Table:
Sex differences in the association between social health markers and annual change in cognition by domain in the main analysis
| I2 (%) | τ2 | Interaction effect of social connection marker, sex, and time in study, b (95% CI) |
Egger’s test, Z score (p value) |
Simple main effects for men and women (when b is significant; 95% CI) |
|
|---|---|---|---|---|---|
| Global cognition | |||||
| Structure | |||||
| Being married or in a relationship | 0·00% | 0·00 | 0·033 (0·009 to 0·578) | −0·42 (p=0·68) | −0·023 (−0·045 to −0·002) for men; 0·010 (−0·001 to 0·021) for women |
| Living with others | 14·96% | 0·00 | 0·004 (−0·011 to 0·018) | −0·82 (p=0·41) | |
| Yearly engagement in community group | 0·69% | 0·00 | 0·013 (−0·015 to 0·042) | −0·39 (p=0·70) | |
| Monthly engagement in community group | 15·53% | 0·00 | −0·009 (−0·038 to 0·019) | 0·03 (p=0·97) | ·· |
| Weekly engagement in community group | 0·00% | 0·00 | 0·010 (−0·013 to 0·034) | −0·30 (p=0·77) | ·· |
| Yearly interactions with family and friends | 0·00% | 0·00 | 0·039 (−0·028 to 0·107) | 0·44 (p=0·66) | ·· |
| Monthly interactions with family and friends | 0·00% | 0·00 | 0·006 (−0·019 to 0·031) | −0·08 (p=0·94) | |
| Weekly interactions with family and friends | 0·00% | 0·00 | 0·004 (−0·017 to 0·026) | 0·11 (p=0·91) | |
| Function | |||||
| High availability of social support | 0·45% | 0·00 | 0·002 (−0·013 to 0·014) | −1·66 (p=0·10) | |
| Having a confidante | 0·00% | 0·00 | −0·002 (−0·023 to 0·018) | 0·10 (p=0·92) | ·· |
| Quality | |||||
| High relationship satisfaction | 0·00% | 0·00 | −0·036 (−0·078 to 0·006) | −0·27 (p=0·80) | |
| Never feeling lonely | 0·00% | 0·00 | −0·057 (−0·140 to 0·027) | 0·45 (p=0·66) | |
| Memory | |||||
| Structure | |||||
| Being married or in a relationship | 7·14% | 0·00 | 0·042 (0·010 to 0·074) | 0·01 (p=0·99) | −0·023 (−0·047 to 0·001) for men; 0·024 (0·001 to 0·048) for women |
| Living with others | 42·70% | 0·00 | 0·009 (−0·012 to 0·031) | 0·94 (p=0·35) | ·· |
| Yearly engagement in community group | 8·33% | 0·00 | 0·001 (−0·035 to 0·054) | NR* | ·· |
| Monthly engagement in community group | 0·00% | 0·00 | 0·006 (−0·025 to 0·037) | 0·10 (p=0·92) | ·· |
| Weekly engagement in community group | 0·00% | 0·00 | 0·017 (−0·017 to 0·051) | 0·86 (p=0·39) | ·· |
| Yearly interactions with family and friends | 57·32% | 0·05 | −0·076 (−0·389 to 0·235) | −0·14 (p=0·89) | ·· |
| Monthly interactions with family and friends | 0·00% | 0·00 | 0·011 (−0·014 to 0·036) | −1·42 (p=0·16) | ·· |
| Weekly interactions with family and friends | 52·73% | 0·00 | 0·002 (−0·064 to 0·068) | −1·90 (p=0·057) | ·· |
| Function | |||||
| High availability of social support | 33·13% | 0·00 | 0·008 (−0·019 to 0·035) | 0·20 (p=0·84) | ·· |
| Having a confidante | 0·00% | 0·00 | −0·005 (−0·025 to 0·015) | −0·14 (p=0·89) | ·· |
| Quality | |||||
| High relationship satisfaction | 0·00% | 0·00 | −0·029 (−0·087 to 0·028) | −0·42 (p=0·67) | ·· |
| Never feeling lonely | 0·00% | 0·00 | −0·039 (−0·102 to 0·024) | −0·38 (p=0·71) | ·· |
| Language | |||||
| Structure | |||||
| Being married or in a relationship | 0·00% | 0·00 | 0·010 (−0·024 to 0·043) | −1·76 (p=0·079) | ·· |
