Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data

If your doctors got you 100% recovered this would cease to be a problem. So are they working on the primary problem of 100% recovery or the secondary problem of social isolation? The answer to that question tells you about the competence of your doctors. Probably not in a good way. 

Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data

Bogna A. Drozdowska

https://orcid.org/0000-0001-5705-7815

¹, Carlos A. Celis-Morales

https://orcid.org/0000-0003-2612-3917

¹, Donald M. Lyall², Terence J. Quinn

https://orcid.org/0000-0003-1401-0181

¹

Author details

Abstract

Background: Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke.  The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors.
Methods: We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003.
Results: After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 95% CI: -0.51 to -0.13, p=0.001, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 95% CI 0.13 to 0.38, p<0.001, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 95% CI: -0.29 to -0.08, p<0.001, N=2,074; odds ratio=0.66, 95% CI: 0.52 to 0.84, p=0.001, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant.
Conclusions: We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors.

Keywords

Social engagement, Loneliness, Cognition, Stroke, UK Biobank

Corresponding author: Bogna A. Drozdowska Competing interests: No competing interests were disclosed.

Grant information: BD was supported by a Stroke Association Priority Program Award [PPA 2015/01_CSO]; TJQ was supported by a Chief Scientist Office and Stroke Association Senior Clinical Lectureship [TSA LECT 2015/05].

The UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government and the British Heart Foundation.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright:  © 2019 Drozdowska BA et al. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Drozdowska BA, Celis-Morales CA, Lyall DM and Quinn TJ. Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data [version 1; referees: awaiting peer review]. AMRC Open Res 2019, 1:3 (https://doi.org/10.12688/amrcopenres.12862.1) First published: 19 Feb 2019, 1:3 (https://doi.org/10.12688/amrcopenres.12862.1)Latest published: 19 Feb 2019, 1:3 (https://doi.org/10.12688/amrcopenres.12862.1)