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Mogic L, Rutter EC, Tyas SL, Maxwell CJ, O'Connell ME, Oremus M. Functional social support and cognitive function in middle- and older-aged adults: a systematic review of cross-sectional and cohort studies. Syst Rev 2023; 12:86. [PMID: 37211612 DOI: 10.1186/s13643-023-02251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Intact cognitive function is crucial for healthy aging. Functional social support is thought to protect against cognitive decline. We conducted a systematic review to investigate the association between functional social support and cognitive function in middle- and older-aged adults. METHODS Articles were obtained from PubMed, PsycINFO, Sociological Abstracts, CINAHL, and Scopus. Eligible articles considered any form of functional social support and cognitive outcome. We narratively synthesized extracted data by following the Synthesis Without Meta-Analysis (SWiM) guidelines and assessed risk of bias using the Newcastle-Ottawa Scale (NOS). RESULTS Eighty-five articles with mostly low risk-of-bias were included in the review. In general, functional social support-particularly overall and emotional support-was associated with higher cognitive function in middle- and older-aged adults. However, these associations were not all statistically significant. Substantial heterogeneity existed in the types of exposures and outcomes evaluated in the articles, as well as in the specific tools used to measure exposures and outcomes. CONCLUSIONS Our review highlights the role of functional social support in the preservation of healthy cognition in aging populations. This finding underscores the importance of maintaining substantive social connections in middle and later life. SYSTEMATIC REVIEW REGISTRATION Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open;10(4):e037301. https://doi.org/10.1136/bmjopen-2020-037301.
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Affiliation(s)
- Lana Mogic
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Emily C Rutter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Mark Oremus
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
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Kallianpur KJ, Masaki KH, Chen R, Willcox BJ, Allsopp RC, Davy P, Dodge HH. Weak Social Networks in Late Life Predict Incident Alzheimer's Disease: The Kuakini Honolulu-Asia Aging Study. J Gerontol A Biol Sci Med Sci 2023; 78:663-672. [PMID: 36208464 PMCID: PMC10061568 DOI: 10.1093/gerona/glac215] [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: 03/15/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We assessed 10-year longitudinal associations between late-life social networks and incidence of all-cause dementia (ACD), Alzheimer's disease (AD), and vascular dementia (VaD) in Japanese-American men. METHODS We prospectively analyzed, from baseline (1991-1993) through 1999-2000, 2636 initially nondemented Kuakini Honolulu-Asia Aging Study participants who remained dementia-free during the first 3 years of follow-up. Global cognition was evaluated by the Cognitive Abilities Screening Instrument (CASI); depressive symptoms by the 11-item Center for Epidemiologic Studies Depression (CES-D) Scale; and social networks by the Lubben Social Network Scale (LSNS). Median split of LSNS scores defined weak/strong social network groups. A panel of neurologists and geriatricians diagnosed and classified dementia; AD and VaD diagnoses comprised cases in which AD or VaD, respectively, were considered the primary cause of dementia. RESULTS Median (range) baseline age was 77 (71-93) years. Participants with weak (LSNS score ≤29) versus strong (>29) social networks had higher age-adjusted incidence (in person-years) of ACD (12.6 vs. 8.7; p = .014) and AD (6.7 vs. 4.0; p = .007) but not VaD (2.4 vs. 1.4; p = .15). Kaplan-Meier curves showed a lower likelihood of survival free of ACD (log-rank p < .0001) and AD (p = .0006) for men with weak networks. In Cox proportional hazards models adjusting for age, education, APOE ɛ4, prevalent stroke, depressive symptoms, and CASI score (all at baseline), weak networks predicted increased incidence of ACD (hazard ratio [HR] = 1.52, p = .009) and AD (HR = 1.67, p = .014) but not VaD (p > .2). CONCLUSION Weak social networks may heighten the risk of dementia and AD, underscoring the need to promote social connectedness in older adults.
