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Karen A. Ertel, ScD, M. Maria Glymour, ScD and Lisa F. Berkman, PhD

Karen A. Ertel, M. Maria Glymour, and Lisa F. Berkman are with the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. M. Maria Glymour is a Robert Wood Johnson Health and Society Scholar in the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, and the Institute for Social and Economic Research and Policy, New York.

Correspondence: Requests for reprints should be sent to Lisa F. Berkman, Chair, Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: lberkman{at}hsph.harvard.edu).

Objectives. We tested whether social integration protects against memory loss and other cognitive disorders in late life in a nationally representative US sample of elderly adults, whether effects were stronger among disadvantaged individuals, and whether earlier cognitive losses explained the association (reverse causation).

Methods. Using data from the Health and Retirement Study (N = 16 638), we examined whether social integration predicted memory change over 6 years. Memory was measured by immediate and delayed recall of a 10-word list. Social integration was assessed by marital status, volunteer activity, and frequency of contact with children, parents, and neighbors. We examined growth-curve models for the whole sample and within subgroups.

Results. The mean memory score declined from 11.0 in 1998 to 10.0 in 2004. Higher baseline social integration predicted slower memory decline in fully adjusted models (P<.01). Memory among the least integrated declined at twice the rate as among the most integrated. This association was largest for respondents with fewer than 12 years of education. There was no evidence of reverse causation.

Conclusions. Our study provides evidence that social integration delays memory loss among elderly Americans. Future research should focus on identifying the specific aspects of social integration most important for preserving memory.