| Living with others | 0·13% | 0·00 | 0·007 (−0·007 to 0·022) | 0·87 (p=0·39) | ·· |
| Yearly engagement in community group | 77·24%† | 0·00 | −0·001 (−0·094 to 0·092) | NR* | ·· |
| Monthly engagement in community group | 90·58%† | 0·02 | 0·018 (−0·135 to 0·171) | 2·61 (p=0·0069) | ·· |
| Weekly engagement in community group | 47·96% | 0·00 | −0·011 (−0·077 to 0·055) | −0·06 (p=0·95) | ·· |
| Yearly interactions with family and friends | 39·08% | 0·03 | −0·072 (−0·343 to 0·198) | −0·43 (p=0·67) | ·· |
| Monthly interactions with family and friends | 0·00% | 0·00 | −0·006 (−0·030 to 0·018) | −0·29 (p=0·80) | ·· |
| Weekly interactions with family and friends | 0·00% | 0·00 | 0·004 (−0·017 to 0·024) | −0·60 (p=0·55) | ·· |
| Function | |||||
| High availability of social support | 0·00% | 0·00 | 0·002 (−0·011 to 0·016) | 0·65 (p=0·52) | ·· |
| Having a confidante | 0·00% | 0·00 | −0·001 (−0·022 to 0·019) | 0·25 (p=0·81) | ·· |
| Quality | |||||
| High relationship satisfaction | 0·00% | 0·00 | −0·000 (−0·057 to 0·056) | NR* | ·· |
| Never feeling lonely | NR‡ | NR‡ | NR‡ | NR* | ·· |
| Executive function | |||||
| Structure | |||||
| Being married or in a relationship | 0·00% | 0·00 | 0·046 (0·011 to 0·082) | −0·38 (p=0·71) | −0·027 (−0·054 to 0·000) for men; 0·017 (−0·002 to 0·036) for women |
| Living with others | 0·00% | 0·00 | 0·016 (0·001 to 0·031) | 0·25 (p=0·80) | −0·009 (−0·022 to 0·003) for men; 0·005 (−0·002 to 0·013) for women |
| Yearly engagement in community group | 61·34% | 0·00 | −0·033 (−0·110 to 0·045) | NR* | ·· |
| Monthly engagement in community group | 73·11%† | 0·01 | −0·034 (−0·138 to 0·070) | −1·59 (p=0·11) | ·· |
| Weekly engagement in community group | 0·00% | 0·00 | −0·035 (−0·079 to 0·010) | −0·76 (p=0·45) | ·· |
| Yearly interactions with family and friends | 57·15% | 0·06 | 0·133 (−0·246 to 0·513) | −0·11 (p=0·91) | ·· |
| Monthly interactions with family and friends | 0·01% | 0·00 | 0·008 (−0·022 to 0·038) | −0·08 (p=0·93) | ·· |
| Weekly interactions with family and friends | 0·00% | 0·00 | 0·023 (−0·002 to 0·049) | −0·39 (p=0·70) | ·· |
| Function | |||||
| High availability of social support | 0·00% | 0·00 | 0·005 (−0·008 to 0·019) | 0·54 (p=0·59) | ·· |
| Having a confidante | 0·00% | 0·00 | −0·024 (−0·081 to 0·033) | 0·23 (p=0·82) | ·· |
| Quality | |||||
| High relationship satisfaction | 11·29% | 0·00 | −0·014 (−0·093 to 0·065) | 1·37 (p=0·17) | ·· |
| Never feeling lonely | 42·24% | 0·00 | 0·042 (−0·078 to 0·162) | 0·81 (p=0·42) | ·· |
The model results reflect the annual change in cognition (b [95% CI]) for women compared with men and are controlled for age at baseline, education, and sex. Positive interaction effect b indicates slower annual decline in cognition for women than for men; negative interaction effect b indicates slower annual decline in cognition for men than for women. For sex-stratified analyses, simple main effects positive b indicates slower annual decline in cognition than for the reference group for the specific social connection marker. NR=not reported.
*
Some models had less than three cohort studies, and we could not compute Egger’s test for them.
†
p<0·05.
‡
Not enough data points to run analysis.