Living alone and cognitive function in later life
Open accessAbstract
BACKGROUND: Living alone may be associated with greater risk for social isolation and loneliness. Living alone, social isolation, loneliness, and limited engagement in social activity have all been associated with poorer cognitive function in later life. Hence, if individuals who live alone are also at greater risk of isolation and loneliness, this may exacerbate poor cognitive function. OBJECTIVE: To determine whether people living alone are more at risk of social isolation, feelings of loneliness, and limited social activity, and to examine the associations between living alone and cognitive function in later life. METHOD: Baseline (N = 2197) and two-year follow-up (N = 1498) data from community-dwelling participants, age ≥65 years, without cognitive impairment or depression at baseline from CFAS-Wales were used. Linear regression analyses were conducted to assess the association between living arrangement and cognitive function at baseline and two-year follow-up. RESULTS: People living alone were more isolated from family and experienced more emotional loneliness than those living with others, but were not more isolated from friends, did not experience more social loneliness, and were more likely to engage in regular social activity. Living alone was not associated with poorer cognitive function at baseline or two-year follow-up. DISCUSSION: These findings have positive implications and suggest that people who live alone in later life are not at greater risk of poor cognitive function at baseline or two-year follow-up. Social isolation may be more associated with poor cognitive function.
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Written from the paper’s full text.
TL;DR
In CFAS-Wales, community-dwelling adults aged ≥65 without baseline cognitive impairment or depression who lived alone were more isolated from family and more emotionally lonely, but not more isolated from friends or socially lonely, and were slightly more likely to engage in regular social activity. Living alone was not associated with poorer global cognitive function at baseline or two-year follow-up.
Key findings
- At baseline (N = 2197; 624 living alone), people living alone had lower overall social isolation scores (15.75 vs 16.33, p = .032) and family isolation scores (8.31 vs 8.83, p < .001), but no difference in friend isolation (7.44 vs 7.50, p = .762). They reported greater overall loneliness (.99 vs .75, p < .001) and emotional loneliness (.55 vs .31, p < .001), but no difference in social loneliness (.44 vs .44, p = .982). They were more likely to attend social groups regularly (53.53% vs 47.11%, p = .025).
- Living alone was not significantly associated with global CAMCOG score at baseline in the fully adjusted model (B = −.02, 95% CI −.09 to .06, p = .641) or at two-year follow-up (B = .03, 95% CI −.13 to .18, p = .735).
- In baseline subdomain analyses, living alone was significantly associated with praxis (B = .08, 95% CI .02 to .14, p = .016), but not orientation, comprehension, expression, memory, attention/calculation, abstract thinking, or perception. At two-year follow-up, living alone was not significantly associated with any CAMCOG subdomain.
- Social isolation predicted poor cognitive function at baseline and two-year follow-up; loneliness and social activity predicted poor cognitive function at baseline but not at follow-up.
Methods
- Longitudinal CFAS-Wales study of community-dwelling people aged ≥65 years, recruited from general practice registers in one rural and one urban Welsh location, stratified into 65–74 and ≥75 age groups; baseline data collected 2011–2013 and follow-up two years later, 2013–2015.
- Exclusions at baseline included MMSE ≤25 (N = 908), AGECAT dementia (N = 185), AGECAT depression (N = 333), institutional residence (N = 95), and missing data (N = 463 baseline; N = 699 follow-up), leaving N = 2197 for cross-sectional analyses and N = 1498 for two-year follow-up analyses.
- Linear regressions assessed living arrangement and CAMCOG score at baseline and two-year follow-up, controlling for baseline cognition in longitudinal models and for age, gender, education, social isolation, loneliness, social activity, marital status, and ADL impairment; an attrition weight was applied to prospective analyses.
Limitations
- Stated: limited cognitive decline occurred over two years, with some participants improving, so a two-year follow-up may be insufficient to detect an association with living alone; dropouts were more socially isolated, lonelier, and had poorer cognitive and cognitive reserve scores, making the follow-up sample selectively higher functioning; duration of living alone and circumstances such as recent bereavement could not be determined; “playing chess and cards” may reflect both cognitive and social activity; the study used global, person-level variables and lacked qualitative perspective on the experience of living alone.
