The Sensory & Social Neglect Index: A Novel Multidimensional Risk Tool for Metabolic and Cognitive Decline

TL;DR

A new tool called the Sensory/Social Neglect Index (SNI) was developed to assess how sensory and social neglect in older adults relate to diabetes and cognitive decline.

Contribution

The SNI is a novel multidimensional index combining sensory and social neglect domains to evaluate risk for metabolic and cognitive decline.

Findings

Higher SNI levels were significantly associated with increased risk of cognitive decline and diabetes in older adults.

The highest SNI levels showed the strongest association with both conditions combined, though with wide confidence intervals due to small sample sizes.

SNI levels were more common in older adults, racial/ethnic minorities, and nonmetropolitan residents.

Abstract

Older adults experience multisensory impairment and low social engagement; their combined impact on metabolic and cognitive decline is rarely examined. Our objective was to develop a Sensory/Social Neglect Index (SNI), integrating four domains and assessing its association with diabetes and cognitive decline in older adults. Using cross-sectional data and multinomial logistic regression, we examined the relationship between SNI levels and diabetes/cognitive decline (alone/combined), adjusting for demographic/health covariates. Data was extracted from the 2020 National Health Interview Survey. The SNI was created by summing 4 domains from NHIS variables: dental neglect, hearing impairment, vision impairment, and social neglect, yielding a cumulative level from 0-4. Respondents (4,573 U.S. adults aged ≥65) were categorized into neither condition, diabetes only, cognitive decline only, or both. SNI levels were right-skewed, with 36.1% of participants at level 0, 35.5% at level 1, 19.5% at level 2, 7.4% at level 3, and 1.5% at level 4. Higher SNI levels were more common in older adults, racial/ethnic minorities, and nonmetropolitan residents. The risk of cognitive decline only was significantly higher at SNI=3 (ARRR=3.65, 95% CI:1.33–10.01) and remained elevated at level 4 (ARRR=4.26, 95% CI:1.25–14.51). The risk of both conditions rose from level 2 (ARRR=18.10, 95% CI:2.07–157.93) to level 4 (ARRR=91.33, 95% CI:6.03–1382.52), though wide confidence intervals reflect small sample sizes. Final analyses will refine model estimates/explore category consolidation. Results suggest that sensory/social neglect is associated with cognitive decline and diabetes. Incorporating SNI-based screening into primary care could identify at-risk individuals and foster preventive care.