Examining the Moderating Roles of Social Isolation and Social Technology Use in Health Disparities of Cognitive Impairment

Background
There are profound racial disparities in cognitive impairment and dementia. Black and rural older adults are nearly twice as likely to develop dementia compared to White and urban-dwelling older adults, respectively. However, the way social factors affect these racial and rural-urban disparities in dementia prevalence remains poorly understood. Social isolation is associated with poorer cognitive outcomes among older adults, yet social technology use may provide a means to reduce social isolation. This research examines how two social factors—social isolation and social technology use influence racial and rural disparities in cognitive impairment and dementia.

Method
Data was extracted from the 2014 to 2018 waves of the Health and Retirement Study (N = 5,358). Participants (aged 50-102) completed survey measures of social isolation, loneliness, and frequency of online social communication (e.g., use of Facebook, Skype). The modified Telephone Interview for Cognitive Status was used to operationalize dementia. The validated TICS classification system was used to classify scores with a cognitive status of dementia (scores ≤6), cognitive impairment (score of 7-11), or cognitively normal (scores ≥12). Data was analyzed using structural equation models.

Result
Across all groups, frequency of social technology use moderated the negative relationship between social isolation and cognitive impairment, controlling for age, education, gender, wealth, and general computer usage. More frequent social technology use was associated with cognitively normal status among older adults who reported greater degrees of social isolation. In terms of health disparities, the results revealed racial, but not rural-urban, differences in the relationship between frequency of social technology use and cognitive status. Frequent social technology use was associated with improved cognitive status in Black American older adults but not White older adults, irrespective of their level of social isolation.

Conclusion
Social technology may offer a means to mitigate cognitive decline; the potential benefit of such technology may be particularly promising among Black older adults.