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Affiliation(s)
- Kalpana J Kallianpur
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii, Honolulu, Hawaii, USA
| | - Kamal H Masaki
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
- Department of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Randi Chen
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
| | - Bradley J Willcox
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
- Department of Geriatric Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Richard C Allsopp
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
| | - Philip Davy
- Kuakini Center for Translational Research on Aging, Kuakini Medical Center, Honolulu, Hawaii, USA
| | - Hiroko H Dodge
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer’s Disease Center, Oregon Health & Science University, Portland, Oregon, USA
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3
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Ren Y, Savadlou A, Park S, Siska P, Epp JR, Sargin D. The impact of loneliness and social isolation on the development of cognitive decline and Alzheimer's Disease. Front Neuroendocrinol 2023; 69:101061. [PMID: 36758770 DOI: 10.1016/j.yfrne.2023.101061] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/19/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
Alzheimer's Disease (AD) is the leading cause of dementia, observed at a higher incidence in women compared with men. Treatments aimed at improving pathology in AD remain ineffective to stop disease progression. This makes the detection of the early intervention strategies to reduce future disease risk extremely important. Isolation and loneliness have been identified among the major risk factors for AD. The increasing prevalence of both loneliness and AD emphasizes the urgent need to understand this association to inform treatment. Here we present a comprehensive review of both clinical and preclinical studies that investigated loneliness and social isolation as risk factors for AD. We discuss that understanding the mechanisms of how loneliness exacerbates cognitive impairment and AD with a focus on sex differences will shed the light for the underlying mechanisms regarding loneliness as a risk factor for AD and to develop effective prevention or treatment strategies.
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Affiliation(s)
- Yi Ren
- Department of Cell Biology and Anatomy, University of Calgary, Canada; Cumming School of Medicine, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | - Aisouda Savadlou
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Soobin Park
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Paul Siska
- Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada
| | - Jonathan R Epp
- Department of Cell Biology and Anatomy, University of Calgary, Canada; Cumming School of Medicine, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | - Derya Sargin
- Department of Psychology, University of Calgary, Canada; Department of Physiology & Pharmacology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Canada.
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4
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Wang S, Molassiotis A, Guo C, Leung ISH, Leung AYM. Association between social integration and risk of dementia: A systematic review and meta-analysis of longitudinal studies. J Am Geriatr Soc 2023; 71:632-645. [PMID: 36307921 DOI: 10.1111/jgs.18094] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/24/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of the association between different aspects of social integration and the risk of dementia is unclear. METHODS Five databases were systematically searched. Newcastle-Ottawa scale for assessing the quality of the reporting was used for quality appraisal. Longitudinal cohort studies examining the association between social integration and the risk of dementia were analyzed using random effects model. A series of sensitivity analyses was conducted to enhance the robustness of the findings. RESULTS Forty publications generated from 32 studies/databases were included. The meta-analysis showed that strong social engagement (overall RR = 0.81, 95% CI = 0.74-0.89, p < 0.001) and frequent social contact (overall RR = 0.86, 95% CI = 0.76-0.97, p = 0.018) were positively associated with decreased risk of dementia. The influence of social support (overall RR = 0.92, 95% CI = 0.80-1.06, p = 0.238) and close social contact (overall RR = 0.74, 95% CI = 0.48-1.13, p = 0.167) was not significant. Loneliness was significantly associated with an increased risk of dementia (overall RR = 1.42, 95% CI = 1.26-1.60, p < 0.001), whereas the influence of social isolation (overall RR = 1.58, 95% CI = 0.80-3.12, p = 0.192) was not significant. A larger social network size (RR = 0.75, 95% CI = 0.59-0.97, p = 0.028) was a promising influencing factor even though the number of studies was insufficient for a meta-analysis. However, the heterogeneity among studies was generally high even though sensitivity analysis was conducted. CONCLUSIONS Our findings reveal that high social engagement and frequent social contact are significantly associated with a lower risk of dementia, whereas loneliness is associated with a higher risk. The promising impact of large social network size is also identified. Substantial heterogeneity appeared in most of the analysis, making the inference tentative. Nevertheless, the sensitivity analysis provided valuable implications that enhancing social engagement and reducing loneliness may prevent or delay the onset of dementia among middle-aged and older adults.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Chunlan Guo
