School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Gerontol B Psychol Sci Soc Sci. 2024 May 1;79(5). doi: 10.1093/geronb/gbae050.
This study examines the gender-specific associations between a wide range of social activities and dementia risk.
A prospective cohort study was conducted involving community-dwelling older Australians (≥70 years) without significant cognitive impairment at enrolment. During the first year of enrolment, we assessed 25 self-reported social activities covering various aspects, including support from relatives and friends, community participation, social interactions with surroundings, and loneliness. Dementia diagnosis followed DSM-IV criteria, adjudicated by an international expert panel. To estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between social activities and dementia, we performed Cox proportional hazards models, adjusting for age, educational attainment, baseline global cognition, and depressive symptoms.
Among 9,936 participants who completed all social activity questionnaires (median [IQR] age: 73.4 [71.6-77.1] years; 47.4% men), dementia was diagnosed in 3.8% of men (n = 181/4,705) and 2.6% of women (n = 138/5,231) over a median 6.4 years (IQR: 5.3-7.6, range: 0.2-10.1) follow-up. Gender-specific relationships emerged: caregiving for a person with illness/disability in women (HR: 0.65, 95% CI: 0.42-0.99), and having ≥9 relatives feeling close to call for help in men (HR: 0.56, 95% CI: 0.33-0.96; reference <9 relatives) were associated with reduced dementia risk. Unexpectedly, in women, having ≥5 friends with whom they felt comfortable discussing private matters were associated with a greater dementia risk (HR: 1.69, 95% CI: 1.10-2.59; reference ≤2 friends). Imputed models further identified that babysitting/childminding was associated with lower dementia risk in men (HR: 0.75, 95% CI: 0.56-0.99). No other social activities showed significant associations with dementia.
This study provides evidence of social activities influencing dementia risk. Further investigations are required to uncover the mechanisms driving these observed relationships.
本研究旨在探讨广泛的社会活动与痴呆风险之间的性别特异性关联。
本研究为前瞻性队列研究,纳入了无明显认知障碍的澳大利亚社区老年人(≥70 岁)。在入组的第一年,我们评估了 25 项自我报告的社会活动,涵盖了亲属和朋友的支持、社区参与、与周围环境的社会互动以及孤独感等多个方面。痴呆症的诊断依据 DSM-IV 标准,由国际专家小组裁定。为了评估社会活动与痴呆症之间的关联风险比(HR)和 95%置信区间(CI),我们使用 Cox 比例风险模型进行了分析,调整了年龄、教育程度、基线总体认知和抑郁症状等因素。
在完成所有社会活动问卷的 9936 名参与者中(中位[IQR]年龄:73.4 [71.6-77.1]岁;47.4%为男性),男性中有 3.8%(n=181/4705)和女性中有 2.6%(n=138/5231)在中位 6.4 年(IQR:5.3-7.6,范围:0.2-10.1)的随访中被诊断为痴呆症。出现了性别特异性的关系:女性中照顾患病/残疾的人(HR:0.65,95%CI:0.42-0.99),以及男性中与≥9 位亲近的亲戚有联系(HR:0.56,95%CI:0.33-0.96;参考值<9 位亲戚)与降低痴呆症风险相关。出乎意料的是,在女性中,与≥5 位可以与之讨论私人事务的朋友相处融洽与更高的痴呆症风险相关(HR:1.69,95%CI:1.10-2.59;参考值≤2 位朋友)。补充模型进一步确定,男性中照顾婴儿/儿童与较低的痴呆症风险相关(HR:0.75,95%CI:0.56-0.99)。其他社会活动与痴呆症没有显著关联。
本研究提供了社会活动影响痴呆风险的证据。需要进一步的研究来揭示驱动这些观察到的关系的机制。