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Rhea EM, Leclerc M, Yassine HN, Capuano AW, Tong H, Petyuk VA, Macauley SL, Fioramonti X, Carmichael O, Calon F, Arvanitakis Z. State of the Science on Brain Insulin Resistance and Cognitive Decline Due to Alzheimer's Disease. Aging Dis 2024; 15:1688-1725. [PMID: 37611907 PMCID: PMC11272209 DOI: 10.14336/ad.2023.0814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is common and increasing in prevalence worldwide, with devastating public health consequences. While peripheral insulin resistance is a key feature of most forms of T2DM and has been investigated for over a century, research on brain insulin resistance (BIR) has more recently been developed, including in the context of T2DM and non-diabetes states. Recent data support the presence of BIR in the aging brain, even in non-diabetes states, and found that BIR may be a feature in Alzheimer's disease (AD) and contributes to cognitive impairment. Further, therapies used to treat T2DM are now being investigated in the context of AD treatment and prevention, including insulin. In this review, we offer a definition of BIR, and present evidence for BIR in AD; we discuss the expression, function, and activation of the insulin receptor (INSR) in the brain; how BIR could develop; tools to study BIR; how BIR correlates with current AD hallmarks; and regional/cellular involvement of BIR. We close with a discussion on resilience to both BIR and AD, how current tools can be improved to better understand BIR, and future avenues for research. Overall, this review and position paper highlights BIR as a plausible therapeutic target for the prevention of cognitive decline and dementia due to AD.
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Affiliation(s)
- Elizabeth M Rhea
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA.
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA 98195, USA.
| | - Manon Leclerc
- Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada.
- Neuroscience Axis, CHU de Québec Research Center - Laval University, Quebec, Quebec, Canada.
| | - Hussein N Yassine
- Departments of Neurology and Medicine, University of Southern California, Los Angeles, CA 90033, USA.
| | - Ana W Capuano
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Han Tong
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| | - Vladislav A Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA 99352, USA.
| | - Shannon L Macauley
- Department of Physiology, University of Kentucky, Lexington, KY 40508, USA.
| | - Xavier Fioramonti
- International Associated Laboratory OptiNutriBrain, Bordeaux, France and Quebec, Canada.
- Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, F-33000 Bordeaux, France.
| | - Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
| | - Frederic Calon
- Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada.
- Neuroscience Axis, CHU de Québec Research Center - Laval University, Quebec, Quebec, Canada.
- International Associated Laboratory OptiNutriBrain, Bordeaux, France and Quebec, Canada.
| | - Zoe Arvanitakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
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Jiang Y, Wu Y, Hu Y, Li S, Ren L, Wang J, Yu M, Yang R, Liu Z, Zhang N, Hu K, Zhang Y, Livingston G, Zhang JJ, Zeng Y, Chen H, Yao Y. Bi-directional association between outdoor or social activities and cognitive function: do the PM 2.5 exposure catalyze the detrimental inactivity-poor cognition cycle? ENVIRONMENTAL RESEARCH 2024; 252:118868. [PMID: 38580003 DOI: 10.1016/j.envres.2024.118868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Previous research has shown that lack of leisure activities, either outdoor or social activities, impedes cognitive function. However, the interrelationship between poor cognition and deficient activities is understudied. In addition, whether exposure to air pollution, such as PM2.5, can accelerate the detrimental 'inactivity-poor cognition' cycle, is worthy of investigation. METHODS We used data from the 2008, 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We assessed the frequency of outdoor or social activities at each wave. The cognitive function was examined using a China-Modified Mini-mental State Examination. We estimated the residential exposure to fine particular matter (PM2.5) via a satellite-based model. We applied cross-lagged panel (CLP) model to examine the bi-directional relationship between outdoor or social activities and cognitive function. We then examined the effect of PM2.5 exposure with sequent cognitive function and activities using generalized estimation equation (GEE) model. FINDINGS Overall, we observed significant bi-directional associations between outdoor or social activities and cognitive function. Participants with better cognitive function in the last wave were more likely to engage in outdoor or social activities in the following wave (outdoor activities: β = 0.37, 95% CI [0.27,0.48], P < 0.01; social activities: β = 0.05, 95% CI [0.02,0.09] P < 0.01). Meanwhile, higher engagement in outdoor or social activities in the last wave was associated with more favorable cognitive function in the following wave (outdoor activities: β = 0.06, 95% CI [0.03,0.09], P < 0.01; social activities: β = 0.10, 95% CI [0.03,0.18], P < 0.01). Notably, an increase in PM2.5 exposure during the preceding year was significantly associated with a declining cognitive function (β = -0.05, 95% CI [-0.08,-0.03], P < 0.01), outdoor activities (β = -0.02, 95% CI [-0.04, -0.01], P < 0.01) and social activities (β = -0.02, 95% CI [-0.02, -0.01], P < 0.01) in the current year; the lagged effects of the PM2.5 exposure in the past year of the last wave on activities and cognitive function of the following wave were also observed. INTERPRETATION Our findings not only indicate the bi-directional links between the frequency of outdoor or social activities and cognitive function, but also report that PM2.5 exposure plays a role in catalyzing the detrimental inactivity-poor cognition cycle. Future research should investigate whether the policy-driven interventions, such as clean air policies, can break the unfavorable activity-cognition cycle, and thereby promoting health from the dual gains in leisure activities and cognition.
