社交联系作为认知健康的决定因素，以及作为针对阿尔茨海默病和相关疾病患者或高危人群的社会干预的目标：范围综述。
Social connections as determinants of cognitive health and as targets for social interventions in persons with or at risk of Alzheimer's disease and related disorders: a scoping review.
机构信息
Psychiatry Department, Banner University Medical Center, and University of Arizona College of Medicine, Phoenix, AZ, USA.
Women's Operational Military Exposure Network (WOMEN), VA Palo Alto Health Care System, Palo Alto, CA, USA.
出版信息
Int Psychogeriatr. 2024 Feb;36(2):92-118. doi: 10.1017/S1041610223000923. Epub 2023 Nov 23.
BACKGROUND
Social connections have a significant impact on health across age groups, including older adults. Loneliness and social isolation are known risk factors for Alzheimer's disease and related dementias (ADRD). Yet, we did not find a review focused on meta-analyses and systematic reviews of studies that had examined associations of social connections with cognitive decline and trials of technology-based and other social interventions to enhance social connections in people with ADRD.
STUDY DESIGN
We conducted a scoping review of 11 meta-analyses and systematic reviews of social connections as possible determinants of cognitive decline in older adults with or at risk of developing ADRD. We also examined eight systematic reviews of technology-based and other social interventions in persons with ADRD.
STUDY RESULTS
The strongest evidence for an association of social connections with lower risk of cognitive decline was related to social engagement and social activities. There was also evidence linking social network size to cognitive function or cognitive decline, but it was not consistently significant. A number of, though not all, studies reported a significant association of marital status with risk of ADRD. Surprisingly, evidence showing that social support reduces the risk of ADRD was weak. To varying degrees, technology-based and other social interventions designed to reduce loneliness in people with ADRD improved social connections and activities as well as quality of life but had no significant impact on cognition. We discuss strengths and limitations of the studies included.
CONCLUSIONS
Social engagement and social activities seem to be the most consistent components of social connections for improving cognitive health among individuals with or at risk for ADRD. Socially focused technology-based and other social interventions aid in improving social activities and connections and deserve more research.
背景
社会联系对各年龄段人群的健康都有着重要影响，包括老年人。孤独和社会隔离是阿尔茨海默病和相关痴呆症（ADRD）的已知风险因素。然而，我们没有找到一篇专门针对元分析和系统综述的综述，这些研究考察了社会联系与认知能力下降的关系，以及旨在增强 ADRD 患者社会联系的基于技术和其他社会干预措施的试验。
研究设计
我们对 11 项关于社会联系作为 ADRD 患者或有发展 ADRD 风险的老年人认知能力下降的可能决定因素的元分析和系统综述进行了范围界定审查。我们还研究了八项关于 ADRD 患者基于技术和其他社会干预措施的系统综述。
研究结果
与社会参与和社会活动相关的社会联系与较低的认知能力下降风险之间存在最强的关联证据。社会网络规模与认知功能或认知能力下降之间也存在关联，但并不始终具有统计学意义。一些研究（尽管不是全部）报告了婚姻状况与 ADRD 风险之间存在显著关联。令人惊讶的是，表明社会支持降低 ADRD 风险的证据较弱。在不同程度上，旨在减少 ADRD 患者孤独感的基于技术和其他社会干预措施改善了社会联系和活动以及生活质量，但对认知能力没有显著影响。我们讨论了所纳入研究的优缺点。
结论
社会参与和社会活动似乎是改善 ADRD 患者或有发展 ADRD 风险的个体认知健康的最一致的社会联系组成部分。以社交为重点的基于技术和其他社会干预措施有助于改善社会活动和联系，值得进一步研究。
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