Duffner Lukas A, Deckers Kay, Cadar Dorina, de Vugt Marjolein E, Köhler Sebastian
Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
Department of Behavioural Science and Health, Institute of Epidemiology and Health, University College London, UK.
Psychol Med. 2024 Aug;54(11):3115-3125. doi: 10.1017/S0033291724001272. Epub 2024 Sep 4.
Different aspects of social relationships (e.g., social network size or loneliness) have been associated with dementia risk, while their overlap and potentially underlying pathways remain largely unexplored. This study therefore aimed to (1) discriminate between different facets of social relationships by means of factor analysis, (2) examine their associations with dementia risk, and (3) assess mediation by depressive symptoms.
Thirty-six items from questionnaires on social relationships administered in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing ( = 7536) were used for exploratory and confirmatory factor analysis. Factors were then used as predictors in Cox proportional hazard models with dementia until Wave 9 as outcome, adjusted for demographics and cardiovascular risk factors. Structural equation modeling tested mediation by depressive symptoms through effect decomposition.
Factor analyses identified six social factors. Across a median follow-up time of 11.8 years (IQR = 5.9-13.9 years), 501 people developed dementia. Higher factor scores for frequency and quality of contact with children (HR = 0.88; = 0.021) and more frequent social activity engagement (HR = 0.84; < 0.001) were associated with lower dementia risk. Likewise, higher factor scores for loneliness (HR = 1.13; = 0.011) and negative experiences of social support (HR = 1.10; = 0.047) were associated with higher dementia risk. Mediation analyses showed a significant partial effect mediation by depressive symptoms for all four factors. Additional analyses provided little evidence for reverse causation.
Frequency and quality of social contacts, social activity engagement, and feelings of loneliness are associated with dementia risk and might be suitable targets for dementia prevention programs, partly by lowering depressive symptoms.
社会关系的不同方面（如社交网络规模或孤独感）与痴呆症风险相关，但其重叠部分及潜在的潜在途径在很大程度上仍未得到探索。因此，本研究旨在：（1）通过因子分析区分社会关系的不同方面；（2）研究它们与痴呆症风险的关联；（3）评估抑郁症状的中介作用。
采用英国老龄化纵向研究第二轮（2004/2005年）中关于社会关系问卷的36个项目进行探索性和验证性因子分析。然后将这些因子用作Cox比例风险模型中的预测因子，以痴呆症直至第九轮为结局，并对人口统计学和心血管危险因素进行调整。结构方程模型通过效应分解检验抑郁症状的中介作用。
因子分析确定了六个社会因子。在中位随访时间11.8年（四分位间距=5.9 - 13.9年）内，501人患上痴呆症。与子女联系的频率和质量得分较高（风险比=0.88；P=0.021）以及更频繁参与社交活动（风险比=0.84；P<0.001）与较低的痴呆症风险相关。同样，孤独感得分较高（风险比=1.13；P=0.011）和社会支持的负面经历得分较高（风险比=1.10；P=0.047）与较高的痴呆症风险相关。中介分析显示，抑郁症状对所有四个因子均有显著的部分效应中介作用。进一步分析几乎没有发现反向因果关系的证据。
社交接触的频率和质量、社交活动参与度以及孤独感与痴呆症风险相关，可能是痴呆症预防项目的合适目标，部分原因是通过降低抑郁症状。