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Affiliation(s)
- Yuling Jiang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Yifei Wu
- School of Public Health, Peking University, Beijing, China
| | - Yang Hu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Longbin Ren
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingjing Wang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Mingzhi Yu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Rui Yang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Zhouwei Liu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Nan Zhang
- Manchester Urban Ageing Research Group (MUARG), The University of Manchester, Manchester, UK
| | - Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, and Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | - Junfeng Jim Zhang
- Global Health Institute and the Nicholas School of Environment, Duke University, Durham, NC, USA
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, USA
| | - Huashuai Chen
- Business School of Xiangtan University, Xiangtan, China.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
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Bloomberg M, Muniz-Terrera G, Brocklebank L, Steptoe A. Healthy lifestyle and cognitive decline in middle-aged and older adults residing in 14 European countries. Nat Commun 2024; 15:5003. [PMID: 38937442 PMCID: PMC11211489 DOI: 10.1038/s41467-024-49262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Studies examining lifestyle and cognitive decline often use healthy lifestyle indices, making it difficult to understand implications for interventions. We examined associations of 16 lifestyles with cognitive decline. Data from 32,033 cognitively-healthy adults aged 50-104 years participating in prospective cohort studies of aging from 14 European countries were used to examine associations of lifestyle with memory and fluency decline over 10 years. The reference lifestyle comprised not smoking, no-to-moderate alcohol consumption, weekly moderate-plus-vigorous physical activity, and weekly social contact. We found that memory and fluency decline was generally similar for non-smoking lifestyles. By contrast, memory scores declined up to 0.17 standard deviations (95% confidence interval= 0.08 - 0.27) and fluency scores up to 0.16 standard deviations (0.07 - 0.25) more over 10 years for those reporting smoking lifestyles compared with the reference lifestyle. We thus show that differences in cognitive decline between lifestyles were primarily dependent on smoking status.
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Affiliation(s)
- Mikaela Bloomberg
- Department of Behavioural Science and Health, University College London, London, UK.
| | | | - Laura Brocklebank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Stafford J, Dekhtyar S, Welmer AK, Vetrano DL, Grande G, Laukka EJ, Marseglia A, Moulton V, Mansfield R, Liu Y, Ning K, Wolf-Ostermann K, Brodaty H, Samtani S, Ikram MA, Melis R, Rymaszewska J, Szcześniak D, Di Gessa G, Richards M, Davis D, Patalay P, Maddock J. Social health and subsequent cognitive functioning in people aged 50 years and older: examining the mediating roles of depressive symptoms and inflammatory biomarkers in two European longitudinal studies. THE LANCET. HEALTHY LONGEVITY 2024; 5:e356-e369. [PMID: 38705153 DOI: 10.1016/s2666-7568(24)00046-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Social health markers, including marital status, contact frequency, network size, and social support, have been shown to be associated with cognition. However, the mechanisms underlying these associations remain poorly understood. We investigated whether depressive symptoms and inflammation mediated associations between social health and subsequent cognition. METHODS In the English Longitudinal Study of Ageing (ELSA), a nationally representative longitudinal study in England, UK, we sampled 7136 individuals aged 50 years or older living in private households without dementia at baseline or at the intermediate mediator assessment timepoint, who had recorded information on at least one social health marker and potential mediator. We used four-way decomposition to examine to what extent depressive symptoms, C-reactive protein, and fibrinogen mediated associations between social health and subsequent standardised cognition (verbal fluency and delayed and immediate recall), including cognitive change, with slopes derived from multilevel models (12-year slope). We examined whether findings were replicated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a population-based longitudinal study in Sweden, in a sample of 2604 individuals aged 60 years or older living at home or in institutions in Kungsholmen (central Stockholm) without dementia at baseline or at the intermediate mediator assessment timepoint (6-year slope). Social health exposures were assessed at baseline, potential mediators were assessed at an intermediate timepoint (wave 2 in ELSA and 6-year follow-up in SNAC-K); cognitive outcomes were assessed at a single timepoint (wave 3 in ELSA and 12-year follow-up in SNAC-K), and cognitive change (between waves 3 and 9 in ELSA and between 6-year and 12-year follow-ups in SNAC-K). FINDINGS The study sample included 7136 participants from ELSA, of whom 3962 (55·5%) were women and 6934 (97·2%) were White; the mean baseline age was 63·8 years (SD 9·4). Replication analyses included 2604 participants from SNAC-K, of whom 1604 (61·6%) were women (SNAC-K did not collect ethnicity data); the mean baseline age was 72·3 years (SD 10·1). In ELSA, we found indirect effects via depressive symptoms of network size, positive support, and less negative support on subsequent verbal fluency, and of positive support on subsequent immediate recall (pure indirect effect [PIE] 0·002 [95% CI 0·001-0·003]). Depressive symptoms also partially mediated associations between less negative support and slower decline in immediate recall (PIE 0·001 [0·000-0·002]) and in delayed recall (PIE 0·001 [0·000-0·002]), and between positive support and slower decline in immediate recall (PIE 0·001 [0·000-0·001]). We did not observe mediation by inflammatory biomarkers. Findings of mediation by depressive symptoms in the association between positive support and verbal fluency and between positive support and change in immediate recall were replicated in SNAC-K. INTERPRETATION The findings of this study provide new insights into mechanisms linking social health with cognition, suggesting that associations between interactional aspects of social health, especially social support, and cognition are partly underpinned by depressive symptoms. FUNDING EU Joint Programme-Neurodegenerative Disease Research (JPND) and Alzheimer's Society. TRANSLATION For the Swedish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jean Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK.
