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Evaluating the influence of social engagement on cognitive impairment and mobility outcomes within the Boston RISE cohort study

Steere, Hannah K. MD1,2; Quach, Lien MD, PhD, MPH3; Grande, Laura PhD4,5; Bean, Jonathan F. MD, MS, MPH1,2,3

American Journal of Physical Medicine & Rehabilitation: March 6, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001175
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OBJECTIVE We investigated the associations between mild cognitive impairment (MCI), social engagement (SE) and mobility.

DESIGN We evaluated data from a cohort study of older adult primary care patients (N=430). Outcomes included self-reported function (Late-Life Function Instrument-LLFI) and performance based mobility (Short Physical Performance Battery score-SPPB). Linear regression models evaluated the association between MCI and mobility, MCI and SE, mobility measures and SE, and whether SE mediated the association between MCI status and mobility.

RESULTS Participants with MCI had significantly lower mobility and lower SE as compared to those without MCI (LLFI: 53.5 vs. 56.9, p<.001; SPPB: 7.9 vs. 9.3, p<.001; SE score 44.9 vs. 49.0, p<.001). MCI was significantly associated with both LLFI and SPPB (LLFI β=-2.93, p= <.001; SPPB β=-1.26, p= <.001) and SE (β=-3.20, p= <.001). SE was significantly associated with both LLFI and SPPB (LLFI β=0.22; p= <.001; SPPB β=0.08; p= <.001). There was a positive association between SE and mobility (p-value <0.05). A mediator effect of SE was supported when evaluating the association between MCI and mobility.

CONCLUSION Among older adult primary care patients at risk for mobility decline, higher levels of SE mitigate the association between MCI and mobility.

1 Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA

2 Spaulding Rehabilitation Hospital, Charlestown, MA

3 Massachusetts Veterans Epidemiology Research and Information Center, Geriatric Research Education and Clinical Center, Boston, MA

4 Psychology Service, VA Boston Healthcare System, Boston, MA

5 Department of Psychiatry, School of Medicine, Boston University, Boston, MA

Corresponding Author: Hannah Steere, MD, Spaulding Rehabilitation Hospital, 300 1st Ave, 2nd floor, Charlestown, MA, 02129, USA, Tel: 617-952-5243 | Fax: 617-952-5934 | Email: steere.hannah@gmail.com

Author Disclosures: There are no competing interests or financial benefits to the authors to disclose. This work was supported by the National Institute on Aging (R01 AG032052-03), Eunice Kennedy Shriver National Institute of Child Health and Human Development (1K24HD070966-01), and the National Center for Research Resources in a grant to the Harvard Clinical and Translational Science Center (1 UL1 RR025758-01). The main results of this study have been presented as a poster presentation at the 2017 American Congress of Rehabilitation Medicine conference. This study has not been previously submitted to any journal.

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