social isolation

Socially active 60-year-olds face lower dementia risk

August 2, 2019

Science Daily/University College London

Being more socially active in your 50s and 60s predicts a lower risk of developing dementia later on, finds a new UCL-led study.

 

The longitudinal study, published in PLOS Medicine, reports the most robust evidence to date that social contact earlier in life could play an important role in staving off dementia.

 

"Dementia is a major global health challenge, with one million people expected to have dementia in the UK by 2021, but we also know that one in three cases are potentially preventable," said the study's lead author, Dr Andrew Sommerlad (UCL Psychiatry).

 

"Here we've found that social contact, in middle age and late life, appears to lower the risk of dementia. This finding could feed into strategies to reduce everyone's risk of developing dementia, adding yet another reason to promote connected communities and find ways to reduce isolation and loneliness."

 

The research team used data from the Whitehall II study, tracking 10,228 participants who had been asked on six occasions between 1985 and 2013 about their frequency of social contact with friends and relatives. The same participants also completed cognitive testing from 1997 onwards, and researchers referred to the study subjects' electronic health records up until 2017 to see if they were ever diagnosed with dementia.

 

For the analysis, the research team focused on the relationships between social contact at age 50, 60 and 70, and subsequent incidence of dementia, and whether social contact was linked to cognitive decline, after accounting for other factors such as education, employment, marital status and socioeconomic status.

 

The researchers found that increased social contact at age 60 is associated with a significantly lower risk of developing dementia later in life. The analysis showed that someone who saw friends almost daily at age 60 was 12% less likely to develop dementia than someone who only saw one or two friends every few months.

 

They found similarly strong associations between social contact at ages 50 and 70 and subsequent dementia; while those associations did not reach statistical significance, the researchers say that social contact at any age may well have a similar impact on reducing dementia risk.

 

Social contact in mid to late life was similarly correlated with general cognitive measures.

 

Previous studies have found a link between social contact and dementia risk, but they did not have such long follow-up times, so they could not rule out the possibility that the beginnings of cognitive decline may have been causing people to see fewer people, rather than the other way around. The long follow-up in the present study strengthens the evidence that social engagement could protect people from dementia in the long run.

 

The researchers say there are a few explanations for how social contact could reduce dementia risk.

 

"People who are socially engaged are exercising cognitive skills such as memory and language, which may help them to develop cognitive reserve -- while it may not stop their brains from changing, cognitive reserve could help people cope better with the effects of age and delay any symptoms of dementia," said senior author Professor Gill Livingston (UCL Psychiatry).

 

"Spending more time with friends could also be good for mental wellbeing, and may correlate with being physically active, both of which can also reduce the risk of developing dementia," added Professor Livingston, who previously led a major international study outlining the lifecourse factors that affect dementia risk.

 

The researchers were supported by Wellcome and the National Institute for Health Research UCLH Biomedical Research Centre, while the Whitehall II study is supported by the US National Institutes of Health, UK Medical Research Council and the British Heart Foundation.

 

The study was conducted by researchers in UCL Psychiatry, UCL Epidemiology & Public Health, Camden & Islington NHS Foundation Trust and Inserm.

 

Dr Kalpa Kharicha, Head of Innovation, Policy and Research at the Campaign to End Loneliness, said: "We welcome these findings that show the benefits of frequent social contact in late/middle age on dementia risk. As we found in our Be More Us Campaign, almost half of UK adults say that their busy lives stop them from connecting with other people. It's important we make changes to our daily lives to ensure we take the time to connect with others. We need more awareness of the benefits that social wellbeing and connectedness can have to tackle social isolation, loneliness and reduce dementia risk."

 

Fiona Carragher, Chief Policy and Research Officer at Alzheimer's Society, said: "There are many factors to consider before we can confirm for definite whether social isolation is a risk factor or an early sign of the condition -- but this study is a step in the right direction. We are proud of supporting work which helps us understand the condition better -- it is only through research that we can understand true causes of dementia and how best to prevent it.

 

"As the number of people in the UK with dementia is set to rise to one million by 2021, we must do what we can to reduce our risk -- so along with reducing your alcohol intake and stopping smoking, we encourage people across the country to get out into the sunshine, and do something active with family and friends.

 

"The Government's recent emphasis on health prevention is a welcome opportunity to reduce the risk of dementia across society. We now need to see Ministers prioritise better support initiatives to help people reduce the risk of dementia, and look forward to seeing this when the results of the Green Paper on Prevention are published later in the year."

https://www.sciencedaily.com/releases/2019/08/190802144414.htm

With age comes hearing loss and a greater risk of cognitive decline

But study suggests higher education might counter effects of milder hearing impairment

February 12, 2019

Science Daily/University of California - San Diego

In a new study, researchers report that hearing impairment is associated with accelerated cognitive decline with age, though the impact of mild hearing loss may be lessened by higher education

 

Hearing impairment is a common consequence of advancing age. Almost three-quarters of U.S. adults age 70 and older suffer from some degree of hearing loss. One unanswered question has been to what degree hearing impairment intersects with and influences age-related cognitive decline.