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit, Medical Psychology, Karolinska University Hospital, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Vanessa Moulton
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, London, UK
| | - Rosie Mansfield
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, London, UK
| | - Yiwen Liu
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK
| | - Ke Ning
- Division of Community Medicine and Public Health Practice, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany; Leibniz Science Campus Digital Public Health, Bremen, Germany
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Suraj Samtani
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | | | - René Melis
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Joanna Rymaszewska
- Department of Clinical Neuroscience, Faculty of Medicine, Wrocław University of Science and Technology, Wrocław, Poland
| | - Dorota Szcześniak
- Division of Psychotherapy and Somatic Medicine, Department of Psychiatry, Wrocław Medical University, Wrocław, Poland
| | - Giorgio Di Gessa
- UCL Research Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK; Centre for Longitudinal Studies, UCL Institute of Education, University College London, London, UK
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing at UCL, Faculty of Population Health Sciences, University College London, London, UK
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Meng X, Su J, Gao T, Ma D, Zhao Y, Fang S, Zhi S, Li H, Sun J. Multidomain interventions based on a life-course model to prevent dementia in at-risk Chinese older adults: A randomized controlled trial. Int J Nurs Stud 2024; 152:104701. [PMID: 38330865 DOI: 10.1016/j.ijnurstu.2024.104701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Due to the time-dependent effect of specific risk factors for dementia, multidomain interventions based on a life-course model might achieve optimal preventive effects against dementia. OBJECTIVE The purpose of this study was to investigate the effectiveness of multidomain interventions based on a life-course model of modifiable risk factors for dementia in at-risk Chinese older adults. DESIGN This was a two-arm, proof-of-concept, randomized controlled trial. SETTING AND PARTICIPANTS We randomly assigned 96 community-dwelling at-risk adults aged 60 years or older in a 1:1 ratio to either the 6-month multidomain intervention group (dementia literacy, physical activity, cognitive training, social activity and optional modules) or the control group (health education). METHODS The primary outcomes were the dementia risk score and cognitive composite Z score. The secondary outcomes included the individual components of the dementia risk score (protective and risk factors) and cognitive composite Z score (global cognition, memory, executive function and language), social isolation (loneliness, social contact, and social participation), dementia literacy and prevention belief. Linear mixed models with maximum likelihood estimation were used to calculate the outcomes between the groups over time. RESULTS The primary analyses showed that the dementia risk score was significantly lower (p < 0.001) and that the cognitive composite Z score was significantly higher (p = 0.013) in the multidomain intervention group than in the control group. Baseline characteristics did not modify the effects of the multidomain interventions (p value for interaction > 0.05). For secondary outcomes, statistically significant group × time interactions were observed for the protective (p = 0.001) and risk factors (p = 0.049), as well as in executive function (p = 0.020), loneliness (p = 0.029), dementia literacy (p < 0.001) and prevention belief (p < 0.001). CONCLUSIONS Multidomain interventions based on a life-course model are feasible and have the potential to reduce dementia risk and improve cognitive function in at-risk Chinese older adults. REGISTRATION The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100053417).
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Affiliation(s)
- Xiangfei Meng
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jianping Su
- School of Nursing, Jilin University, Changchun, Jilin, China; School of Nursing, Xinjiang Medical University, Urumqi Municipality, Xinjiang, China
| | - Tianbao Gao
- Department of Internal Medicine, Beian No.2 People's Hospital, Beian, Heilongjiang, China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Yanjie Zhao
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shuyan Fang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Shengze Zhi
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Hongyang Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China.
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Zuelsdorff M, Limaye VS. A Framework for Assessing the Effects of Climate Change on Dementia Risk and Burden. THE GERONTOLOGIST 2024; 64:gnad082. [PMID: 37392416 PMCID: PMC10860581 DOI: 10.1093/geront/gnad082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Indexed: 07/03/2023] Open
Abstract
Alzheimer's disease and related dementias (ADRD) represent a public health crisis poised to worsen in a changing climate. Substantial dementia burden is modifiable, attributable to risk rooted in social and environmental conditions. Climate change threatens older populations in numerous ways, but implications for cognitive aging are poorly understood. We illuminate key mechanisms by which climate change will shape incidence and lived experiences of ADRD, and propose a framework for strengthening research, clinical, and policy actions around cognitive health in the context of climate change. Direct impacts and indirect risk pathways operating through built, social, interpersonal, and biomedical systems are highlighted. Air pollution compromises brain health directly and via systemic cardiovascular and respiratory ailments. Flooding and extreme temperatures constrain health behaviors like physical activity and sleep. Medical care resulting from climate-related health shocks imposes economic and emotional tolls on people living with dementia and caregivers. Throughout, inequitable distributions of climate-exacerbated risks and adaptive resources compound existing disparities in ADRD incidence, comorbidities, and care burden. Translational research, including work prioritizing underserved communities, is crucial. A mechanistic framework can guide research questions and methods and identify clinical- and policy-level intervention loci for prevention and mitigation of climate-related impacts on ADRD risk and burden.