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hung Hom, Hong Kong SAR, China
| | - Isaac Sze Him Leung
- Department of Statistics, The Chinese University of Hong Kong, Hung Hom, Hong Kong SAR, China
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
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5
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Yoga improves older adults’ Affective functioning and resting-state brain connectivity: Evidence from a pilot study. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2021.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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Kunutsor SK, Laukkanen JA, Kauhanen J, Willeit P. Physical activity may not be associated with long-term risk of dementia and Alzheimer's disease. Eur J Clin Invest 2021; 51:e13415. [PMID: 32991743 PMCID: PMC7988584 DOI: 10.1111/eci.13415] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/21/2020] [Accepted: 09/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND While it is well established that physical activity is associated with reduced risk of vascular and nonvascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer's disease (AD). MATERIAL AND METHODS We analysed data on 2394 apparently healthy men with good baseline cognitive function from the prospective population-based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12-month leisure time physical activity (LTPA) questionnaire. Using Cox regression, we calculated hazard ratios adjusted for body mass index, systolic blood pressure, smoking status, history of type-2 diabetes, total cholesterol, high-density lipoprotein cholesterol, alcohol consumption, history of coronary heart disease and high-sensitivity C-reactive protein. RESULTS During a median follow-up of 24.9 years (interquartile range: 18.3-26.9), 208 men developed dementia and 128 developed AD. Multivariable adjusted hazard ratios for dementia comparing top vs bottom tertiles of physical activity were 0.97 (95% confidence intervals: 0.69-1.38) for total physical activity volume, 0.96 (0.69-1.34) for conditioning LTPA volume and 1.13 (0.80-1.61) for total LTPA volume. Corresponding hazard ratios for AD were 1.19 (0.76-1.85), 0.98 (0.64-1.49) and 1.22 (0.77-1.93). Associations were consistent in analyses restricted to participants with ≥10 years of follow-up. CONCLUSIONS In middle-aged Caucasian men, various physical activity exposures were not associated with all-cause dementia or AD. Future studies should address biases due to reverse causation and regression dilution and should involve objective measures of physical activity.
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Affiliation(s)
- Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.,Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Learning & Research Building (Level 1), Southmead Hospital, University of Bristol, Bristol, UK
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Central Finland Health Care District Hospital District, Jyväskylä, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Peter Willeit
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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8
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Floud S, Balkwill A, Sweetland S, Brown A, Reus EM, Hofman A, Blacker D, Kivimaki M, Green J, Peto R, Reeves GK, Beral V. Cognitive and social activities and long-term dementia risk: the prospective UK Million Women Study. Lancet Public Health 2021; 6:e116-e123. [PMID: 33516288 PMCID: PMC7848753 DOI: 10.1016/s2468-2667(20)30284-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Although dementia is associated with non-participation in cognitive and social activities, this association might merely reflect the consequences of dementia, rather than any direct effect of non-participation on the subsequent incidence of dementia. Because of the slowness with which dementia can develop, unbiased assessment of any such direct effects must relate non-participation in such activities to dementia detection rates many years later. Prospective studies with long-term follow-up can help achieve this by analysing separately the first and second decade of follow-up. We report such analyses of a large, 20-year study. METHODS The UK Million Women Study is a population-based prospective study of 1·3 million women invited for National Health Service (NHS) breast cancer screening in median year 1998 (IQR 1997-1999). In median year 2001 (IQR 2001-2003), women were asked about participation in adult education, groups for art, craft, or music, and voluntary work, and in median year 2006 (IQR 2006-2006), they were asked about reading. All participants were followed up through electronic linkage to NHS records of hospital admission with mention of dementia, the first mention of which was the main outcome. Comparing non-participation with participation in a particular activity, we used Cox regression to assess fully adjusted dementia risk ratios (RRs) during 0-4, 5-9, and 10 or more years, after information