Factors influencing cognitive decline in living alone by the residence characteristics: A longitudinal study

Purpose: This study aimed to identify the risk factors of cognitive decline in older adults living alone in local communities and to find cognitive nursing methods by the area of residence. Methods: The participants were 164 people living alone for 12 years. The data were analyzed using a generalized estimating equations method. Results: The following factors were identified as statistically significant predictors that increased cognitive decline in older adults living alone: 1) rural areas: age (odds ratio [OR]=1.02, 95% confidence interval [CI]=1.01~1.02), low education (OR=1.53, 95% CI=1.13~2.07), number of diseases (OR=1.07, 95% CI=1.01~1.14), 2) urban areas: women (OR=1.27, 95% CI=1.09~1.49), age (OR=1.02, 95% CI=1.01~1.03), low education (OR=1.26, 95% CI=1.14~1.40), body mass index (OR=0.98, 95% CI=0.96~0.99), instrumental activities of daily living (OR=1.02, 95% CI=1.00~1.04), depressive symptom (OR=1.14, 95% CI=1.03~1.25). Conclusion: The older adults who lived alone had different risk factors for cognitive decline depending on their areas of residence. Preventive management for cognitive decline should be presented according to the areas of residence among older adults living alone.