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Affiliation(s)
- Megan Zuelsdorff
- School of Nursing, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Vijay S Limaye
- Science Office, Natural Resources Defense Council, New York City, New York, USA
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Posis AIB, Shadyab AH, Parada H, Alcaraz JE, Kremen WS, McEvoy LK. Multimorbidity, Social Engagement, and Age-Related Cognitive Decline in Older Adults from the Rancho Bernardo Study of Healthy Aging. J Alzheimers Dis 2024; 97:1689-1702. [PMID: 38306034 PMCID: PMC10922723 DOI: 10.3233/jad-230809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Background Multimorbidity is associated with increased rate of cognitive decline with age. It is unknown whether social engagement, which is associated with reduced risk of dementia, modifies associations between multimorbidity and cognitive decline. Objective To examine the associations of multimorbidity with longitudinal cognitive test performance among community-dwelling older adults, and to determine whether associations differed by levels of social engagement. Methods We used data from the Rancho Bernardo Study of Healthy Aging, a community-based prospective cohort study. Starting in 1992-1996, participants completed a battery of cognitive function tests at up to 6 study visits over 23.7 (mean = 7.2) years. Multimorbidity was defined as≥2 of 14 chronic diseases. Social engagement was assessed using items based on the Berkman-Syme Social Network Index. Multivariable linear mixed-effects models were used to test associations of multimorbidity and cognitive performance trajectories. Effect measure modification by social engagement was evaluated. Results Among 1,381 participants (mean age = 74.5 years; 60.8% women; 98.8% non-Hispanic White), 37.1% had multimorbidity and 35.1% had low social engagement. Multimorbidity was associated with faster declines in Mini-Mental State Examination (MMSE; β= -0.20; 95% CI -0.35, -0.04), Trail-Making Test Part B (β= 10.02; 95% CI 5.77, 14.27), and Category Fluency (β= -0.42; 95% CI -0.72, -0.13) after adjustment for socio-demographic and health-related characteristics. Multimorbidity was associated with faster declines in MMSE among those with low compared to medium and high social engagement (p-interaction < 0.01). Conclusions Multimorbidity was associated with faster declines in cognition among community-dwelling older adults. Higher social engagement may mitigate multimorbidity-associated cognitive decline.
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Affiliation(s)
- Alexander Ivan B. Posis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Humberto Parada
- School of Public Health, San Diego State University, San Diego, CA, USA
- Moores Cancer Center, UC San Diego Health, La Jolla, CA, USA
- Department of Radiation Medicine & Applied Science, University of California, San Diego, La Jolla, CA, USA
| | - John E. Alcaraz
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Linda K. McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Meaning in life and Parkinson's disease in the UK Biobank. Clin Park Relat Disord 2023; 10:100231. [PMID: 38234675 PMCID: PMC10792733 DOI: 10.1016/j.prdoa.2023.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/15/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Meaning in life is an aspect of eudaimonic well-being associated with lower dementia risk. This research examines whether this protective association extends to Parkinson's disease (PD). Methods Participants (N = 153,569) from the UK Biobank reported on their meaning in life. Cases of PD were identified through health records. Results Meaning in life was associated with a 50 % lower likelihood of prevalent PD (OR = 0.68, 95 % CI = 0.59-0.78). Over the 5-year follow-up, meaning was associated with a 35 % lower risk of incident PD (HR = 0.74, 95 % CI = 0.65-0.83), an association robust to sociodemographic characteristics, depression, history of seeking mental health care, smoking, physical activity, and genetic risk and not moderated by age, sex, education, deprivation, or genetic risk. Conclusions Meaning in life is associated with lower risk of incident PD, an association independent of other major risk factors and generalizable across sociodemographic groups. Meaning is a promising target of intervention for common neurodegenerative diseases.
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Chen S, Zhang Y, Wang Y, Lawrence WR, Rhee J, Guo T, Chen S, Du Z, Wu W, Li Z, Wei J, Hao Y, Zhang W. Long-term particulate matter exposure and the risk of neurological hospitalization: Evidence from causal inference of a large longitudinal cohort in South China. CHEMOSPHERE 2023; 345:140397. [PMID: 37838030 PMCID: PMC10841469 DOI: 10.1016/j.chemosphere.2023.140397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 10/16/2023]
Abstract
With limited evidence on the neurological impact of particulate matter (PM) exposure in China, particularly for PM1 which is smaller but more toxic, we conducted a large Chinese cohort study using causal inference approaches to comprehensively clarify such impact. A total of 36,271 participants in southern China were recruited in 2015 and followed up through 2020. We obtained the neurological hospitalizations records by linking the cohort data to the electronic reports from 418 medical institutions across the study area. By using high-resolution PM concentrations from satellite-based spatiotemporal models and the cohort data, we performed marginal structural Cox models under causal assumptions to assess the potential causal links between time-varying PM exposure and neurological hospitalizations. Our findings indicated that increasing PM1, PM2.5, and PM10 concentrations by 1 μg/m³ were associated with higher overall neurological hospitalization risks, with hazard ratios (HRs) of 1.10 (95% confidence interval (CI) 1.04-1.16), 1.09 (95% CI 1.04-1.14), and 1.03 (95% CI 1.00-1.06), respectively. PM1 appeared to have a stronger effect on neurological hospitalization, with a 1% and 7% higher impact compared to PM2.5 and PM10, respectively. Additionally, each 1-μg/m3 increase in the annual PM1 concentration was associated with an elevated risk of hospitalizations for ischemic stroke (HR: 1.15; 95% CI, 1.06-1.26), which tended to be larger than the estimates for PM2.5 (HR: 1.13, 95% CI, 1.04-1.23) and PM10 (HR: 1.05, 95% CI, 1.00-1.09). Furthermore, never-married or female individuals tended be at a greater risk compared with their counterparts. Our study provides important insights into the health impact of particles, particularly smaller particles, on neurological hospitalization risk and highlights the need for clean-air policies that specifically target these particles.
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Affiliation(s)
- Shimin Chen
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ying Wang
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wayne R Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Jongeun Rhee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Tong Guo
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shirui Chen
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, United States.
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China.
