Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing

Mahalingam G 1 , Samtani S 1 , Lam BCP 1 , Lipnicki DM 1 , Lima-Costa MF 2 , Blay SL 3 Show all authors , Castro-Costa E 2 , Shifu X 4 , Guerchet M 5 , Preux PM 5 , Gbessemehlan A 5 , Skoog I 6 , Najar J 6 , Sterner TR 6 , Scarmeas N 7 , Yannakoulia M 8 , Dardiotis T 9 , Kim KW 10 , Riedel-Heller S 11 , Röhr S 11 , Pabst A 11 , Shahar S 12 , Numbers K 1 , Ganguli M 13 , Hughes TF 14 , Chang CH 15 , Crowe M 16 , Ng TP 17 , Gwee X 17 , Chua DQL 17 , Rymaszewska J 18 , Wolf-Ostermann K 19 , Welmer AK 20 , Stafford J 21 , Mélis R 22 , Vernooij-Dassen M 23 , Jeon YH 24 , Sachdev PS 1 , Brodaty H 1 , SHARED consortium for the Cohort Studies of Memory in an International Consortium (COSMIC)

Affiliations 

  • 1 Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, Australia
  • 2 Center for Studies in Public Health and Aging' René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
  • 3 Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, São Paulo, Brazil
  • 4 Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 5 Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
  • 6 Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg, Mölndal, Sweden
  • 7 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
  • 8 Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
  • 9 Department of Neurology, University of Thessaly, Larisa, Greece
  • 10 Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
  • 11 Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany
  • 12 Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 13 Departments of Psychiatry, Epidemiology, and Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  • 14 Youngstown State University, Youngstown, Ohio, USA
  • 15 Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  • 16 Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
  • 17 Yong Loo Lin School of Medicine, Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
  • 18 Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
  • 19 Department of Health Services and Nursing Science Research, Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
  • 20 Aging Research Center & Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  • 21 MRC Unit for Lifelong Health and Ageing, University College London, London, UK
  • 22 Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Gelderland, The Netherlands
  • 23 Faculty of Medical Sciences, Radboud University, Nijmegen, The Netherlands
  • 24 Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Alzheimers Dement, 2023 Nov;19(11):5114-5128.
PMID: 37102417 DOI: 10.1002/alz.13072

Abstract

INTRODUCTION: Previous meta-analyses have linked social connections and mild cognitive impairment, dementia, and mortality. However, these used aggregate data from North America and Europe and examined a limited number of social connection markers.

METHODS: We used individual participant data (N = 39271, Mage  = 70.67 (40-102), 58.86% female, Meducation  = 8.43 years, Mfollow-up  = 3.22 years) from 13 longitudinal ageing studies. A two-stage meta-analysis of Cox regression models examined the association between social connection markers with our primary outcomes.

RESULTS: We found associations between good social connections structure and quality and lower risk of incident mild cognitive impairment (MCI); between social structure and function and lower risk of incident dementia and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality.

DISCUSSION: Different aspects of social connections - structure, function, and quality - are associated with benefits for healthy aging internationally.

HIGHLIGHTS: Social connection structure (being married/in a relationship, weekly community group engagement, weekly family/friend interactions) and quality (never lonely) were associated with lower risk of incident MCI. Social connection structure (monthly/weekly friend/family interactions) and function (having a confidante) were associated with lower risk of incident dementia. Social connection structure (living with others, yearly/monthly/weekly community group engagement) and function (having a confidante) were associated with lower risk of mortality. Evidence from 13 longitudinal cohort studies of ageing indicates that social connections are important targets for reducing risk of incident MCI, incident dementia, and mortality. Only in Asian cohorts, being married/in a relationship was associated with reduced risk of dementia, and having a confidante was associated with reduced risk of dementia and mortality.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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