A Multigroup Path Analysis of the Association Between Social Isolation, Loneliness, Physiological Mediators, and Cognitive Function: How Does It Vary With the Presence of Diabetes?

The study investigated the direct and indirect effects of social isolation and loneliness on cognitive function in older adults, with systemic inflammation and sleep disturbance as mediators and diabetes as a moderator. Data were drawn from 5,722 older adults who participated in the 10th and 12th waves of the Health and Retirement Study. Social isolation directly affected cognitive function, whereas loneliness did not. Sleep disturbance mediated the effects of both social isolation and loneliness on cognitive function. Systemic inflammation did not mediate the effects of social isolation or loneliness on cognitive function. Multigroup path analysis revealed no significant differences in the pathways linking social isolation, loneliness, physiological mediators, and cognitive function between the diabetes and non-diabetes groups. These findings suggest that sleep disturbance may serve as a pivotal target for interventions aimed at mitigating the pathways through which social isolation and loneliness detrimentally affect cognitive function.