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10
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Mahalingam G, Samtani S, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Riedel-Heller S, Dardiotis T, Röhr S, Kim KW, Pabst A, Shahar S, Numbers K, Ganguli M, Hughes TF, Chang CCH, Crowe M, Ng TP, Gwee X, Chua DQL, Rymaszewska J, Wolf-Ostermann K, Welmer AK, Stafford J, Mélis R, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing. Alzheimers Dement 2023; 19:5114-5128. [PMID: 37102417 PMCID: PMC10603208 DOI: 10.1002/alz.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Previous meta-analyses have linked social connections and mild cognitive impairment, dementia, and mortality. However, these used aggregate data from North America and Europe and examined a limited number of social connection markers. METHODS We used individual participant data (N = 39271, Mage = 70.67 (40-102), 58.86% female, Meducation = 8.43 years, Mfollow-up = 3.22 years) from 13 longitudinal ageing studies. A two-stage meta-analysis of Cox regression models examined the association between social connection markers with our primary outcomes. RESULTS We found associations between good social connections structure and quality and lower risk of incident mild cognitive impairment (MCI); between social structure and function and lower risk of incident dementia and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality. DISCUSSION Different aspects of social connections - structure, function, and quality - are associated with benefits for healthy aging internationally. HIGHLIGHTS Social connection structure (being married/in a relationship, weekly community group engagement, weekly family/friend interactions) and quality (never lonely) were associated with lower risk of incident MCI. Social connection structure (monthly/weekly friend/family interactions) and function (having a confidante) were associated with lower risk of incident dementia. Social connection structure (living with others, yearly/monthly/weekly community group engagement) and function (having a confidante) were associated with lower risk of mortality. Evidence from 13 longitudinal cohort studies of ageing indicates that social connections are important targets for reducing risk of incident MCI, incident dementia, and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality.
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Affiliation(s)
- Gowsaly Mahalingam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
- School of Psychology and Public Health, La Trobe University Melbourne, UNSW Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Sergio Luis Blay
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT – Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Health and Ageing Research Team, School of Psychology, Massey University, Palmerston, New Zealand
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Mary Ganguli
- Departments of Psychiatry, Epidemiology, and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Chung-Chou H. Chang
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tze Pin Ng
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Denise Qian Ling Chua
- Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | | | - Karin Wolf-Ostermann
- Department of Health Services and Nursing Science Research, Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Anna-Karin Welmer
- Aging Research Center & Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jean Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
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11
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Yu K, Siang Ng TK. Investigating Biological Pathways Underpinning the Longitudinal Association Between Loneliness and Cognitive Impairment. J Gerontol A Biol Sci Med Sci 2023; 78:1417-1426. [PMID: 36200979 PMCID: PMC11015400 DOI: 10.1093/gerona/glac213] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness precedes the onset of cognitive impairment (CI) in older adults. Although the mechanisms through which loneliness "gets under the skin" to influence the risk of developing CI have been conceptually proposed, they are rarely empirically examined. The Evolutionary Theory of Loneliness posits that loneliness as a stressor could cause dysregulations in multiple physiological systems. The current study investigated whether inflammatory, cardiovascular, and kidney biomarkers mediate the longitudinal association between loneliness and CI. METHODS Cross-lagged panel models were used to examine the hypothesized relationships, using 2006, 2010, and 2014 waves of data from the Health and Retirement Study (N = 7,037). Loneliness was measured with the 3-item UCLA loneliness scale. CI was assessed with the modified telephone interview for cognitive status. Biomarkers included HbA1C, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, and Cystatin C. Using a stepwise model-building approach, first, the model included only loneliness, CI, and biomarker variables; then, sociodemographic covariates were added; lastly, health status were controlled for. RESULTS In unadjusted and partially adjusted models, loneliness was associated with higher odds of worse cognitive status in an 8-year follow-up. Only HbA1C mediated the longitudinal association between loneliness and CI. However, after further controlling for health status, all associations became nonsignificant. CONCLUSIONS Examining a large number of participants and linking a limited number of biological markers with cognition and loneliness longitudinally, our empirical data did not support theoretical propositions, highlighting the critical importance of controlling for confounders in future studies examining longitudinal mediational relationships underlying loneliness and CI.
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Affiliation(s)
- Kexin Yu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
- NIA-Layton Aging and Alzheimer’s Disease Center, and Oregon Center for Aging and Technology, Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Ted Kheng Siang Ng
- Center for Innovation in Healthy and Resilient Aging (CIHRA), Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Center for Gait and Movement Analysis (CGMA), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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12
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Coleman ME, Roessler MEH, Peng S, Roth AR, Risacher SL, Saykine AJ, Apostolova LG, Perry BL. Social enrichment on the job: Complex work with people improves episodic memory, promotes brain reserve, and reduces the risk of dementia. Alzheimers Dement 2023; 19:2655-2665. [PMID: 37037592 PMCID: PMC10272079 DOI: 10.1002/alz.13035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 04/12/2023]
Abstract
Individuals with more complex jobs experience better cognitive function in old age and a lower risk of dementia, yet complexity has multiple dimensions. Drawing on the Social Networks in Alzheimer Disease study, we examine the association between occupational complexity and cognition in a sample of older adults (N = 355). A standard deviation (SD) increase in complex work with people is associated with a 9% to 12% reduction in the probability of mild cognitive impairment or dementia, a 0.14-0.19 SD increase in episodic memory, and a 0.18-0.25 SD increase in brain reserve, defined as the gap (residual) between global cognitive function and magnetic resonance imaging (MRI) indicators of brain atrophy. In contrast, complexity with data or things is rarely associated with cognitive outcomes. We discuss the clinical and methodological implications of these findings, including the need to complement data-centered activities (e.g., Sudoku puzzles) with person-centered interventions that increase social complexity.
