Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-28T10:14:01.125Z Has data issue: false hasContentIssue false

The link between social and emotional isolation and dementia in older black and white Brazilians

Published online by Cambridge University Press:  15 June 2021

Robert S. Wilson*
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
Ana W. Capuano
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA Instituto de Assistencia Medica ao Servidor Publico do Estado (IAMSPE), Sao Paulo, Brazil
Carolina Sampaio
Affiliation:
Instituto de Assistencia Medica ao Servidor Publico do Estado (IAMSPE), Sao Paulo, Brazil
Sue E. Leurgans
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
Lisa L. Barnes
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
Jose M. Farfel
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Instituto de Assistencia Medica ao Servidor Publico do Estado (IAMSPE), Sao Paulo, Brazil
David A. Bennett
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA Instituto de Assistencia Medica ao Servidor Publico do Estado (IAMSPE), Sao Paulo, Brazil
*
Correspondence should be addressed to: Robert S. Wilson, PhD, Rush Alzheimer’s Disease Center, Rush University Medical Center, 1750 West Harrison Street, Suite 1000, Chicago, IL 60612, USA. Phone: 708-310-1725; Fax: 312-942-2297. E-mail: robert_s_wilson@rush.edu

Abstract

Objective:

To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians.

Design:

Cross-sectional clinical–pathological cohort study.

Setting:

Medical center in Sao Paulo, Brazil.

Participants:

As part of the Pathology, Alzheimer’s and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents.

Measurements:

The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI).

Results:

Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI.

Conclusion:

Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnes, L. L., Mendes de Leon, C. F., Wilson, R. S., Bienias, J. L. and Evans, D. A. (2004). Social resources and cognitive decline in a population of older African Americans and Caucasians. Neurology, 63, 23222326.CrossRefGoogle Scholar
Bennett, D. A., Schneider, J. A., Tang, Y., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurology, 5, 406412.CrossRefGoogle ScholarPubMed
Boss, L., Kang, D. H. and Branson, S. (2015). Loneliness and cognitive function in the older adult: a systematic review. International Psychogeriatrics, 27, 541553.CrossRefGoogle ScholarPubMed
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C. and, Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms. Psychology and Aging, 21, 140151.CrossRefGoogle ScholarPubMed
Casey, A. N. S., Liu, Z., Kochan, N. A., Sachdev, P. S. and Brodaty, H. (2020). Cross-lagged modeling of cognition and social network size in the Sydney Memory and Ageing Study. The Journals of Gerontology. Series B Psychological Sciences, gbaa193. doi: 10.1093/geronb/gbaa193.CrossRefGoogle Scholar
Cornoni-Huntley, J., Brock, D. B., Ostfeld, A., Taylor, J. O. and Wallace, R. B. (1986). Established Populations for Epidemiological Studies of the Elderly Resource Data Book. Washington, DC: US Dept of Health and Human Services. NIH Publication No. 86-2443.Google Scholar
Costa, P. T. and McCrae, R. R. (1992). NEO PI-R Professional Manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Crooks, V. C., Lubben, J., Petitti, D. B., Little, D. and Chiu, V. (2008). Social network, cognitive function, and dementia incidence among elderly women. American Journal of Public Health, 98, 12211227.CrossRefGoogle ScholarPubMed
Domenech-Abella, J. et al. (2017). Loneliness and depression in the elderly: the role of social network. Social Psychiatry and Psychiatric Epidemiology, 52, 381390.CrossRefGoogle ScholarPubMed
Donovan, N. J., Wu, Q., Rentz, D. M., Sperling, R. A., Marshall, G. A. and Glymour, M. M. (2017). Loneliness, depression and cognitive function in older U.S. adults. International Journal of Geriatric Psychiatry, 32, 564573.CrossRefGoogle ScholarPubMed
Ferretti, R. E. et al. (2010). Post-mortem diagnosis of dementia by informant interview. Dementia and Neuropsychology, 4, 138144.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M. and Winblad, B. (2000). Influence of social network on occurrence of dementia. Lancet Neurology, 355, 13151319.CrossRefGoogle ScholarPubMed
Gilley, D. W. (1995). Impact of Alzheimer’s-type dementia and information source on the assessment of depression. Psychological Assessment, 7, 4248.CrossRefGoogle Scholar
Hebert, L. E., Weuve, J., Scherr, P. A. and Evans, D. A. (2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology 80, 17781783.CrossRefGoogle ScholarPubMed
Hertzog, C., Kramer, A. F., Wilson, R. S. and Lindenberger, U. (2009). Enrichment effects on adult cognitive development: can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest, 9, 165.CrossRefGoogle Scholar
Holwerda, T. J. et al. (2014). Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL). Journal of Neurology and Psychiatry, 85, 135142.CrossRefGoogle Scholar
Hughes, M. E., Waite, L. J., Hawkley, L. C. and Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys. Research on Aging, 26, 655672.CrossRefGoogle Scholar
Kuiper, J. S. et al. (2015). Social relationships and risk of dementia: a systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 22, 3957.CrossRefGoogle ScholarPubMed
Morris, J. C. (1992). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 24122414.Google Scholar
Mund, M., Freuding, M. M., Mobius, K., Horn, N. and Neyer, F. J. (2020). The stability and change of loneliness across the life span: a meta-analysis of longitudinal studies. Personality and Social Psychology Review, 24, 2452.CrossRefGoogle ScholarPubMed
Penninkilampi, R., Casey, A. N., Singh, M. F. and Brodaty, H. (2018). The association between social engagement, loneliness, and risk of dementia: a systematic review and meta-analysis. Journal of Alzheimers Disease, 1619–1633.CrossRefGoogle Scholar
Rafnsson, S. B., Orrell, M., d’Orsi, E., Hogervorst, E. and Steptoe, A. (2020). Loneliness, social integration, and incident dementia over 6 years: prospective findings from the English Longitudinal Study of Aging. Journals of Gerontology B Psychological Sciences and Social Science, 75, 114124.CrossRefGoogle Scholar
Robins, L. N., Helzer, J. E. and Croughan, J. (1981). National Institute of Mental Health Diagnostic Interview Schedule: history, characteristics, validity. Archives of General Psychiatry, 38, 381389.CrossRefGoogle Scholar
Rohr, S. et al. (2020). Changes in social network size are associated with cognitive changes in the oldest-old. Front Psychiatry, 11, 330. doi: 10.3389/fpsyt.2020.00330.CrossRefGoogle ScholarPubMed
Russell, D., Peplau, L. A. and Cutrona, C. E. (1980). The Revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39, 472480.CrossRefGoogle ScholarPubMed
Saczynski, J. S. et al. (2010). Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology, 75, 3541.CrossRefGoogle ScholarPubMed
Saldanha, N. M. et al. (2020). Beta-amyloid pathology is not associated with depression in a large community-based autopsy study. Journal of Affective Disorders, 278, 372381.CrossRefGoogle ScholarPubMed
Sander, J., Schupp, J. and Richter, D. (2017). Getting together: social contact frequency across the life span. Developmental Psychology, 53, 15711588.CrossRefGoogle ScholarPubMed
Shankar, A., Hamer, M., McMunn, A. and Steptoe, A. (2013). Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosomatic Medicine, 75, 161170.CrossRefGoogle ScholarPubMed
Sharifian, N., Kraal, A. Z., Zaheed, A. B., Sol, K. and Zahodne, L. B. (2020). The longitudinal association between social network composition and episodic memory in older adulthood: the importance of contact frequency with friends. Aging and Mental Health, 24, 17891795.CrossRefGoogle ScholarPubMed
Sundstrom, A., Adolfsson, A. N., Nordin, M. and Adolfsson, R. (2020). Loneliness increases the risk of all-cause dementia and Alzheimer’s disease. Journals of Gerontology B Psychological Sciences and Social Sciences, 75, 919926.CrossRefGoogle ScholarPubMed
Sutin, A. R., Stephan, Y., Luchetti, M. and Terraccciano, A. (2020). Loneliness and risk of dementia. Journals of Gerontology B Psychological Sciences and Social Sciences, 75, 14141422.CrossRefGoogle ScholarPubMed
Tilvis, R. S. et al. (2004). Predictors of cognitive decline and mortality of aged people over a 10-year period. Journals of Gerontology A Biological Sciences and Medical Sciences, 59, 268274.CrossRefGoogle ScholarPubMed
Waite, L. et al. (1999). Informant-based staging of dementia using the clinical dementia rating. Alzheimer’s Disease and Associated Disorders, 13, 3437.CrossRefGoogle ScholarPubMed
Wilson, R. S. et al. (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64, 234240.CrossRefGoogle ScholarPubMed
Wrzus, C., Hanel, M., Wagner, J. and Neyer, F. J. (2013). Social network changes and life events across the life span: a meta-analysis. Psychological Bulletin, 139, 5380.CrossRefGoogle ScholarPubMed
Yin, J., Lassale, C., Steptoe, A. and Cadar, D. (2019). Exploring the bidirectional associations between loneliness and cognitive functioning over 10 years: the English Longitudinal Study of Ageing. International Journal of Epidemiology, 48, 19371948. doi: 10.1093/ije/dyz085 CrossRefGoogle ScholarPubMed
Yu, J., Lam, C. L. M. and Lee, T. M. C. (2016). Perceived loneliness among older adults with mild cognitive impairment. International Psychogeriatrics, 28, 16811685.CrossRefGoogle ScholarPubMed
Zahodne, L. B., Ajrouch, K. J., Sharifian, N. and Antonucci, T. C. (2019). Social relations and age-related change in memory. Psychology and Aging, 34, 751765.CrossRefGoogle ScholarPubMed