Loneliness, Social Integration, and Incident Dementia Over 6 Years: Prospective Findings From the English Longitudinal Study of Ageing

Abstract Objectives Social relationships are important for the maintenance of cognitive function at older ages, with both objective features of social networks and perceived social connections (loneliness) being relevant. There is limited evidence about how different aspects of social experience predict diagnosed dementia. Methods The sample comprised 6,677 dementia-free individuals at baseline (2004) from the English Longitudinal Study of Ageing. Baseline information on loneliness, number of close relationships, marital status, and social isolation (contact with family and friends and participation in organizations) was analyzed in relation to incident dementia over an average 6.25 years using Cox regression, controlling for potential confounding factors. Results Two hundred twenty participants developed dementia during follow-up. In multivariable analyses, dementia risk was positively related to greater loneliness (hazard ratio 1.40, 95% confidence interval 1.09–1.80, p = .008), and inversely associated with number of close relationships (p < .001) and being married (p = .018). Sensitivity analyses testing for reverse causality and different criteria for diagnosing dementia confirmed the robustness of these findings. There was no association with social isolation. Discussion Dementia risk is associated with loneliness and having fewer close relationships in later life. The underlying mechanisms remain to be elucidated, but efforts to enhance older peoples’ relationship quality may be relevant to dementia risk.

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P2-423: Interactive Impacts of Loneliness and Social Isolation on Incident Dementia in the English Longitudinal Study of Ageing

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.1635 ◽

2016 ◽

Vol 12 ◽

pp. P807-P807 ◽

Cited By ~ 1

Author(s):

Joanna McHugh ◽

Brian Lawlor ◽

Andrew Steptoe ◽

Frank Kee

Keyword(s):

Longitudinal Study ◽

Social Isolation ◽

Incident Dementia ◽

English Longitudinal Study

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Cultural engagement and incident depression in older adults: evidence from the English Longitudinal Study of Ageing

The British Journal of Psychiatry ◽

10.1192/bjp.2018.267 ◽

2018 ◽

Vol 214 (4) ◽

pp. 225-229 ◽

Cited By ~ 11

Author(s):

Daisy Fancourt ◽

Urszula Tymoszuk

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Lower Risk ◽

Depression Scale ◽

Epidemiological Studies ◽

Cognitive Stimulation ◽

Sensitivity Analyses ◽

Reverse Causality ◽

Cultural Engagement ◽

English Longitudinal Study

BackgroundThere is a recognised need for the identification of factors that might be protective against the development of depression in older adults. Over the past decade, there has been growing research demonstrating the effects of cultural engagement (which combines a number of protective factors including social interaction, cognitive stimulation and gentle physical activity) on the treatment of depression, but as yet not on its prevention.AimsTo explore whether cultural engagement in older adults is associated with a reduced risk of developing depression over the following decade.MethodWorking with data from 2148 adults in the English Longitudinal Study of Ageing who were free from depression at baseline, we used logistic regression models to explore associations between frequency of cultural engagement (including going to museums, theatre and cinema) and the risk of developing depression over the following 10 years using a combined index of the Centre for Epidemiological Studies Depression Scale (CES-D) and physician-diagnosed depression.ResultsThere was a dose–response relationship between frequency of cultural engagement and the risk of developing depression independent of sociodemographic, health-related and social confounders. This equated to a 32% lower risk of developing depression for people who attended every few months (odds ratio (OR) = 0.68, 95% CI 0.47–0.99, P = 0.046) and a 48% lower risk for people who attended once a month or more (OR = 0.52, 95% CI 0.34–0.80, P = 0.003). Results were robust to sensitivity analyses exploring reverse causality, subclinical depressive symptoms and alternative CES-D thresholds.ConclusionsCultural engagement appears to be an independent risk-reducing factor for the development of depression in older age.Declaration of interestNone.

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Changes in body mass in later life and incident dementia

International Psychogeriatrics ◽

10.1017/s1041610212001834 ◽

2012 ◽

Vol 25 (3) ◽

pp. 467-478 ◽

Cited By ~ 13

Author(s):

Brian D. Power ◽

Helman Alfonso ◽

Leon Flicker ◽

Graeme J. Hankey ◽

Bu B. Yeap ◽

...