- Evident: living arrangement and marital status were highly correlated (r = −.78), making it difficult to separate their effects; the follow-up sample was selective toward higher-functioning individuals, which may account for limited cognitive change and null follow-up findings.
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Cites
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Claims the paper makes
0 of 70 cited sources checked · 0 supported · 0 flagged
- Findingown data
Living arrangement was not significantly associated with cognitive function at two-year follow-up in the fully adjusted model.
“Living arrangement was not significantly associated with cognitive function at follow-up in the fully adjusted model (adjusted R 2 = .49,F(10, 1488) = 93.15,p < .001:Table 6).”
Quote in the paperSubstantial claim - Findingown data
People living alone reported greater emotional loneliness than those living with others.
“People living alone reported significantly greater feelings of overall loneliness and emotional loneliness, but there was no difference in feelings of social loneliness.”
Quote in the paperNot a substantial claim - Findingown data
Living alone was significantly associated with the praxis sub-domain of the CAMCOG at baseline.
“Living alone was significantly associated with praxis (adjusted R 2 = .07,F(9, 2187) = 19.08,p < .001),but not orientation”
Quote in the paperNot a substantial claim - Findingown data
Living alone was not significantly associated with poorer CAMCOG scores at baseline in the fully adjusted model.
“Living alone was not significantly associated with poorer CAMCOG scores in the fully adjusted model (adjusted R 2 = .17,F(9, 2187) = 52.36,p < .001:Table 4).”
Quote in the paperSubstantial claim - Findingown data
Living alone was not significantly associated with two-year change in scores on any CAMCOG sub-domain.
“Living alone was not significantly associated with two-year change in scores on any of”
Quote in the paperSubstantial claim
- Findingown data
People living alone reported greater overall loneliness than those living with others.
“People living alone reported significantly greater feelings of overall loneliness and emotional loneliness, but there was no difference in feelings of social loneliness.”
Quote in the paperNot a substantial claim - Findingown data
People living alone did not report greater social loneliness than those living with others.
“People living alone reported significantly greater feelings of overall loneliness and emotional loneliness, but there was no difference in feelings of social loneliness.”
Quote in the paperNot a substantial claim - Findingown data
People living alone were slightly more likely to engage in regular social activity than those living with others.
“People living alone were slightly more likely to engage in regular social activity than those living with others.”
Quote in the paperNot a substantial claim - Findingown data
People living alone were not more isolated from friends than those living with others.
“People living alone were more likely to be socially isolated overall and to be isolated from family than those living with others, but there was no difference in isolation from friends.”
Quote in the paperNot a substantial claim - Findingown data
People living alone were more socially isolated overall than those living with others.
“People living alone were more likely to be socially isolated overall and to be isolated from family than those living with others, but there was no difference in isolation from friends.”
Quote in the paperNot a substantial claim - Findingown data
People living alone were more isolated from family than those living with others.
“People living alone were more likely to be socially isolated overall and to be isolated from family than those living with others, but there was no difference in isolation from friends.”
Quote in the paperNot a substantial claim - Findingown data
Living alone was significantly associated with poorer scores in praxis at baseline and follow-up.
“However, we did find that living alone was significantly associated with poorer scores in praxis at baseline and follow-up.”
Quote in the paperSubstantial claim - Findingown data
Living alone was not associated with greater feelings of social loneliness compared with living with others.
“no difference in isolation from friends or feelings of social loneliness”
Quote in the paperNot a substantial claim - Findingown data
Living alone was not associated with greater isolation from friends compared with living with others.
“no difference in isolation from friends”
Quote in the paperNot a substantial claim - Findingown data
Living alone was not associated with global cognitive function at two-year follow-up.
“There was no association between living alone and global cognitive function at two-year follow-up.”
Quote in the paperSubstantial claim - Findingcitation
Living alone was not significantly associated with cognitive function at baseline.
“The finding that living alone is not significantly associated with cognitive function at baseline is consistent with most previous studies”
Quote in the paperSubstantial claim - Findingown data
There was no difference in cognitive reserve scores at baseline between those living alone and those living with others.
“We found no difference in cognitive reserve scores at baseline between those living alone and with others.”
Quote in the paperSubstantial claim - Findingown data
People who dropped out between baseline and follow-up had poorer scores on measures of cognitive function.
“People who dropped out between baseline and follow-up were more likely to be socially isolated and to experience feelings of loneliness, and had poorer scores on measures of cognitive function and cognitive reserve.”
