Possible and Probable Dementia and Depressive/Anxiety Symptoms: Mediation Effects of Social Engagement and Loneliness

Using a nationally representative sample of older adults (age 65+, <i>N</i> = 7,547) and a path model, we examined the direct effects of dementia on social engagement, loneliness, and depressive/anxiety symptoms, and the mediation effects of loneliness and social engagement on the associations between dementia and depressive/anxiety symptoms. Of the study population, 7.7% and 5.5% had possible and probable dementia, respectively; 14.3% and 21.9% of those with possible and probable dementia had moderate to severe depressive/anxiety symptoms. The ratios of the indirect effects of social engagement and loneliness on a possible dementia to the total effect of possible dementia on depressive/anxiety symptoms were 0.26 and 0.28, respectively. The ratios in probable dementia were 0.11 and 0.21. The lack of social engagement and loneliness contribute substantially to depressive/anxiety symptoms in dementia. Strategies to increase social engagement and reduce social isolation are necessary to improve the psychological well-being of people living with dementia.