logistic models. Contemporaneous living alone was recorded when a respondent’s household size was equal to 1 in a given wave. Cumulative living alone was calculated by adding the number of living alone statuses up to a given wave. Results: Contemporaneous living alone was either not associated (male-only subsample), or inversely associated (female-only subsample) with dementia. By contrast, a one-unit (i.e., one wave) increase in cumulative living alone was associated with about a 10% increase in the odds of dementia for both men (odds ratio [OR] = 1.111) and women (OR = 1.088), net of several covariates, including marital status, age, social activities, and social support. Discussion: Living alone during late life is an important risk factor for dementia, but the cognitive effects of solitary living probably do not take hold immediately for most older adults and potentially demonstrate a dose-response relationship.