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Affiliation(s)
- Max E. Coleman
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Meghan E. H. Roessler
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Adam R. Roth
- Department of Sociology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Shannon L. Risacher
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Andrew J. Saykine
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Departments of Neurology, Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Liana G. Apostolova
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Departments of Neurology, Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brea L. Perry
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
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13
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Shaw BA, Yang TC, Kim S. Living Alone During Old Age and the Risk of Dementia: Assessing the Cumulative Risk of Living Alone. J Gerontol B Psychol Sci Soc Sci 2023; 78:293-301. [PMID: 36179214 PMCID: PMC9938918 DOI: 10.1093/geronb/gbac156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study examines the association between living alone during old age and dementia. Whereas most previous studies on this topic utilize measures of living alone status that were obtained at a single point in time, we compare this typical approach to one that measures long-term exposure to living alone among older adults and assesses whether dementia is more likely to occur within individuals with more accumulated time living alone. METHODS Data come from the Health and Retirement Study, with a follow-up period of 2000-2018. A total of 18,171 older adults were followed during this period, resulting in 78,490 person-waves analyzed in a series of multi-level logistic models. Contemporaneous living alone was recorded when a respondent's household size was equal to 1 in a given wave. Cumulative living alone was calculated by adding the number of living alone statuses up to a given wave. RESULTS Contemporaneous living alone was either not associated (male-only subsample), or inversely associated (female-only subsample) with dementia. By contrast, a one-unit (i.e., one wave) increase in cumulative living alone was associated with about a 10% increase in the odds of dementia for both men (odds ratio [OR] = 1.111) and women (OR = 1.088), net of several covariates, including marital status, age, social activities, and social support. DISCUSSION Living alone during late life is an important risk factor for dementia, but the cognitive effects of solitary living probably do not take hold immediately for most older adults and potentially demonstrate a dose-response relationship.
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Affiliation(s)
- Benjamin A Shaw
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Tse-Chuan Yang
- Department of Sociology, University at Albany SUNY, Albany, New York, USA
| | - Seulki Kim
- Department of Sociology, University Nebraska, Lincoln, Nebraska, USA
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14
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Plummer J, Nguyen K, Everly J, Kiesow A, Leith K, Neils-Strunjas J. How an Intergenerational Book Club Can Prevent Cognitive Decline in Older Adults: A Pilot Study. Gerontol Geriatr Med 2023; 9:23337214221150061. [PMID: 36698383 PMCID: PMC9869223 DOI: 10.1177/23337214221150061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 01/23/2023] Open
Abstract
Older adults are at higher risk for social isolation because of widowhood, loss of friends, retirement, physical limitations, geographic relocation, and caregiving demands. Behavioral interventions aimed at increasing social contact may help to maintain cognition and prevent cognitive decline. The purpose of this pilot study was to examine a novel intervention for social isolation with an intergenerational book club that had weekly in-person and virtual meetings of college students and older adults. We wanted to know whether the study was feasible and if our methods would be likely to generate meaningful results should it be expanded to a larger number of participants. We predicted that wellbeing and cognition would improve following participation in the book club. Results found that while measures of quality of life and affect were not statistically different before and after participation in a book club, scores on a measure of cognition (the Montreal Cognitive Assessment) were statistically significant between groups (intervention and control) showing greater improvement among book club participants.
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Affiliation(s)
| | | | | | | | | | | | - Jean Neils-Strunjas
- University of South Carolina, Columbia, USA,Jean Neils-Strunjas, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 1705 College Street, Room 215, Columbia, SC 29208, USA.
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15
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Samtani S, Mahalingam G, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kim KW, Riedel-Heller S, Röhr S, Pabst A, Shahar S, Numbers K, Ganguli M, Jacobsen E, Hughes TF, Crowe M, Ng TP, Maddock J, Marseglia A, Mélis R, Szcześniak D, Wiegelmann H, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Associations between social connections and cognition: a global collaborative individual participant data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2022; 3:e740-e753. [PMID: 36273484 PMCID: PMC9750173 DOI: 10.1016/s2666-7568(22)00199-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis. METHODS We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression. FINDINGS Of the 40 006 participants in the 13 cohort studies, we excluded 1392 people with dementia at baseline. 38 614 individual participants were included in our analyses. For the main models, being in a relationship or married predicted slower global cognitive decline (b=0·010, 95% CI 0·000-0·019) than did being single or never married; living with others predicted slower global cognitive (b=0·007, 0·002-0·012), memory (b=0·017, 0·006-0·028), and language (b=0·008, 0·000-0·015) decline than did living alone; and weekly interactions with family and friends (b=0·016, 0·006-0·026) and weekly community group engagement (b=0·030, 0·007-0·052) predicted slower memory decline than did no interactions and no engagement. Never feeling lonely predicted slower global cognitive (b=0·047, 95% CI 0·018-0·075) and executive function (b=0·047, 0·017-0·077) decline than did often feeling lonely. Degree of social support, having a confidante, and relationship satisfaction did not predict cognitive decline across global cognition or cognitive domains. Heterogeneity was low (I2=0·00-15·11%) for all but two of the significant findings (association between slower memory decline and living with others [I2=58·33%] and community group engagement, I2=37·54-72·19%), suggesting robust results across studies. INTERPRETATION Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline. FUNDING EU Joint Programme-Neurodegenerative Disease Research grant, funded by the National Health and Medical Research Council Australia, and the US National Institute on Aging of the US National Institutes of Health.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Gowsaly Mahalingam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luís Blay
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition University Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University College of Medicine and Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Henrik Wiegelmann
- Department of Health Care Research, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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16
