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.
J Gerontol A Biol Sci Med Sci. 2023 Mar 30;78(4):663-672. doi: 10.1093/gerona/glac215.
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.
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.
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).
Weak social networks may heighten the risk of dementia and AD, underscoring the need to promote social connectedness in older adults.
我们评估了晚年社交网络与全因痴呆（ACD）、阿尔茨海默病（AD）和血管性痴呆（VaD）在日本裔美国人男性中的 10 年纵向关联。
我们前瞻性地分析了基线（1991-1993 年）至 1999-2000 年期间的 2636 名最初无痴呆的库阿基尼·檀香山-亚洲老龄化研究参与者，这些参与者在随访的前 3 年内没有出现痴呆。通过认知能力筛查工具（CASI）评估整体认知能力；通过 11 项中心流行病学研究抑郁量表（CES-D）评估抑郁症状；通过卢本社交网络量表（LSNS）评估社交网络。LSNS 评分的中位数分割定义了弱/强社交网络组。一组神经学家和老年病学家诊断和分类痴呆；AD 和 VaD 诊断包括 AD 或 VaD 分别被认为是痴呆的主要原因的病例。
中位（范围）基线年龄为 77 岁（71-93 岁）。与强社交网络（LSNS 得分>29）相比，弱社交网络（LSNS 得分≤29）者的 ACD（12.6 比 8.7；p=.014）和 AD（6.7 比 4.0；p=.007）的年龄调整发病率更高，但 VaD（2.4 比 1.4；p=.15）没有更高。Kaplan-Meier 曲线显示，网络较弱的男性发生 ACD（对数秩 p<.0001）和 AD（p=.0006）的可能性较低。在调整年龄、教育程度、APOE ɛ4、既往卒中、抑郁症状和基线时的 CASI 评分（均为基线）的 Cox 比例风险模型中，弱网络预测 ACD（风险比[HR] = 1.52，p=.009）和 AD（HR = 1.67，p =.014）的发病率增加，但 VaD（p>.2）没有增加。
弱社交网络可能会增加痴呆和 AD 的风险，这突显了在老年人中促进社交联系的必要性。