Quote in the paperSubstantial claim - Findingown data
People who dropped out between baseline and follow-up were more likely to experience feelings of loneliness.
“People who dropped out between baseline and follow-up were more likely to be socially isolated and to experience feelings of loneliness, and had poorer scores on measures of cognitive function and cognitive reserve.”
Quote in the paperSubstantial claim - Findingreasoning
Living alone and being unmarried were highly correlated.
“Living alone and being unmarried were highly correlated.”
Quote in the paperSubstantial claim - Findingown data
People who lived alone engaged in slightly more frequent social activity than those living with others.
“Interestingly, people who lived alone engaged in slightly more frequent social activity than those living with others.”
Quote in the paperNot a substantial claim - Findingown data
Limited cognitive decline was observed across the sample over the two-year follow-up.
“Limited cognitive decline was observed across the sample over the two-year follow-up”
Quote in the paperSubstantial claim - Findingnone given
Some participants had significant improvements in their CAMCOG scores at follow-up.
“some participants had significant improvements in their CAMCOG scores at follow-up.”
Quote in the paperNot a substantial claim - Findingown data
People who dropped out between baseline and follow-up were more likely to be socially isolated.
“People who dropped out between baseline and follow-up were more likely to be socially isolated and to experience feelings of loneliness, and had poorer scores on measures of cognitive function and cognitive reserve.”
Quote in the paperSubstantial claim - Findingnone given
People who live alone may be more isolated in terms of family networks.
“people who live alone may be more isolated in terms of family networks”
Quote in the paperSubstantial claim - Findingown data
People who dropped out between baseline and follow-up had poorer scores on measures of cognitive reserve.
“People who dropped out between baseline and follow-up were more likely to be socially isolated and to experience feelings of loneliness, and had poorer scores on measures of cognitive function and cognitive reserve.”
Quote in the paperSubstantial claim - Premisecitation
Feelings of loneliness have been associated with poor cognitive outcomes.
“Social isolation (DiNapoli, Wu, & Scogin, 2014;Shankar, Hamer, McMunn, & Steptoe, 2013), feelings of loneliness (Conroy, Golden, Jeffares, O'Neill, & McGee, 2010;Ellwardt, Aartsen, Deeg, & Steverink, 2013;Fung, Leung, & Lam, 2011;Gerst-Emerson, Shovali, & Markides, 2014;Gow et al., 2013;O'Luanaigh et al., 2012;Shankar et al., 2013;Tilvis et al., 2004), and low engagement in social activity (Barnes”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Low engagement in social activity has been associated with poor cognitive outcomes.
“Social isolation (DiNapoli, Wu, & Scogin, 2014;Shankar, Hamer, McMunn, & Steptoe, 2013), feelings of loneliness (Conroy, Golden, Jeffares, O'Neill, & McGee, 2010;Ellwardt, Aartsen, Deeg, & Steverink, 2013;Fung, Leung, & Lam, 2011;Gerst-Emerson, Shovali, & Markides, 2014;Gow et al., 2013;O'Luanaigh et al., 2012;Shankar et al., 2013;Tilvis et al., 2004), and low engagement in social activity (Barnes”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Living alone in later life may increase the risk of poor cognitive function.
“Living alone in later life may increase the risk of poor cognitive function (Gow, Pattie, Whiteman, Whalley, & Deary, 2007;Gow, Corley, Starr, & Deary, 2013;van Gelder et al., 2006;Yaffe et al., 2009)”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Findings from studies that assess the association between living alone and cognitive function are conflicting.
“However, findings from studies that assess the association between living alone and cognitive function are conflicting.”
Quote in the paperSubstantial claim - Premisecitation
Social isolation has been associated with poor cognitive outcomes.
“Social isolation (DiNapoli, Wu, & Scogin, 2014;Shankar, Hamer, McMunn, & Steptoe, 2013), feelings of loneliness (Conroy, Golden, Jeffares, O'Neill, & McGee, 2010;Ellwardt, Aartsen, Deeg, & Steverink, 2013;Fung, Leung, & Lam, 2011;Gerst-Emerson, Shovali, & Markides, 2014;Gow et al., 2013;O'Luanaigh et al., 2012;Shankar et al., 2013;Tilvis et al., 2004), and low engagement in social activity (Barnes”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Most studies of living alone and cognitive function have been cross-sectional.