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Lamar M, James BD, Glover CM, Capuano AW, McSorley VE, Wilson RS, Barnes LL. Social Engagement and All-Cause Mortality: A Focus on Participants of the Minority Aging Research Study. Am J Prev Med 2022; 63:700-707. [PMID: 36272760 PMCID: PMC10019601 DOI: 10.1016/j.amepre.2022.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/10/2022] [Accepted: 05/09/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Social engagement is known to improve health; less is known about whether social activities at the core of African American life decrease mortality risk in this minoritized population. This study investigated whether and which aspects of social engagement predict mortality risk in older African Americans. METHODS Data from 768 African Americans (aged ∼73 years; nondemented at baseline) participating in the Minority Aging Research Study, a longitudinal community-based, cohort study of aging, was collected between 2004 and 2020 and analyzed in 2020. Participants self-reported late-life social activity, social network size, life space, and purpose in life at baseline and completed approximately 6.5 years of annual follow-up (range=15.70). Cox models included time from baseline to death or censoring and an indicator for death versus censored with age, sex, education, cardiovascular disease risk factor burden, depressive symptomatology, and motor gait performance as covariates. RESULTS As of March 2020, 25% of participants died (n=192; age at death ∼83 years). In fully adjusted Cox models, mortality risk decreased by 34% (hazard ratio=0.66; 95% CI=0.48, 0.91; p=0.012) for those with higher compared with that for those with lower social activity generally, with community/volunteer-, group-, and socially-related activities specifically driving these results. CONCLUSIONS Engaging in late-life social activity, especially group- and socially-based activities, was most consistently and robustly associated with reduced mortality risk in African Americans regardless of health. These results lay the foundation for considering community-based approaches to increase and/or maintain social participation in older African Americans as a potential means by which to increase longevity in this population.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois.
| | - Bryan D James
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - V Eloesa McSorley
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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17
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Xu Z, Tian Y, Li AX, Tang J, Jing XY, Deng C, Mo Z, Wang J, Lai J, Liu X, Guo X, Li T, Li S, Wang L, Lu Z, Chen Z, Liu XA. Menthol Flavor in E-Cigarette Vapor Modulates Social Behavior Correlated With Central and Peripheral Changes of Immunometabolic Signalings. Front Mol Neurosci 2022; 15:800406. [PMID: 35359576 PMCID: PMC8960730 DOI: 10.3389/fnmol.2022.800406] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
The use of electronic cigarette (e-cigarette) has been increasing dramatically worldwide. More than 8,000 flavors of e-cigarettes are currently marketed and menthol is one of the most popular flavor additives in the electronic nicotine delivery systems (ENDS). There is a controversy over the roles of e-cigarettes in social behavior, and little is known about the potential impacts of flavorings in the ENDS. In our study, we aimed to investigate the effects of menthol flavor in ENDS on the social behavior of long-term vapor-exposed mice with a daily intake limit, and the underlying immunometabolic changes in the central and peripheral systems. We found that the addition of menthol flavor in nicotine vapor enhanced the social activity compared with the nicotine alone. The dramatically reduced activation of cellular energy measured by adenosine 5′ monophosphate-activated protein kinase (AMPK) signaling in the hippocampus were observed after the chronic exposure of menthol-flavored ENDS. Multiple sera cytokines including C5, TIMP-1, and CXCL13 were decreased accordingly as per their peripheral immunometabolic responses to menthol flavor in the nicotine vapor. The serum level of C5 was positively correlated with the alteration activity of the AMPK-ERK signaling in the hippocampus. Our current findings provide evidence for the enhancement of menthol flavor in ENDS on social functioning, which is correlated with the central and peripheral immunometabolic disruptions; this raises the vigilance of the cautious addition of various flavorings in e-cigarettes and the urgency of further investigations on the complex interplay and health effects of flavoring additives with nicotine in e-cigarettes.
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Affiliation(s)
- Zhibin Xu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Ye Tian
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - A.-Xiang Li
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Department of Forensic Medicine, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Jiahang Tang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiao-Yuan Jing
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chunshan Deng
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zhizhun Mo
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jiaxuan Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Juan Lai
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xuemei Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xuantong Guo
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Tao Li
- Department of Forensic Medicine, School of Medicine, Xi’an Jiaotong University, Xi’an, China
| | - Shupeng Li
- State Key Laboratory of Oncogenomics, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Key Laboratory of Modern Toxicology of Shenzhen, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liping Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zhonghua Lu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zuxin Chen
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- *Correspondence: Zuxin Chen,
| | - Xin-an Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Zuxin Chen,
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Abstract
PURPOSE OF REVIEW There is increasing recognition of social health being protective against disease, including age-related cognitive decline and dementia. Many concepts around social health, reserve and connectedness are imprecise and without agreed definitions. The mechanisms by which social health is protective are not well understood. RECENT FINDINGS Several observational studies suggest that social participation and connectedness are protective against cognitive decline whereas loneliness is a risk factor for dementia. The possible mechanisms include effects on inflammatory process and immune function, reduced vascular disease risk, improved health behaviours, lower risk of depression, and increased cognitive reserve through cognitive stimulation and physical activity. Social networks have been shown to modify the relationship between Alzheimer's disease and cognitive impairment. The relationship of social networks is, however, reciprocal, with dementia leading to social loss, which in turn worsens cognitive decline. Social reserve is conceptualized as both brain processes underlying the ability and predisposition to form meaningful social ties, and their instantiation as an environmental resource in high-quality social networks. SUMMARY Consistent definitions of social health-related terms will lead to better understanding of their determinants so that tailored interventions can be developed to increase social reserve and improve social health of an individual.
