Pathways from Social Support to Cognition Among Adults in the United States: A Longitudinal Mediation Analysis of Perceived Stress and Sleep Quality.

OBJECTIVE

We examined whether perceived stress and sleep quality mediate the association between social support and later cognition among adults in the United States.

METHODS

We used longitudinal Midlife in the United States (MIDUS) data. Social support (1995-1996) was modeled as a latent construct indicated by family and friend support. Perceived stress and sleep quality were measured in the MIDUS 2 Biomarker Project (2004-2009), and cognition was assessed in MIDUS 2 and MIDUS 3. Structural equation models evaluated parallel indirect pathways, adjusting for MIDUS 2 cognition and covariates.

RESULTS

Higher social support was associated with lower perceived stress (β=-0.32, 95% CI:-0.41, -0.23) and better sleep quality (β=-0.25, 95% CI:-0.35, -0.15). Greater perceived stress was associated with lower cognition (β=-0.06, 95% CI:-0.11, -0.01), whereas sleep quality was not associated with cognition. Direct and total social support-cognition associations were not statistically significant. A small positive indirect association through perceived stress was identified (β=0.02, 95% CI:0.00, 0.04); no indirect association through sleep quality was identified.

CONCLUSIONS

Findings are consistent with a possible psychosocial pathway through perceived stress, although the effect was modest and total and direct associations were not statistically significant. Sleep quality showed no statistically significant indirect association.