Date of Award

Spring 5-15-2019

Author's School

Graduate School of Arts and Sciences

Author's Department

Social Work

Degree Name

Doctor of Philosophy (PhD)

Degree Type

Dissertation

Abstract

Promoting social engagement is a promising approach to prevent or delay conversion from cognitive impairment no dementia (CIND) to dementia. However, little is known about social engagement among people with CIND. This dissertation project aimed to improve understanding of social engagement among people with CIND by addressing gaps in the literature. It had three specific aims including: to describe and identify factors associated with heterogeneity of social engagement among older adults with CIND, to assess the association between heterogeneity of social engagement and conversion from CIND to dementia, and to investigate the relationship among heterogeneity of social engagement, other types of activity engagement, and conversion from CIND to dementia. Data from two waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1,227 people who were classified as having CIND in 2010. To identify the heterogeneity of social engagement, Latent Class Analysis (LCA) was utilized. Multinomial logistic regression analysis was conducted to assess the association between factors and patterns of social engagement. Using LCA, three groups were identified: Formal and informal social engagement group, Informal social engagement only group, and Low social engagement group. Some factors from four domains of WHO’s ICF model were associated with probability of having certain patterns of social engagement. To assess the relationship between heterogeneity of social engagement and conversion from CIND to dementia, binary logistic regression was utilized. The result showed that people in the formal and informal social engagement group and informal social engagement only group had significantly lower probabilities of converting to dementia in four years. To investigate the relationship among different types of activity engagement and conversion from CIND to dementia, path analysis with structural equation model was utilized. The result revealed that the relationship between having the pattern of formal and informal social engagement and lower probability of converting to dementia in four years was mediated by having higher cognitive engagements. Findings suggest that social engagement is heterogeneous among people with CIND and there are some modifiable factors to promote social engagement among them. Results of this study also imply that promoting social engagement may be promising intervention to prevent or delay conversion from CIND to dementia. Findings further indicate that promoting social engagement may be more effective and efficient strategy since it promotes other activity engagements that may prevent or delay conversion from CIND to dementia.

Language

English (en)

Chair and Committee

Nancy Morrow-Howell

Committee Members

Sojung Park, Amy Eyler, Shenyang Guo, Brian Carpenter,

Comments

Permanent URL: https://doi.org/10.7936/53kh-ay12

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