 

In a new study, researchers at University of California San Diego School of Medicine report that hearing impairment is associated with accelerated cognitive decline with age, though the impact of mild hearing loss may be lessened by higher education.

 

The findings are published in the February 12, 2019 issue of the Journal of Gerontology: Series A Medical Sciences.

 

A team of scientists, led by senior author Linda K. McEvoy, PhD, professor in the departments of Radiology and Family Medicine and Public Health, tracked 1,164 participants (mean age 73.5 years, 64 percent women) in the longitudinal Rancho Bernardo Study of Healthy Aging for up to 24 years. All had undergone assessments for hearing acuity and cognitive function between the years 1992 to 1996 and had up to five subsequent cognitive assessments at approximately four-year intervals. None used a hearing aid.

 

The researchers found that almost half of the participants had mild hearing impairment, with 16.8 percent suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse performance at the initial visit on a pair of commonly used cognitive assessment tests: the Mini-Mental State Exam (MMSE) and the Trail-Making Test, Part B. Hearing impairment was associated with greater decline in performance on these tests over time, both for those with mild hearing impairment and those with more severe hearing impairment.

 

However, the association of mild hearing impairment with rate of cognitive decline was modified by education. Mild hearing impairment was associated with steeper decline among study participants without a college education, but not among those with higher education. Moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level.

 

"We surmise that higher education may provide sufficient cognitive reserve to counter the effects of mild hearing loss, but not enough to overcome effects of more severe hearing impairment," said McEvoy.

 

Degree of social engagement did not affect the association of hearing impairment with cognitive decline. "This was a somewhat unexpected finding" said first author Ali Alattar. "Others have postulated that cognitive deficits related to hearing impairment may arise from social isolation, but in our study, participants who had hearing impairment were as socially engaged as those without hearing loss."

 

The findings, said the authors, emphasize the need for physicians to be aware that older patients with hearing impairments are at greater risk for cognitive decline. They also emphasized the importance of preventing hearing loss at all ages, since hearing impairment is rarely reversible. One important way to protect hearing, they said, is to minimize loud noise exposure since this is the largest modifiable risk factor for hearing impairment.

https://www.sciencedaily.com/releases/2019/02/190212134802.htm

 

Known risk factors largely explain links between loneliness and first time heart disease/stroke

But social isolation still associated with death among those with preexisting cardiovascular disease

March 26, 2018

Science Daily/BMJ

Conventional risk factors largely explain the links observed between loneliness/social isolation and first time heart disease/stroke, a new study finds. But having few social contacts still remains an independent risk factor for death among those with pre-existing cardiovascular disease.

 

Recent research has increasingly highlighted links between loneliness and social isolation and cardiovascular disease and death. But most of these studies have not considered a wide range of other potentially influential factors, say the authors.

 

In a bid to clarify what role these other factors might have, they drew on data from nearly 480,000 people aged between 40 and 69, who were all part of the UK Biobank study between 2007 and 2010.

 

Participants provided detailed information on their ethnic background, educational attainment, household income, lifestyle (smoking, drinking, exercise) and depressive symptoms.

 

They were also asked a series of questions to gauge their levels of social isolation and loneliness. Height, weight, and grip strength were measured, and blood samples taken.

 

Their health was then tracked for an average of 7 years.

 

Nearly one in 10 (9%) respondents were deemed to be socially isolated, 6 percent lonely, and 1 percent both.

 

Those who were socially isolated and/or lonely were more likely to have other underlying long term conditions and to be smokers, while those who were lonely reported more depressive symptoms.

 

During the 7 year monitoring period, 12,478 people died. And 5731 people had a first time heart attack while 3471 had a first time stroke.

 

Social isolation was associated with a 43 percent higher risk of first time heart attack, when age, sex, and ethnicity were factored in.

 

But when behavioural, psychological, health, and socioeconomic factors were added into the mix, these factors accounted for most (84%) of the increased risk, and the initial association was no longer significant.

 

Similarly, social isolation was initially associated with a 39 percent heightened risk of a first time stroke, but the other conventional risk factors accounted for 83 percent of this risk.

 

Similar results were observed for loneliness and risk of first time heart attack or stroke.

 

But this was not the case for those with pre-existing cardiovascular disease among whom social isolation was initially associated with a 50 percent heightened risk of death. Although this halved when all the other known factors were considered, it was still 25 percent higher.

 

Similarly, social isolation was associated with a 32 percent heightened risk of death even after all the other conventional factors had been accounted for.

 

This is an observational study so no firm conclusions can be drawn about cause and effect, but the findings echo those of other research in the field, say the study authors.

 

And the size and representative nature of the study prompt the authors to conclude that their findings "indicate that social isolation, similarly to other risk factors such as depression, can be regarded as a risk factor for poor prognosis of individuals with cardiovascular disease."

 

This is important, they emphasise, as around a quarter of all strokes are recurrent, and targeting treatment of conventional risk factors among the lonely and isolated might help stave off further heart attacks and strokes, they suggest.

https://www.sciencedaily.com/releases/2018/03/180326213304.htm

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