“Most of these studies have been crosssectional (Conroy et al., 2010;Gow et al., 2007Gow et al., , 2013;;Wang et al., 2015;Yeh & Liu, 2003).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
In later life, social networks are likely to reduce in size due to the increasing independence of adult children, the death of close social contacts, and the increased selectivity of social interactions with age.
“In later life, social networks are likely to reduce in size due to the increasing independence of adult children, the death of close social contacts, and the increased selectivity of social interactions with age (Baltes & Baltes, 1990;Bordone & Weber, 2012;Carstensen, 1992;de Jong Gierveld & Havens, 2004;Fredrickson & Carstensen, 1990;Freund & Baltes, 1998;Victor et al., 2000).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Interpretationreasoning
Age, gender, educational level, social isolation, and impairments in ADLs may be more associated with cognitive function than living alone at baseline and two-year follow-up.
“The present findings seem to implicate that age, gender, educational level, social isolation, and impairments in ADLs may be more associated with cognitive function than living alone at baseline and two-year follow-up.”
Quote in the paperSubstantial claim - Study design and conductcitation
Social isolation, loneliness, and social activity were controlled for.
“Social isolation, loneliness, and social activity were also controlled for as these factors have been associated with living alone (Victor et al., 2000(Victor et al., , 2005) ) and with cognitive function (DiNapoli et al., 2014;Ellwardt et al., 2013;Gerst-Emerson et al., 2014;Gow et al., 2013;Shankar et al., 2013;Zunzunegui et al., 2003).”
Quote in the paperSubstantial claim0 of 3 sources checked - Study design and conductcitation
Baseline age, gender, and educational level were controlled for in all analyses.
“Baseline age (years), gender, and educational level (years) are all well-established covariates of late-life cognitive function (Barnes et al., 2003;Tervo et al., 2004;Tilvis et al., 2004) and were controlled for in all analyses.”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
People who live alone in later life may be more vulnerable in terms of social, behavioural, functional, and socioeconomic factors.
“People who live alone in later life may be more vulnerable in terms of social, behavioural, functional, and socioeconomic factors (Bergland & Engedal, 2011;Haslbeck, McCorkle, & Schaeffer, 2012;Hughes & Waite, 2002;Shaw, Fors, Fritzell, Lennartsoon, & Agahi, 2017).”
Quote in the paperSubstantial claim0 of 3 sources checked - Study design and conductreasoning
Participants with cognitive impairment or dementia at baseline were excluded to reduce the risk of reverse causation in analyses.
“To reduce the risk of reverse causation in analyses, participants with cognitive impairment (Mini-Mental State Examination: MMSE; score ≤25; N = 908) or an Automated Geriatric Examination Assisted Taxonomy (AGECAT) classification of dementia (N = 185) at baseline were excluded.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Sampling from general practice registers and inviting participation ensured that individuals who were living alone and particularly isolated were more adequately represented in CFAS-Wales than in self-selected samples.
“This ensures that individuals who were living alone and particularly isolated were more adequately represented in CFAS-Wales than in self-selected samples.”
Quote in the paperNot a substantial claim - Premisecitation
Social interaction with the individual(s) with whom an older person resides are likely to be insufficient to build or maintain cognitive reserve alone.
“Social interaction with the individual(s) with whom an older person resides are likely to be insufficient to build or maintain cognitive reserve alone (Berkman & Glass, 2000;Mazzuco et al., 2016).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Berkman & Glass, 2000
Not checked in the free run.
- cites Mazzuco et al., 2016
Not checked in the free run.
- Interpretationreasoning
The follow-up sample was to some degree a selective sample of higher-functioning individuals in terms of social and cognitive variables.
“Hence, the follow-up sample was to some degree a selective sample of higher-functioning individuals in terms of social and cognitive variables.”
Quote in the paperSubstantial claim - Premisenone given
The measure of IQ used in Gow et al. (2007) assesses different cognitive abilities to those assessed by the CAMCOG and other global measures of cognitive function.
“The measure of IQ used in Gow et al. (2007) assesses different cognitive abilities to those assessed by the CAMCOG and other global measures of cognitive function”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gow et al., 2007 source
Not checked in the free run.