Keyword(s):

Body Mass ◽

Cox Regression ◽

Later Life ◽

Cumulative Hazard ◽

Ongoing Debate ◽

Phenotypic Marker ◽

Dementia Risk ◽

Incident Dementia ◽

Aging Men

ABSTRACTBackground: There is ongoing debate about whether a decline in body mass represents a true risk factor for dementia, whether it is a phenotypic marker of incipient dementia, or perhaps a marker of another process that increases dementia risk. This study was designed to determine if changes in body mass index (BMI) in later life are associated with hazard of incident dementia over a follow-up period of up to eight years.Methods: Method followed was a prospective cohort study of 4,181 men aged 65–84 years, resident in Perth, Australia. The exposure of interest was change in BMI measured between 1996–1998 and 2001–2004. The outcome was incident dementia, established using the Western Australia Data Linkage System until 2009. We used Cox regression models to establish crude and adjusted hazard of dementia for change in BMI.Results: Compared with men with a stable BMI, those with a decrease in BMI >1 kg/m2 had a higher adjusted hazard of dementia (hazard ratio (HR) = 1.89, 95% CI = 1.32–2.70). The cumulative hazard of dementia over follow-up for changes in BMI was greatest for men with a decrease in BMI >1 kg/m2; this trend was apparent for men in all BMI categories (underweight, normal, overweight, obese). A reverse “J-shaped” association between BMI change and incident dementia was observed, with the lowest dementia rate being for men whose BMI remained stable.Conclusions: Men who maintained a stable body mass had the lowest incidence of dementia. Further studies are needed to clarify causality and assess feasibility of interventional studies to preserve body mass in aging men.

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Supplemental Material for Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing

Health Psychology ◽

10.1037/hea0000541.supp ◽

2017 ◽

Cited By ~ 1

Keyword(s):

Longitudinal Study ◽

Health Literacy ◽

Social Isolation ◽

Mortality Risk ◽

English Longitudinal Study

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Herpes Labialis, Chlamydophila pneumoniae, Helicobacter pylori, and Cytomegalovirus Infections and Risk of Dementia: The Framingham Heart Study

Journal of Alzheimer s Disease ◽

10.3233/jad-200957 ◽

2021 ◽

pp. 1-13

Author(s):

Eduardo Marques Zilli ◽

Adrienne O’Donnell ◽

Joel Salinas ◽

Hugo J. Aparicio ◽

Mitzi Michelle Gonzales ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antiviral Treatment ◽

Chlamydophila Pneumoniae ◽

Unexpected Result ◽

Herpes Labialis ◽

Reverse Causality ◽

Dementia Risk ◽

Incident Dementia ◽

Postmortem Brain Tissue ◽

H Pylori

Background: An association between chronic infectious diseases and development of dementia has been suspected for decades, based on the finding of pathogens in postmortem brain tissue and on serological evidence. However, questions remain regarding confounders, reverse causality, and how accurate, reproducible and generalizable those findings are. Objective: Investigate whether exposure to Herpes simplex (manifested as herpes labialis), Chlamydophila pneumoniae (C. pneumoniae), Helicobacter pylori (H. pylori), and cytomegalovirus (CMV) modifies the risk of dementia in a populational cohort. Methods: Questionnaires regarding incidence of herpes infections were administered to Original Framingham Study participants (n = 2,632). Serologies for C. pneumoniae, H. pylori, and CMV were obtained in Original (n = 2,351) and Offspring cohort (n = 3,687) participants. Participants are under continuous dementia surveillance. Brain MRI and neuropsychological batteries were administered to Offspring participants from 1999–2005. The association between each infection and incident dementia was tested with Cox models. Linear models were used to investigate associations between MRI or neuropsychological parameters and serologies. Results: There was no association between infection serologies and dementia incidence, total brain volume, and white matter hyperintensities. Herpes labialis was associated with reduced 10-year dementia risk (HR 0.66, CI 0.46–0.97), but not for the duration of follow-up. H. pylori antibodies were associated with worse global cognition (β –0.14, CI –0.22, –0.05). Conclusion: We found no association between measures of chronic infection and incident dementia, except for a reduction in 10-year dementia risk for patients with herpes labialis. This unexpected result requires confirmation and further characterization, concerning antiviral treatment effects and capture of episodes.

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