Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA.
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
J Alzheimers Dis. 2021;84(4):1811-1820. doi: 10.3233/JAD-210519.
Evidence supports a relationship between loneliness, social isolation, and dementia, but less is known about whether social connections confer protection against cognitive decline in disadvantaged neighborhoods.
This longitudinal population-based study examines the relationship between social connectivity and cognitive impairment in a multi-ethnic cohort with low socioeconomic status and high vascular disease risk.
Northern Manhattan Study participants self-reported frequency of social visits, phone calls, satisfaction with social visits, number of friends, and loneliness at baseline, and were followed prospectively with a series of neuropsychological assessments. Social connectivity was examined in relation to incident mild cognitive impairment (MCI)/dementia using logistic regression adjusting for demographics and vascular risk factors.
Among 952 participants (mean age at first neuropsychological assessment = 69±8 years, 62% women, 17% Black, 13% white, 68% Hispanic), 24% developed MCI/dementia. Participants who had phone contact with friends/family 2 + times/week (91%) had a lower odds of MCI/dementia (OR = 0.52, 95% CI = 0.31-0.89), with no association for frequency of in-person visits. Compared to those who were neither socially isolated (≥3 friends) nor lonely (reference, 73%), those who were socially isolated and lonely (3%) had an increased odds of MCI/dementia (OR = 2.89, 95% CI = 1.19-7.02), but differences were not observed for those who were socially isolated but not lonely (10%, OR = 1.05, 95% CI = 0.60-1.84), nor those who were lonely but not isolated (11%, OR = 1.58, 95% CI = 0.97-2.59).
This study raises the possibility that social connections confer some protection for cognitive health in the face of adversity and supports potential opportunities for community social interventions for improving cognition in disadvantaged populations.
有证据表明孤独、社会隔离与痴呆之间存在关联,但对于社会联系是否能预防贫困社区认知能力下降,人们知之甚少。
本纵向人群研究以具有低社会经济地位和高血管疾病风险的多民族队列为研究对象,调查社会联系与认知障碍之间的关系。
在基线时,北方曼哈顿研究参与者报告社会访问、电话的频率、对社会访问的满意度、朋友的数量和孤独感,并前瞻性地进行一系列神经心理学评估。使用逻辑回归调整人口统计学和血管危险因素,评估社会连通性与新发轻度认知障碍(MCI)/痴呆的关系。
在 952 名参与者(首次神经心理学评估时的平均年龄为 69±8 岁,62%为女性,17%为黑人,13%为白人,68%为西班牙裔)中,24%发展为 MCI/痴呆。每周与朋友/家人通电话 2+次的参与者发生 MCI/痴呆的可能性较低(OR=0.52,95%CI=0.31-0.89),而面对面探访频率与 MCI/痴呆无关。与既不社交孤立(≥3 个朋友)也不孤独(参照,73%)的参与者相比,既社交孤立又孤独(3%)的参与者发生 MCI/痴呆的可能性增加(OR=2.89,95%CI=1.19-7.02),但对于社交孤立但不孤独(10%,OR=1.05,95%CI=0.60-1.84)和孤独但不孤立(11%,OR=1.58,95%CI=0.97-2.59)的参与者则无显著差异。
本研究提示社会联系可能为逆境中的认知健康提供一定保护,并为改善弱势群体认知提供社区社会干预的潜在机会。