- Premisecitation
The measure of IQ used in Gow et al. (2007) assesses reasoning, arithmetic, following directions, and analogies.
“The measure of IQ used in Gow et al. (2007) assesses reasoning, arithmetic, following directions, and analogies.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gow et al., 2007 source
Not checked in the free run.
- Interpretationreasoning
The present findings are inconsistent with one study that reports an association between living alone and cognitive function determined by a measure of IQ at baseline (Gow et al., 2007).
“The present findings are inconsistent with one study that reports an association between living alone and cognitive function determined by a measure of IQ at baseline (Gow et al., 2007).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gow et al., 2007 source
Not checked in the free run.
- Study design and conductnone given
It was not possible to determine for how long people had been living alone in the present sample.
“It was not possible to determine for how long people had been living alone in the present sample.”
Quote in the paperSubstantial claim
- May combine two claims. 21
- Classified as probably not a substantial claim. 18
May combine two claims.
Findingown dataSocial activity predicted poor cognitive function at baseline but not at two-year follow-up.
“loneliness and social activity predicted poor cognitive function at baseline, but not two-year follow-up”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataLoneliness predicted poor cognitive function at baseline but not at two-year follow-up.
“loneliness and social activity predicted poor cognitive function at baseline, but not two-year follow-up”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingreasoningPeople who were widowed, separated/divorced, or single were more likely to live alone, whereas those who were married continued to live with others.
“Unsurprisingly, people who were widowed, separated/ divorced, or single were more likely to live alone whereas those who were married continued to live with others.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSocial isolation predicted poor cognitive function at baseline and two-year follow-up.
“social isolation predicted poor cognitive function at baseline and two-year follow-up”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationOther studies have found no association between living alone and poorer scores on measures of global cognitive function, memory, IQ, verbal fluency, and numeracy.
“Other studies have found no association between living alone and poorer scores on measures of global cognitive function (Conroy et al., 2010;Gow et al., 2013;Mahoney, Eisner, Havighurst, Gray, & Palta, 2000;Wang, He, & Dong, 2015;Yeh & Liu, 2003), memory, IQ (Gow et al., 2013), verbal fluency, and numeracy (Mazzuco et al., 2016).”
Quote in the paperNot a substantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
PremisecitationSome studies have reported an association between living alone and poorer scores on tests of global cognitive function, immediate and delayed recall, orientation, processing speed, and IQ.
“Some studies have reported an association between living alone and poorer scores on tests of global cognitive function (van Gelder et al., 2006;Yaffe et al., 2009), immediate and delayed recall, orientation (Mazzuco, Meggiolaro, Ongaro, & Toffolutti, 2016), processing speed (Gow et al., 2013), and IQ (Gow et al., 2007).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenSocial isolation may be more associated with poor cognitive function.
“Social isolation may be more associated with poor cognitive function.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataPeople who live alone in later life are not at greater risk of poor cognitive function at baseline or two-year follow-up.
“These findings have positive implications and suggest that people who live alone in later life are not at greater risk of poor cognitive function at baseline or two-year follow-up.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationSocial interactions are effortful and require the mobilisation of complex cognitive processes, and therefore may help to build reserve and maintain cognitive function.
“Social interactions are effortful and require the mobilisation of complex cognitive processes, and therefore may help to build reserve and maintain cognitive function (Barnes et al., 2004;Fratiglioni, Paillard-Borg, & Winblad, 2004).”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
PremisecitationLiving with others may enhance cognitive function directly through the stimulation arising from regular social interaction with others.
“From a cognitive reserve perspective, living with others may enhance cognitive function directly through the stimulation arising from regular social interaction with others (van Gelder et al., 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites van Gelder et al., 2006 source
Not checked in the free run.
May combine two claims.
Study design and conductreasoningCFAS-Wales is a large population-based cohort that is representative of the general population.
“CFAS-Wales is a large population-based cohort that is representative of the general population.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningParticipants were randomly selected from general practice registers and stratified into two age groups (65-74 and ≥75) to ensure a representative sample.
“People aged ≥65 years were randomly selected from general practice registers and stratified into two age groups (65-74 and ≥75) to ensure a representative sample.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationHaving poor social relationships has been associated with a range of negative health outcomes.