on that activity was obtained. FINDINGS In 2001, 851 307 women with a mean age of 60 years (SD 5) provided information on participation in adult education, groups for art, craft, or music, and voluntary work. After 10 years, only 9591 (1%) had been lost to follow-up and 789 339 (93%) remained alive with no recorded dementia. Follow-up was for a mean of 16 years (SD 3), during which 31 187 (4%) had at least one hospital admission with mention of dementia, including 25 636 (3%) with a hospital admission with dementia mentioned for the first time 10 years or more after follow-up began. Non-participation in cognitive or social activities was associated with higher relative risks of dementia detection only during the first decade after participation was recorded. During the second decade, there was little association. This was true for non-participation in adult education (RR 1·04, 99% CI 0·98-1·09), in groups for art, craft, or music (RR 1·04, 0·99-1·09), in voluntary work (RR 0·96, 0·92-1·00), or in any of these three (RR 0·99, 0·95-1·03). In 2006, 655 118 women provided information on reading. For non-reading versus any reading, there were similar associations with dementia, again with strong attenuation over time since reading was recorded, but longer follow-up is needed to assess this reliably. INTERPRETATION Life has to be lived forwards, but can be understood only backwards. Long before dementia is diagnosed, there is a progressive reduction in various mental and physical activities, but this is chiefly because its gradual onset causes inactivity and not because inactivity causes dementia. FUNDING UK Medical Research Council, Cancer Research UK.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
| | | | - Siân Sweetland
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Anna Brown
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | | | - Albert Hofman
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Deborah Blacker
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jane Green
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Richard Peto
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Valerie Beral
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
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Abstract
Purpose
This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the extent of their dementia. Dementia was viewed by the care workers primarily as a memory disability.
Design/methodology/approach
A short qualitative study of the communication techniques of care workers in England, who had received training in dementia care and some training in the SPECAL® method (Specialised Early Care for Alzheimer’s),was conducted through semi-structured interviews. Resulting data were analysed using a constructivist grounded theory approach.
Findings
Continued application of the SPECAL techniques appeared to reinforced clients’ sense of well-being and produced benefits for care workers’ own well-being.
Research limitations/implications
This small qualitative study suggests there can be beneficial effects for both clients and the care team when care workers tailor their communication behaviour to the needs of people with dementia. Further research on communication techniques in dementia care is needed and how these benefits might be translated into institutional settings.
Originality/value
Few research studies have been made of the SPECAL dementia care method, and this study was the first to look explicitly at the communication techniques that the care workers used with clients. Public health professionals are less likely to be aware of the SPECAL method.
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Wu J, Hasselgren C, Zettergren A, Zetterberg H, Blennow K, Skoog I, Halleröd B. The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions. Aging Ment Health 2020; 24:395-404. [PMID: 30587010 DOI: 10.1080/13607863.2018.1531368] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Emerging evidence suggests that social networks may protect against the development of dementia among older adults. In this study we analysed the association between social networks, the apolipoprotein E (APOE) ε4 allele, and dementia. We also investigated whether there were gender-specific patterns in this respect.Method: The analyses used population-based longitudinal data from Gothenburg, Sweden: the H70 Birth Cohort Study and the Prospective Population Study on Women (PPSW). A total of 580 individuals born in 1930 underwent semi-structured neuropsychiatric examinations in 2000-2001. Follow-up examinations were carried out in 2005-2006 and 2009-2010. The timing of dementia onset was analysed using Cox proportional hazards regression.Results: The presence of the APOE ε4 allele affected the risk of developing dementia in both genders. Among women, distant social networks had a protective effect on dementia, while among men the significant associations between close social networks and dementia did not remain after controlling for covariates. Significant interactions between social networks and the APOE ε4 allele were not found.Conclusion: Strong social networks do not seem to moderate the increased risk of dementia implied by the APOE ε4 allele. Nevertheless, our results underline the importance of strong social networks in postponing dementia onset and indicate that their impact may differ among men and women.
