Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan.
J Epidemiol Community Health. 2018 Jan;72(1):7-12. doi: 10.1136/jech-2017-209811. Epub 2017 Oct 31.
Social relationships consist of mutually related but distinct dimensions. It remains unclear how these domains independently contribute to incident dementia. This large-scale, prospective cohort study examines associations between the social relationship domains as well as their combinations and incident dementia among community-dwelling older adults.
We analysed data from 13 984 community-dwelling adults aged 65+ without long-term care needs living in Aichi prefecture in Japan. Incident dementia was assessed based on the Long-term Care Insurance records, followed for 3436 days from the baseline survey conducted in 2003. Three social relationships domains (social support, social networks and social activities) were further divided into a total of eight subdomains. A social relationship diversity score was calculated using the social relationship domains which were significantly related to incident dementia.
A Cox proportional hazards model showed that being married, exchanging support with family members, having contact with friends, participating in community groups and engaging in paid work were related to a lower likelihood of developing incident dementia, controlling for covariates and other social relationship domains. The diversity scores, ranging from 0 to 5, were linearly associated with incident dementia (p<0.001), and those who scored highest were 46% less likely to develop incident dementia compared with those in the lowest category.
Our findings revealed five social relationship subdomains which were negatively related to incident dementia, suggesting that dementia may potentially be prevented by enhancing these social relationships. Future studies should examine independent pathways between each social relationship domain and incident dementia.
社会关系由相互关联但又不同的维度组成。这些领域如何独立影响痴呆症的发生尚不清楚。这项大规模的前瞻性队列研究调查了社区居住的老年人的社会关系领域及其组合与痴呆症发病之间的关系。
我们分析了日本爱知县 13984 名无长期护理需求的 65 岁及以上社区居民的数据。根据长期护理保险记录评估痴呆症发病情况，从 2003 年基线调查开始随访 3436 天。将社会关系领域进一步细分为 8 个子领域。使用与痴呆症发病显著相关的社会关系领域计算社会关系多样性评分。
Cox 比例风险模型显示，已婚、与家庭成员相互支持、与朋友保持联系、参加社区团体和从事有薪工作与发生痴呆症的可能性降低相关，控制了协变量和其他社会关系领域。多样性评分范围为 0 到 5，与痴呆症发病呈线性相关（p<0.001），评分最高的人群发生痴呆症的可能性比评分最低的人群低 46%。
我们的研究结果揭示了与痴呆症发病呈负相关的五个社会关系子领域，表明通过增强这些社会关系可能潜在预防痴呆症。未来的研究应研究每个社会关系领域与痴呆症发病之间的独立途径。