“having poor social relationships has been associated with a range of negative health outcomes (Holt-Lunstad & Smith, 2012;Scharf, Phillipson, & Smith, 2004;Steptoe, Shankar, Demakakos, & Wardle, 2013;Tomaszewski, 2013;Umberson & Montez, 2010).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Holt-Lunstad & Smith, 2012
Not checked in the free run.
- cites Steptoe et al., 2013 source
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- cites Umberson & Montez, 2010
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe CAMCOG has good inter-rater reliability (r = .97), high sensitivity (92%) and specificity (96%).
“The CAMCOG has good inter-rater reliability (r = .97),high sensitivity (92%) and specificity (96%: Roth et al., 1986;Wouters, van Gool, Schmand, Zwinderman, & Lindeboom, 2010).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationIndividuals who live alone may have less frequent opportunity for social contact, may be more isolated, and may feel more lonely than those who live with others, which may result in reduced cognitive stimulation and lower cognitive reserve.
“Individuals who live alone may have less frequent opportunity for social contact, may be more isolated (Carstensen, 1992;de Jong Gierveld & Havens, 2004;de Jong Gierveld, 2003;Kobayashi et al., 2009), and may feel more lonely (Newall et al., 2014;Victor et al., 2005) than those who live with others, which may result in reduced cognitive stimulation and lower cognitive reserve (Gow et al., 2007).”
Quote in the paperSubstantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
PremisecitationReserve can be built through a range of experiences across the lifespan, such as educational level, occupational complexity, and social and cognitive activity.
“Reserve can be built through a range of experiences across the lifespan, such as educational level, occupational complexity, and social and cognitive activity (Stern, 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Stern, 2009 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductreasoningPeople living in an institution were excluded because living with others in institutional care is different from living with others in the community.
“We excluded people living in an institution (N = 95) as living with others in institutional care is different to living with others in the community.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationLiving alone, social isolation, and loneliness are distinct concepts and living alone does not necessarily mean that an individual will be isolated, feel lonely, or engage in less social activity.
“Living alone, social isolation, and loneliness are distinct concepts and living alone does not necessarily mean that an individual will be isolated, feel lonely, or engage in less social activity (Klinenberg, 2016;Victor et al., 2000).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationGood social relationships are identified as an important aspect of successful ageing.
“Good social relationships are identified as an important aspect of successful ageing (Rowe & Kahn, 1997)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rowe & Kahn, 1997 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataAn attrition weight was used to account for the attrition of participants between baseline and follow-up and applied to all prospective analyses.
“We used an attrition weight to account for the attrition of participants between baseline and follow-up and applied this to all prospective analyses.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationCognitive reserve theory suggests that individuals differ in their level of resilience against brain pathology and hence may exhibit differences in cognitive function despite equivalent levels of pathology.
“Cognitive reserve theory suggests that individuals differ in their level of resilience against brain pathology and hence may exhibit differences in cognitive function despite equivalent levels of pathology (Stern, 2002(Stern, , 2012)).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationSocial isolation, feelings of loneliness, low engagement in social activity, and living alone simultaneously confer risk for impaired health and poorer wellbeing.
“Social isolation, feelings of loneliness, low engagement in social activity, and living alone simultaneously confer risk for impaired health and poorer wellbeing (Kharicha et al., 2007;Klinenberg, 2016;Pimouguet et al., 2015;Udell et al., 2012).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationOlder people face changes in their social environments and as a result may be at greater risk of social isolation and feelings of loneliness.
“Older people face changes in their social environments and as a result may be at greater risk of social isolation and feelings of loneliness (Finlay & Kobayashi, 2018;Klinenberg, 2016;Victor, Scambler, Bond, & Bowling, 2000).”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
PremisecitationPeople who live alone are often solely responsible for completing household tasks, such as paying the bills, shopping, cleaning, maintenance, and answering the telephone or door, which all require cognitive input.
“People who live alone are often solely responsible for completing household tasks, such as paying the bills, shopping, cleaning, maintenance, and answering the telephone or door, which all require cognitive input (Jekel et al., 2015;Njegovan, Man-Son-Hing, Mitchell, & Molnar, 2001).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningAn additional limitation is that 'playing chess and cards' was included in the cognitive activity score but may also contribute to social activity.
