Men, get socially & physically active
An observational study done by NUS found that those single or widowed men aged 55 years and over have a higher risk of cognitive impairment.
BY: Eleanor Yap
Those who are single or widowed men aged 55 years and over have a higher risk of cognitive impairment, which could lead to dementia, according to an observational study done by the NUS’ Department of Psychological Medicine. The findings, which are similar to those in France and the US, showed that men who have never been married or were widowed, were five- to six-times more likely to be cognitively impaired compared to those who are married.
The on-going study, which started in 2004, interviewed 2,500 seniors in the Geylang area who are mostly Chinese (the number of Malays and Indians were too small to measure), mostly living in HDB, and have low education and income. The study conducts follow-ups every three years (ending this year) and looked solely at how marital status affected cognitive impairment. Its lead investigator Professor Ng Tze-Pin shared that out of those interviewed, 12 percent had cognitive impairment and of those, 3.5 percent had dementia. These findings were published in the journal “Dementia and Geriatric Cognitive Disorders”.
Be like women
Said Prof Ng: “People who do not have a close living relationship tend to experience a higher degree of psychological stress, loneliness and depression, and they are therefore more likely to develop cognitive impairment. I would recommend men who are single or divorced to learn to be more like women and be more socially-active.” This could help to lower their odds of becoming cognitively impaired.
However, the study does not touch on the variations in a relationship and mechanistic factors such as whether a married couple is happy or those living alone may have a live-in companion, and whether these factors could alter the outcomes. What is clear in the study is that marriage seems to “protect” against cognitive impairment, said Prof Ng. He explained the possible reasons for this – “It could be the greater social connectedness and participation in social activities, more emotional support when living with a partner and less loneliness, intimacy of a relationship, and purpose in life in a marriage associated with responsibilities to the spouse and children.”
He said, “Women do a better job of self-preservation and take better care than men. They tend to make friends if they are widowed or divorced. On the other hand, men as a whole are inactive when widowed. Women tend to remain socially-active after being divorced or widowed, doing housework, volunteering, etc.”
Currently, there are 35.6 million cases of dementia worldwide as of 2010, with 7.7 million new cases annually. It is said that the number will double every 20 years as a result of population ageing. According to Prof Ng, the majority of dementia cases can be found in Asia and developing countries. In Singapore, dementia prevalence in those 65 and over is around three to six percent, and is comparable to countries like China and India, but still less than the prevalence in US and Europe, which is at six to nine percent.
Dementia tends to occur around 65 and above. Before diagnosis, there is a rapid rate of cognitive decline and the signs and symptoms show up later in life. It starts with mild cognitive impairment and leads to the more severe impairment of dementia, and dependence in activities of daily living (ADL). Some of the milder symptoms include memory problems, difficulty recalling facts and what one has done a short while ago, while the severe symptoms include not remembering their children or grandchildren, language difficulties and behavioural problems.
Said Prof Ng, “There is no cure, and available drugs have a limited effectiveness of about one to two years, but they help slow down cognitive decline. By delaying the onset, it can reduce the dementia prevalence to 20 to 50 percent.” He said that besides age, other risk factors include genetics, low education, lack of mental activities and social isolation, head injury and certain drugs. Also those who have hypertension and diabetes are certainly at higher risk.
While there are some things we cannot control, what can be controlled are psychosocial and behavioural factors such as activities and exercise, he added. He recommended everyone to participate in social or physical activities at least three times or more a week.