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Piolatto M, Bianchi F, Rota M, Marengoni A, Akbaritabar A, Squazzoni F. The effect of social relationships on cognitive decline in older adults: an updated systematic review and meta-analysis of longitudinal cohort studies. BMC Public Health 2022; 22:278. [PMID: 35148704 PMCID: PMC8831686 DOI: 10.1186/s12889-022-12567-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/12/2022] [Indexed: 04/11/2023] Open
Abstract
Background A previous meta-analysis (Kuiper et al., 2016) has shown that multiple aspects of social relationships are associated with cognitive decline in older adults. Yet, results indicated possible bias in estimations of statistical effects due to the heterogeneity of study design and measurements. We have updated this meta-analysis adding all relevant publications from 2012 to 2020 and performed a cumulative meta-analysis to map the evolution of this growing field of research (+80% of studies from 2012-2020 compared to the period considered in the previous meta-analysis). Methods Scopus and Web of Science were searched for longitudinal cohort studies examining structural, functional and combined effects of social relationships. We combined Odds Ratios (OR) with 95% confidence intervals (CI) using random effects meta-analysis and assessed sources of heterogeneity and the likelihood of publication bias. The risk of bias was evaluated with the Quality of Prognosis Studies in Systematic Reviews (QUIPS) tool. Results The review was prospectively registered on PROSPERO (ID: CRD42019130667). We identified 34 new articles published in 2012-2020. Poor social relationships were associated with cognitive decline with increasing precision of estimates compared to previously reviewed studies [(for structural, 17 articles, OR: 1.11; 95% CI: 1.08; 1.14) (for functional, 16 articles, OR: 1.12; 95% CI: 1.05; 1.20) (for combined, 5 articles, OR: 1.15; 95% CI: 1.06; 1.24)]. Meta-regression, risk and subgroup analyses showed that the precision of estimations improved in recent studies mostly due to increased sample sizes. Conclusions Our cumulative meta-analysis would confirm that multiple aspects of social relationships are associated with cognitive decline. Yet, there is still evidence of publication bias and relevant information on study design is often missing, which could lead to an over-estimation of their statistical effects. Supplementary Information The online version contains supplementary material available at (10.1186/s12889-022-12567-5).
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Affiliation(s)
- Matteo Piolatto
- Cluster of Excellence, Department of Sociology, University of Konstanz, Universität-Str. 10, Konstanz, Germany
| | - Federico Bianchi
- Department of Social and Political Sciences, University of Milan, Via Conservatorio 7 20122, Milan, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, Brescia, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy
| | - Aliakbar Akbaritabar
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, Rostock, Germany
| | - Flaminio Squazzoni
- Department of Social and Political Sciences, University of Milan, Via Conservatorio 7 20122, Milan, Italy.
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20
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Roth AR, Peng S, Coleman ME, Apostolova LG, Perry BL. Do subjective or objective cognitive measures better predict social network type among older adults? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:84-97. [PMID: 35313773 PMCID: PMC9038673 DOI: 10.1080/19485565.2022.2052711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A large literature highlights the link between cognitive function and social networks in later life. Yet there remains uncertainty about the factors driving this relationship. In the present study, we use measures of subjective cognitive decline and clinical cognitive assessments on a sample of older adults to investigate whether the relationship between cognitive function and social networks is driven by psychosocial factors. We found a consistent link between clinical cognitive assessments and social network type, but no association between subjective concerns of cognitive decline and networks. Participants who exhibited signs of clinical cognitive impairment were more likely to have restricted networks (i.e., smaller networks consisting of fewer contacts, more interconnectivity, and less social diversity) compared to their cognitively normal counterparts, regardless of subjective measures of cognitive decline - both from the participant's perspective and study partner's perspective. These findings suggest that neither cognitively impaired older adults nor their network members appear to consciously dissolve social ties on the basis of perceived cognitive decline. However, it remains unclear whether the association between clinical cognitive impairment and social network type indicates the protective nature of social networks against cognitive decline or a subconscious process leading to social contraction.
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Affiliation(s)
- Adam R. Roth
- Department of Sociology, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Max E. Coleman
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Liana G. Apostolova
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brea L. Perry
- Department of Sociology, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, USA
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21
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Peng S, Roth AR, Perry BL. A latent variable approach to measuring bridging social capital and examining its association to older adults' cognitive health. Soc Neurosci 2021; 16:684-694. [PMID: 34727017 DOI: 10.1080/17470919.2021.2001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Access to cognitive stimulation through social interactions is a key mechanism used to explain the association between personal networks, cognitive health, and brain structure in older adults. However, little research has assessed how best to operationalize access to novel or diverse social stimuli using social network measures, many of which were designed to study information diffusion within large whole networks (e.g., structural holes and bridging social capital). Using data from 277 adults in the Social Networks and Alzheimer Disease (SNAD) study, we aimed to evaluate such measures for use in research on cognitive aging using personal social networks. We found a positive association between individual measures of structural holes and cognitive health, but not with brain structure. Further, we extracted a latent measure of bridging social capital using multiple individual measures (i.e., structural holes, network diversity, weak ties, and network size) and found it was significantly associated with cognitive health and brain structure, supporting the utility of this concept and related measures in the study of cognitive aging. Finally, individual measures may underestimate the effects of multidimensional bridging social capital on cognitive health and brain structure compared to a latent measure that combines them.
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Affiliation(s)
- Siyun Peng
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Adam R Roth
- Department of Sociology & Network Science Institute, Indiana University
| | - Brea L Perry
- Department of Sociology & Network Science Institute, Indiana University
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