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Affiliation(s)
- Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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11
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Penninkilampi R, Casey AN, Singh MF, Brodaty H. The Association between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 66:1619-1633. [PMID: 30452410 DOI: 10.3233/jad-180439] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
It has been reported that social engagement may be associated with dementia risk. We searched PubMed, EMBASE, PsycINFO, CINAHL, LILACS, Biomed Central, Scopus, and Web of Science from January 2012 - May 2017, supplemented by extraction from previous reviews. We included cohort and case-control studies examining the association between social engagement or loneliness and dementia risk, pooling data using a random-effects model. Registered: PROSPERO (CRD42017067074). We included 31 cohort and 2 case-control studies comprising 2,370,452 participants. Poor social engagement indices were associated with increased dementia risk, including having a poor social network (RR = 1.59, 95% CI 1.31-1.96; I2 = 0.00%) and poor social support (RR = 1.28, 95% CI 1.01-1.62; I2 = 55.51%). In long-term studies (≥10 years), good social engagement was modestly protective (RR = 0.88, 95% CI 0.80-0.96; I2 = 0.00%). Loneliness was non-significantly associated with increased risk (RR = 1.38, 95% CI 0.98-1.94; I2 = 45.32). Our findings encourage interventions targeting social isolation and disengagement for dementia prevention.
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Affiliation(s)
- Ross Penninkilampi
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Anne-Nicole Casey
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Maria Fiatarone Singh
- The University of Sydney, faculty of Health Sciences and Sydney Medical School Sydney, NSW, Australia.,Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, MA, USA
| | - Henry Brodaty
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia
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Gil I, Costa P, Parola V, Cardoso D, Almeida M, Apóstolo J. Efficacy of reminiscence in cognition, depressive symptoms and quality of life in institutionalized elderly: a systematic review. Rev Esc Enferm USP 2019; 53:e03458. [DOI: 10.1590/s1980-220x2018007403458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022] Open
Abstract
ABSTRACT Objective: To identify the best available evidence on the efficacy of Reminiscence Therapy in cognition, depressive symptoms and quality of life in elderly individuals with cognitive impairment. Method: The methodology proposed by the Joanna Briggs Institute was used. Studies focused on group Reminiscence Therapy aimed at institutionalized elderly people with cognitive impairment aged 65 or over were considered. The critical analysis, extraction and synthesis of results was performed by two independent researchers. Results: Four randomized clinical trials and two quasi-experimental studies (n=296) were included. Given the heterogeneous characteristics of studies found, it was impossible to perform a meta-analysis. Of the six studies included, two presented statistically significant results for efficacy in cognition, and three for efficacy in reducing depressive symptoms. In none of the studies was evaluated the elderly’s quality of life. Conclusion: Reminiscence Therapy has potential efficacy for maintaining cognition and decrease of depressive symptomatology in the target population.
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Affiliation(s)
- Isabel Gil
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal
| | - Paulo Costa
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal
| | - Vítor Parola
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal; Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of Excellence, Portugal
| | - Daniela Cardoso
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal; Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of Excellence, Portugal
| | - Maria Almeida
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal
| | - João Apóstolo
- Escola Superior de Enfermagem de Coimbra, Portugal; Unidade de Investigação em Ciências da Saúde, Portugal; Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of Excellence, Portugal
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Lee J. The Relationship Between Physical Activity and Dementia: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Gerontol Nurs 2018; 44:22-29. [DOI: 10.3928/00989134-20180814-01] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/28/2018] [Indexed: 12/28/2022]
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Rasmussen H, Rosness TA, Bosnes O, Salvesen Ø, Knutli M, Stordal E. Anxiety and Depression as Risk Factors in Frontotemporal Dementia and Alzheimer's Disease: The HUNT Study. Dement Geriatr Cogn Dis Extra 2018; 8:414-425. [PMID: 38476883 PMCID: PMC10928810 DOI: 10.1159/000493973] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/21/2018] [Indexed: 03/14/2024] Open
Abstract
Background The roles of both anxiety and depression as risk factors for frontotemporal dementia (FTD) and Alzheimer's disease (AD) have not been previously investigated together. Objective To study anxiety and depression as independent risk factors for FTD and AD. Methods Eighty-four patients with FTD and 556 patients with AD were compared with 117 cognitively healthy (CH), elderly individuals. Both cases and controls were participants in the second Health Study of Nord-Trøndelag (HUNT2) from 1995 to 1997, in which depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). Results Significant associations were found between anxiety and FTD and between depression and AD. A significantly increased risk of developing FTD was observed in patients who had reported anxiety on the HADS (p = 0.017) (odds ratio [OR]: 2.947, 95% confidence interval [CI]: 1.209-7.158) and a significantly increased risk of developing AD was observed in patients who had reported depression on the HADS (p = 0.016) (OR: 4.389, 95% CI: 1.311-14.690). Conclusion Our study findings suggest that anxiety and depression may play different roles as risk factors for FTD and AD.
