@article {13210, title = {"How Social Connection and Engagement Relate to Functional Limitations and Depressive Symptoms Outcomes After Stroke".}, journal = {medRxiv}, year = {2023}, abstract = {

BACKGROUND: Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke.

METHODS: Participants were 898 individuals with incident stroke from the Health and Retirement Study between 1998-2012. Multilevel modeling was used to examine associations of social connection and engagement with changes in functional limitations in instrumental activities of daily living (IADLs) and depressive symptoms over time. Models controlled for age, gender, education, and race/ethnicity. Moderation analyses examined whether high social connection and engagement reduced depressive symptoms for survivors with high IADL impairment.

RESULTS: Social connection and engagement were generally associated with fewer IADL limitations and depressive symptoms at the time of stroke and after stroke. For example, participants who felt lonely and did not provide help to others before stroke had more IADL limitations. Pre-stroke volunteering was associated with less increase in IADL limitations with stroke and increase in having friends and providing help to others compared to one{\textquoteright}s pre-stroke status were associated with fewer IADL limitations after stroke. For depressive symptoms, participants who felt lonely and did not have a friend or partner before stroke had more depressive symptoms, and participants who had children residing nearby before stroke showed less increase in depressive symptoms. Moderation effects were not found for social connection and engagement on high IADL impairment and depressive symptoms.

CONCLUSIONS: Findings suggest that social connection and engagement may reduce the negative physical and psychological outcomes of stroke, both at baseline and after stroke. Efforts to enhance social engagement and diminish loneliness may both enhance population well-being and enhance resilience and recovery from stroke and other illnesses.

}, doi = {10.1101/2023.03.07.23286965}, author = {Elayoubi, Joanne and Haley, William E and Nelson, Monica E and Hueluer, Gizem} } @article {12077, title = {Change in Episodic Memory with Spousal Loss: The Role of Social Relationships.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {683-694}, abstract = {

OBJECTIVES: The spousal relationship is one of the most important social contexts in old age and the loss of a spouse/partner is associated with stress and cognitive decline. In the present study, we examined whether social relationships can buffer potential negative effects of spousal loss on cognition. We examined the role of social network, social activities, and perceived deficiencies in social relationships (loneliness).

METHOD: We used longitudinal data between 1998-2012 from 2,077 participants of the Health and Retirement Study, who had experienced spousal loss during the study period. Multilevel modeling was used to examine how time-varying indicators of social network, social activities, and loneliness were related to age-related trajectories of episodic memory prior to and after spousal loss. Analyses controlled for gender, race/ethnicity, education, time-varying functional health and being re-partnered/re-married.

RESULTS: Having children living within 10 miles and providing help to others buffered negative effects of widowhood on episodic memory. In addition, within-person increase in providing help to others buffered against decline in episodic memory after spousal loss. Having friends in the neighborhood, more frequent social visits, providing help to others, volunteering, and lack of loneliness were related to higher episodic memory, while having relatives in the neighborhood was related to lower episodic memory.

DISCUSSION: Our findings suggest that social networks, social activities, and loneliness are related to levels of cognitive function at the time of spousal loss and that social relationships can buffer negative effects of spousal loss on cognitive function. Implications for future research are discussed.

}, keywords = {Episodic Memory, longitudinal, Social Relationships, Spousal loss, Widowhood}, issn = {1758-5368}, doi = {10.1093/geronb/gbab231}, author = {H{\"u}l{\"u}r, Gizem and Elayoubi, Joanne and Nelson, Monica E and William E. Haley} } @article {11765, title = {The Role of Social Connection/Engagement in Episodic Memory Change in Stroke.}, journal = {Gerontologist}, volume = {62}, year = {2022}, pages = {364-374}, abstract = {

BACKGROUND AND OBJECTIVES: Positive associations between social connection/engagement and cognitive function are well documented. However, little is known about whether social connection/engagement can buffer the impact of serious brain injury such as stroke on cognitive functioning.

RESEARCH DESIGN AND METHODS: Participants were 898 individuals with incident stroke from the Health and Retirement Study (HRS) between 1998-2012. Multilevel modeling was used to examine how social connection/engagement were associated with episodic memory pre- and post-stroke. Models controlled for age, gender, education, race/ethnicity, number of health conditions, and functional health.

RESULTS: Participants who were lonely pre-stroke recalled significantly fewer words at time of stroke, and participants who had children residing within 10 miles pre-stroke showed significantly less decline in word recall over time. Participants who provided help to others pre-stroke showed less stroke-related decline in word recall. Within-person increase in partnered status, having friends, and helping others were related to better word recall in the post-stroke period.

DISCUSSION AND IMPLICATIONS: Higher pre-stroke levels of social connection/engagement predicted better episodic memory at stroke, smaller decline in episodic memory with stroke, and less decline in episodic memory over time. Increases in social connection/engagement from pre- to post-stroke also predicted better post-stroke episodic memory. Beyond the widely documented benefits of social connection/engagement to well-being, they may also increase cognitive stimulation and cognitive reserve and thus contribute to stroke recovery in the cognitive domain. Social connection/engagement is an important and modifiable risk factor in older adults.

}, keywords = {Cardiovascular accident, Cognition, Cognitive Reserve, Social participation, Word recall}, issn = {1758-5341}, doi = {10.1093/geront/gnab095}, author = {Elayoubi, Joanne and Nelson, Monica E and William E. Haley and Hueluer, Gizem} }