“An additional limitation is that 'playing chess and cards' was included in the cognitive activity score but may also contribute to social activity.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationLiving alone is not necessarily a risk factor in itself for people who are in good health and have sufficient social connections; it may be a positive state for many people and reflect the maintenance of functional independence.
“Living alone is not necessarily a risk factor in itself for people who are in good health and have sufficient social connections; it may be a positive state for many people and reflect the maintenance of functional independence”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Kharicha et al., 2007
Not checked in the free run.
- cites Mazzuco et al., 2016
Not checked in the free run.
May combine two claims.
InterpretationcitationThe importance of social isolation in later life and the benefits of having a wide social network and engagement in frequent social activity on cognitive function are reinforced by the present findings.
“This further reinforces the importance of social isolation in later life and the benefits of having a wide social network and engagement in frequent social activity on cognitive function (Evans et al., 2018).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Evans et al., 2018 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
Premisenone givenLiving arrangement is a basic structural assessment of social connections and does not consider the wider social context.
“Living arrangement is a basic structural assessment of social connections and does not consider the wider social context.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningSocial isolation measured by the LSNS-6 is much more comprehensive than the single question assessing living arrangement and provides an indication of the level of interaction with a range of people in the community.
“This is much more comprehensive than the single question which assesses living arrangement and provides an indication of the level of interaction with a range of people in the community.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationPeople who live alone and are unable to complete household tasks due to poor cognitive function or health are unlikely to manage independently at home and may be more likely to move into a care home.
“People who live alone and are unable to complete household tasks due to poor cognitive function or health are unlikely to manage independently at home and may be more likely to move into a care home (Cornelis, Gorus, Beyer, Bautmans, & De Vriendt, 2017;Wang et al., 2015).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationCrystallised cognitive abilities, such as those assessed in the measure of IQ, may be less associated with cognitive ageing, whereas fluid cognitive domains such as executive functions and memory may be more affected by ageing.
“It has been suggested that crystallised cognitive abilities, such as those assessed in the measure of IQ may be less associated with cognitive ageing, whereas fluid cognitive domains such as executive functions and memory may be more affected by ageing”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
InterpretationreasoningThe friendship networks of people living alone being as strong as those living with others may mitigate the degree of isolation from family and feelings of loneliness and hence benefit cognitive function.
“which may mitigate the degree of isolation from family and feelings of loneliness and hence benefit cognitive function”
Quote in the paperSubstantial claim
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Studies that provided cognitive domain-specific results are scarce and have not accounted for the correlation between repeated measures on the same individual over time.
“Studies that provided cognitive domain-specific results are scarce and have not accounted for the correlation between repeated measures on the same individual over time.10,17,32”
From Are loneliness and social isolation associated with cognitive decline? (2019) · cites this paper as [32]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- ConsistentF(9, 2187) = 52.36reported p < .001 · recomputed p < .001
“F(9, 2187) = 52.36,p < .001”
- ConsistentF(9, 2187) = 19.08reported p < .001 · recomputed p < .001
“F(9, 2187) = 19.08,p < .001”
- ConsistentF(9, 2187) = 1.49reported p = .146 · recomputed p = .146
“F(9, 2187) = 1.49, p = .146”
- ConsistentF(9, 2187) = 5.64reported p < .001 · recomputed p < .001
“F(9, 2187) = 5.64, p < .001”
- ConsistentF(9, 2187) = 31.89reported p < .001 · recomputed p < .001
“F(9, 2187) = 31.89,p < .001”
- ConsistentF(9, 2187) = 11.21reported p < .001 · recomputed p < .001
“F(9, 2187) = 11.21,p < .001”
- ConsistentF(9, 2187) = 7.38reported p < .001 · recomputed p < .001
“F(9, 2187) = 7.38, p < .001”
- ConsistentF(9, 2187) = 10.51reported p < .001 · recomputed p < .001
“F(9, 2187) = 10.51,p < .001”
- ConsistentF(9, 2187) = 34.26reported p < .001 · recomputed p < .001
“F(9, 2187) = 34.26,p < .001”
- ConsistentF(10, 1488) = 93.15reported p < .001 · recomputed p < .001
“F(10, 1488) = 93.15,p < .001”
- ConsistentF(10, 1488) = 4.77reported p < .001 · recomputed p < .001
“F(10, 1488) = 4.77, p < .001”
- ConsistentF(10, 1488) = 9.35reported p < .001 · recomputed p < .001
“F(10, 1488) = 9.35, p < .001”
- ConsistentF(10, 1488) = 34.6reported p < .001 · recomputed p < .001
“F(10, 1488) = 34.60,p < .001”
- ConsistentF(10, 1488) = 53reported p < .001 · recomputed p < .001
“F(10, 1488) = 53.00,p < .001”
- ConsistentF(10, 1488) = 17.48reported p < .001 · recomputed p < .001
“F(10, 1488) = 17.48, p < .001”
- ConsistentF(10, 1488) = 30.1reported p < .001 · recomputed p < .001
“F (10, 1488) = 30.10,p < .001”
- ConsistentF(10, 1488) = 22.64reported p < .001 · recomputed p < .001
“F (10, 1488) = 22.64, p < .001”
- ConsistentF(10, 1488) = 43.36reported p < .001 · recomputed p < .001
“F(10, 1488) = 43.36,p < .001”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion claims a follow-up praxis association that the results do not show
MajorThe discussion says living alone was significantly associated with poorer praxis scores at follow-up. Table 7 reports a follow-up praxis coefficient whose confidence interval includes zero and whose p-value is .481.
