Department of Epidemiology and Public Health, University College London, UK.
Institute of Mental Health, University of Nottingham, UK.
J Gerontol B Psychol Sci Soc Sci. 2020 Jan 1;75(1):114-124. doi: 10.1093/geronb/gbx087.
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.
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.
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.
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.
社会关系对于老年人认知功能的维持很重要，社交网络的客观特征和感知到的社交联系（孤独感）都与之相关。关于不同方面的社会经验如何预测诊断为痴呆的证据有限。
本研究样本包括基线（2004 年）时无痴呆的 6677 名英国老龄化纵向研究参与者。使用 Cox 回归分析了基线时孤独感、亲密关系数量、婚姻状况和社会隔离（与家人和朋友的联系以及参与组织活动）与平均 6.25 年随访期间发生痴呆的关系，同时控制了潜在的混杂因素。
220 名参与者在随访期间发生了痴呆。多变量分析表明，痴呆风险与较高的孤独感呈正相关（危险比 1.40，95%置信区间 1.09-1.80，p =.008），与亲密关系数量（p <.001）和已婚状况（p =.018）呈负相关。针对反向因果关系和不同的痴呆诊断标准进行的敏感性分析证实了这些发现的稳健性。与社会隔离没有关联。
痴呆风险与老年人的孤独感和亲密关系较少有关。其潜在机制仍有待阐明，但努力提高老年人的人际关系质量可能与痴呆风险相关。
