Self-neglect and cognitive function among community-dwelling older persons

Elder self-neglect is a common public health issue, but it is unclear to what degree it is associated with cognitive function. This study aimed to examine the cross-sectional association between self-neglect and cognitive function.

Chicago Health and Aging Project (CHAP) is a population-based epidemiological study conducted in a geographically defined community in Chicago (N = 8698): we identified 1094 CHAP participants who had self-neglect reported to social services agency, which assessed the self-neglect severity. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Perceptual Speed), and both immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Linear regression models were used to assess the association of self-neglect severity and cognitive function.

Self-neglect was associated with poorer cognitive function. After adjusting for confounders, self-neglect was associated with lower global cognitive function (parameter estimate[PE] = -0.367, standard error[SE] = 0.026, p < 0.001), lower MMSE (PE = -2.592, SE = 0.182, p < 0.001), episodic memory (PE = -0.288, SE = 0.032, p < 0.001), and perceptual speed (PE = -5.428, SE = 0.444, p < 0.001). In addition, higher self-neglect severity scores were associated with lower global cognitive function (PE = -0.008, SE = 0.003, p = 0.014). Greater self-neglect severity was not correlated with worse performance on MMSE, but was correlated with worse performance on episodic memory (PE = -0.008,=SE = 0.003, p = 0.010), and perceptual speed (PE = -0.131, SE = 0.042, p = 0.002).

Self-neglect is associated with lower global cognitive function, episodic memory and perceptual speed. Future studies are needed to examine the temporality of these associations.