“However, we did find that living alone was significantly associated with poorer scores in praxis at baseline and follow-up.”
“| Praxis | B (95% CI) | p | -.06 (-.23, .11) | .481 |”
Included participants' social-isolation subscales do not sum to the overall score
MinorThe scale's overall score is defined as the sum of its family and friends subscales. For participants included at follow-up, the reported means sum to 17.48, not the reported overall mean of 16.48.
Reported 16.48 · recomputed 17.48
“| Overall | 16.48 (5.77) | 15.50 (5.58) | t(1, 2195) = -3.76 | | | | | p < .001 | | Family | 8.79 (3.31) | 8.47 (3.30) | t(1, 2195) = -2.11 | | | | | p = .035 | | Friends | 8.69 (4.07) | 7.03 (3.89) | t(1, 2195) = -3.61 |”
Conflicting descriptions of loneliness among participants lost to follow-up
MinorThe study-population section says those excluded from follow-up did not experience greater loneliness, whereas the limitations section says those who dropped out were more likely to experience loneliness.
“but were no more likely to be women, live alone, or experience greater feelings of loneliness, and there was no difference in marital status.”
“People who dropped out between baseline and follow-up were more likely to be socially isolated and to experience feelings of loneliness, and had poorer scores on measures of cognitive function and cognitive reserve.”
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Are loneliness and social isolation associated with cognitive decline?
Lara, E., Caballero, F. F., Rico‐Uribe, L. A., Olaya, B., Haro, J. M., Ayuso‐Mateos, J. L., & Miret, M. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5174 · Cited by 423 · see citing works
- Authors
- Evans, I. E. M., Llewellyn, D. J., Matthews, F. E., Woods, R. T., Brayne, C., & Clare, L.
- Affiliations
- University of Exeter (GB)
- University of Cambridge (GB)
- Australian National University (AU)
- Corresponding author
- Evans, Isobel E.M.
- Venue
- Archives of Gerontology and Geriatrics
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 81
- Pages
- 222-233
- ISSN
- 0167-4943 (ISSN-L)
- OpenAlex
- W2907120003
- Semantic Scholar
- 449a6e2fd2163cfb32f3ef3199bc1f0fa9401551
- Cited by
- 142
- References
- 126
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 38 · 2023: 23 · 2022: 15 · 2021: 22 · 2020: 16 · 2019: 5
- FWCI
- 11.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Archives of Gerontology and Geriatrics (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (acceptedVersion, cc-by-nc-nd)
- Figshare (submittedVersion, cc-by-nc-nd)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- ANU Open Research (Australian National University) (submittedVersion, cc-by)
- Bangor University Research Portal (Bangor University) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- ESRC (RES-060-25-0060)
- HEFCW
- Alzheimer’s Society
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- living alone, cognitive function, social isolation, loneliness, social activity, older adults, living arrangements, emotional loneliness, social loneliness, family isolation
- MeSH terms
- Aged, Aged, 80 and over, Cognition, Female, Humans, Loneliness, Male, Social Isolation, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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