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Affiliation(s)
- Hege Rasmussen
- Namsos Hospital, Clinic for Mental Health and Substance Abuse, Nord-Trøndelag Hospital Trust (HNT), Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tor Atle Rosness
- The Faculty of Mathematics and Natural Sciences, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Ole Bosnes
- Namsos Hospital, Clinic for Mental Health and Substance Abuse, Nord-Trøndelag Hospital Trust (HNT), Namsos, Norway
| | - Øyvind Salvesen
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marlen Knutli
- Levanger Hospital, Department of Research, Nord-Trøndelag Hospital Trust (HNT), Levanger, Norway
| | - Eystein Stordal
- Namsos Hospital, Clinic for Mental Health and Substance Abuse, Nord-Trøndelag Hospital Trust (HNT), Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Yue W, Wang XD, Shi Z, Wang Y, Liu S, Liu S, Zhang Y, Zhang Y, Lu H, Su W, Ji Y. The prevalence of dementia with Lewy bodies in a rural area of China. Parkinsonism Relat Disord 2016; 29:72-7. [DOI: 10.1016/j.parkreldis.2016.05.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/03/2016] [Accepted: 05/21/2016] [Indexed: 11/16/2022]
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Huang HC, Chen YT, Chen PY, Huey-Lan Hu S, Liu F, Kuo YL, Chiu HY. Reminiscence Therapy Improves Cognitive Functions and Reduces Depressive Symptoms in Elderly People With Dementia: A Meta-Analysis of Randomized Controlled Trials. J Am Med Dir Assoc 2015; 16:1087-94. [PMID: 26341034 DOI: 10.1016/j.jamda.2015.07.010] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Cognitive function impairments and depressive symptoms are common in elderly people with dementia. Previous meta-analyses of outdated and small-scale studies have reported inconsistent results regarding the effects of reminiscence therapy on cognitive functions and depressive symptoms; therefore, we conducted a meta-analysis by including more recent randomized controlled trials (RCTs) with large sample sizes to investigate the immediate and long-term (6-10 months) effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia. REVIEW METHODS Electronic databases, including PubMed, Medline, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, ProQuest, Google Scholar, and Chinese databases were searched to select eligible articles. Primary outcome measures included the scores of cognitive functions and depressive symptoms. In total, 12 RCT studies investigating the effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia were included. Two reviewers independently extracted data. All analyses were performed using a random-effects model. RESULTS Reminiscence therapy had a small-size effect on cognitive functions (g = 0.18, 95% confidence interval [CI] 0.05-0.30) and a moderate-size effect on depressive symptoms (g = -0.49, 95% CI -0.70 to -0.28) in elderly people with dementia. Long-term effects of reminiscence therapy on cognitive functions and depressive symptoms were not confirmed. Moderator analysis revealed that institutionalized elderly people with dementia exhibited greater improvement in depressive symptoms than community-dwelling people with dementia did (g = -0.59 vs. -0.16, P = .003). CONCLUSIONS This meta-analysis confirms that reminiscence therapy is effective in improving cognitive functions and depressive symptoms in elderly people with dementia. Our findings suggest that regular reminiscence therapy should be considered for inclusion as routine care for the improvement of cognitive functions and depressive symptoms in elderly people with dementia, particularly in institutionalized residents with dementia.
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Affiliation(s)
- Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chung Gung University, Taoyuan, Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery, Chung Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chung Gung University, Taoyuan, Taiwan
| | - Sophia Huey-Lan Hu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Fang Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ying-Ling Kuo
- Department of Nursing, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan; School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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