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Hopper S, Wister AV, Cosco TD, Best JR. Social Isolation, Physical Activity, and Subsequent Changes in Cognition Among Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging. Psychosom Med 2024; 86:107-115. [PMID: 38193775 DOI: 10.1097/psy.0000000000001271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The objectives of this study were to a) evaluate associations between social isolation and change in cognition over a 3-year period, and b) evaluate whether physical activity mediates the association between social isolation and cognition change. METHODS Using baseline and follow-up 1 data from the Canadian Longitudinal Study on Aging, latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of social isolation on cognitive change through physical activity. Multigroup models were constructed based on age group (45-65 versus 65+ years) and sex to allow for varying estimates across age and sex. The final analytic sample included 51,338 participants. RESULTS Indirect effects of social isolation on cognition through physical activity were evident in men and women 65+ years old for memory change ( = -0.005 [99.9% confidence interval = -0.007 to -0.002], p < .001 in both groups) and in male adults 65+ years old for executive function change ( = -0.01 [99.9% confidence interval = -0.02 to -0.006], p < .001). Statistically significant indirect effects were not observed for adults between 45 and 65 years old. CONCLUSIONS Social isolation is associated with diminished physical activity, and in turn, diminished physical activity is associated with decline in memory in older women and men, with larger declines in executive function in older men. Public health initiatives to promote physical activity-perhaps incorporating social interaction-among older adults experiencing social isolation could be one way to mitigate the negative impact of social isolation on cognitive health.
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Affiliation(s)
- Shawna Hopper
- From the Department of Gerontology (Hopper, Wister, Cosco, Best) and Gerontology Research Centre (Wister, Cosco, Best), Simon Fraser University, Vancouver, British Columbia, Canada; Oxford Institute of Population Ageing (Cosco), University of Oxford, Oxford, United Kingdom; and Department of Psychiatry (Best), University of British Columbia, Vancouver, British Columbia, Canada
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Zhao A, Balcer LJ, Himali JJ, O’Donnell A, Rahimpour Y, DeCarli C, Gonzales MM, Aparicio HJ, Ramos-Cejudo J, Kenney R, Beiser A, Seshadri S, Salinas J. Association of Loneliness with Functional Connectivity MRI, Amyloid-β PET, and Tau PET Neuroimaging Markers of Vulnerability for Alzheimer's Disease. J Alzheimers Dis 2024; 99:1473-1484. [PMID: 38820017 PMCID: PMC11191473 DOI: 10.3233/jad-231425] [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] [Accepted: 04/21/2024] [Indexed: 06/02/2024]
Abstract
Background Loneliness has been declared an "epidemic" associated with negative physical, mental, and cognitive health outcomes such as increased dementia risk. Less is known about the relationship between loneliness and advanced neuroimaging correlates of Alzheimer's disease (AD). Objective To assess whether loneliness was associated with advanced neuroimaging markers of AD using neuroimaging data from Framingham Heart Study (FHS) participants without dementia. Methods In this cross-sectional observational analysis, we used functional connectivity MRI (fcMRI), amyloid-β (Aβ) PET, and tau PET imaging data collected between 2016 and 2019 on eligible FHS cohort participants. Loneliness was defined as feeling lonely at least one day in the past week. The primary fcMRI marker was Default Mode Network intra-network connectivity. The primary PET imaging markers were Aβ deposition in precuneal and FLR (frontal, lateral parietal and lateral temporal, retrosplenial) regions, and tau deposition in the amygdala, entorhinal, and rhinal regions. Results Of 381 participants (mean age 58 [SD 10]) who met inclusion criteria for fcMRI analysis, 5% were classified as lonely (17/381). No association was observed between loneliness status and network changes. Of 424 participants (mean age 58 [SD = 10]) meeting inclusion criteria for PET analyses, 5% (21/424) were lonely; no associations were observed between loneliness and either Aβ or tau deposition in primary regions of interest. Conclusions In this cross-sectional study, there were no observable associations between loneliness and select fcMRI, Aβ PET, and tau PET neuroimaging markers of AD risk. These findings merit further investigation in prospective studies of community-based cohorts.
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Affiliation(s)
- Amanda Zhao
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Laura J. Balcer
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health and Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
| | - Jayandra J. Himali
- The Framingham Study, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Adrienne O’Donnell
- The Framingham Study, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Yashar Rahimpour
- Department of Anatomy and Neurobiology, Center for Biomedical Imaging, Boston University School of Medicine, Boston, MA, USA
| | - Charles DeCarli
- Department of Neurology, University of California Davis, Davis, CA, USA
| | - Mitzi M. Gonzales
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Hugo J. Aparicio
- The Framingham Study, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jaime Ramos-Cejudo
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Rachel Kenney
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health and Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
| | - Alexa Beiser
- The Framingham Study, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Sudha Seshadri
- The Framingham Study, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Joel Salinas
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
- The Framingham Study, Boston, MA, USA
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Lara E, Matovic S, Vasiliadis HM, Grenier S, Berbiche D, de la Torre-Luque A, Gouin JP. Correlates and trajectories of loneliness among community-dwelling older adults during the COVID-19 pandemic: A Canadian longitudinal study. Arch Gerontol Geriatr 2023; 115:105133. [PMID: 37499331 DOI: 10.1016/j.archger.2023.105133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/26/2023] [Accepted: 07/16/2023] [Indexed: 07/29/2023]
Abstract
The COVID-19 pandemic provided a unique opportunity to examine the contributions of social interaction and other non-social factors to loneliness among older adults in the context of confinement measures constraining opportunities for in-person social interactions. This study aims to identify groups of individuals with heterogeneous trajectories of loneliness during the COVID-19 pandemic and to explore the sociodemographic, health, psychological and social interaction-related factors associated with these trajectories. In this 12-month longitudinal study, 614 community-dwelling individuals aged 60+ years completed telephone-based interviews on four occasions between May 2020 and May 2021. Loneliness was evaluated using the three-item version of the UCLA Loneliness Scale. Multilevel modelling assessed average changes in loneliness over time. Group-based trajectory modelling was performed to identify distinct trajectories of loneliness over time. Multinomial logistic regressions were conducted to explore the predictors of these trajectories. On average, there was a curvilinear change in loneliness that tracked the stringency of the COVID-19-related confinement measures. In this convenience sample, three heterogeneous trajectories were identified: a stable-low (17.2%), a fluctuating-moderate (48.8%) and a sustained-elevated (34.0%) trajectory. Participants in the sustained-elevated loneliness trajectory were more likely to live alone and experience elevated psychological distress and greater COVID-19 perceived health threat compared to those in the stable-low trajectory. Participants in the fluctuating-moderate loneliness group were more likely to have multimorbidity, experience greater psychological distress, and have less frequent in-person interactions than the stable-low loneliness group. Assessing the combination of sociodemographic, health, psychological and social factors may help identify individuals at higher risk for chronic loneliness.
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Affiliation(s)
- Elvira Lara
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Matovic
- Department of Psychology, Concordia University, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, QC, Canada
| | - Alejandro de la Torre-Luque
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain; Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
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Kennedy M, Liu SW. Geriatric Emergency Medicine: The Need Has Never Been Greater. Clin Geriatr Med 2023; 39:xv-xvii. [PMID: 37798074 DOI: 10.1016/j.cger.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Maura Kennedy
- Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - Shan W Liu
- Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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