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Social relationships and risk of dementia: a population-based study

Published online by Cambridge University Press:  17 March 2015

Daniel Eriksson Sörman
Department of Psychology, Umeå University, S-901 87 Umeå, Sweden
Michael Rönnlund
Department of Psychology, Umeå University, S-901 87 Umeå, Sweden
Anna Sundström
Department of Psychology, Umeå University, S-901 87 Umeå, Sweden Centre for Population Studies/Ageing and Living Conditions, Umeå University, S-901 87 Umeå, Sweden
Rolf Adolfsson
Department of Clinical Sciences, Division of Psychiatry, Umeå University, S-901 85 Umeå, Sweden
Lars-Göran Nilsson
Aging Research Center (ARC), Karolinska Institutet, S-113 30 Stockholm, Sweden Umeå Center of Functional Brain Imaging, Umeå University, S-901 87 Umeå, Sweden



The objective was to examine whether aspects of social relationships in old age are associated with all-cause dementia and Alzheimer's disease (AD).


We studied 1,715 older adults (≥ 65 years) who were dementia-free at baseline over a period of up to 16 years. Data on living status, contact/visit frequency, satisfaction with contact frequency, and having/not having a close friend were analyzed using Cox proportional hazards regressions with all-cause dementia or AD as the dependent variable. To control for reverse causality and to identify potential long-term effects, we additionally performed analyses with delayed entry.


We identified 373 incident cases of dementia (207 with AD) during follow-up. The variable visiting/visits from friends was associated with reduced risk of all-cause dementia. Further, a higher value on the relationships index (sum of all variables) was associated with reduced risk of all-cause dementia and AD. However, in analyses with delayed entry, restricted to participants with a survival time of three years or more, none of the social relationship variables was associated with all-cause dementia or AD.


The results indicate that certain aspects of social relationships are associated with incident dementia or AD, but also that these associations may reflect reverse causality. Future studies aimed at identifying other factors of a person's social life that may have the potential to postpone dementia should consider the effects of reverse causality.

Research Article
Copyright © International Psychogeriatric Association 2015 

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American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revised. Washington, DC: American Psychiatric Association.Google Scholar
Amieva, H., Stoykova, R., Matharan, F., Helmer, C., Antonucci, T. C. and Dartigues, J.-F. (2010). What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later. Psychosomatic Medicine, 72, 905911. doi:10.1097/PSY.0b013e3181f5e121.CrossRefGoogle Scholar
Amieva, al. (2008). Prodromal Alzheimer's disease: successive emergence of the clinical symptoms. Annals of Neurology, 64, 492498. doi:10.1002/ana.21509.CrossRefGoogle ScholarPubMed
Barger, S. D. (2013). Social integration, social support and mortality in the US National Health Interview Survey. Psychosomatic Medicine, 75, 510517. doi:10.1097/PSY.0b013e318292ad99.CrossRefGoogle ScholarPubMed
Beard, C. M., Kokmen, E., Offord, K. P. and Kurland, L.T. (1992). Lack of association between Alzheimer's disease and education, occupation, marital status, or living arrangement. Neurology, 42, 20632068.CrossRefGoogle ScholarPubMed
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. The Lancet. Neurology, 5, 406412. doi:10.1016/S1474-4422(06)70417-3.CrossRefGoogle ScholarPubMed
Bickel, H. and Cooper, B. (1994). Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychological Medicine, 24, 179192. Retrieved from 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. doi:10.2105/AJPH.2007.115923.CrossRefGoogle ScholarPubMed
Diniz, B. S., Butters, M. A, Albert, S. M., Dew, M. A. and Reynolds, C. F. (2013). Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies. The British Journal of Psychiatry: The Journal of Mental Science, 202, 329335. doi:10.1192/bjp.bp.112.118307.CrossRefGoogle ScholarPubMed
Drivsholm, al. (2006). Representativeness in population-based studies: a detailed description of non-response in a Danish cohort study. Scandinavian Journal of Public Health, 34, 623631. doi:10.1080/14034940600607616.CrossRefGoogle Scholar
Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M. and Winblad, B. (2000). Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet, 355, 13151319. doi:10.1016/S0140-6736(00)02113-9.CrossRefGoogle ScholarPubMed
Gao, al. (2013). Depression as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. International Journal of Geriatric Psychiatry, 28, 441449. doi:10.1002/gps.3845.CrossRefGoogle ScholarPubMed
Giles, L. C., Anstey, K. J., Walker, R. B. and Luszcz, M. A. (2012). Social networks and memory over 15 Years of followup in a cohort of older Australians: results from the Australian longitudinal study of ageing. Journal of Aging Research, (online) doi:10.1155/2012/856048.CrossRefGoogle Scholar
Goetz, C.G., Emre, M. and Dubois, B. (2008). Parkinson's disease dementia: definitions, guidelines, and research perspectives in diagnosis. Annals of neurology, 64, S81S92. doi:10.1002/ana.21455.CrossRefGoogle ScholarPubMed
Håkansson, al. (2009). Association between mid-life marital status and cognitive function in later life: population based cohort study. BMJ (Clinical Research Ed.), 339, b2462. doi:10.1136/bmj.b2462.CrossRefGoogle ScholarPubMed
Helmer, al. (1999). Marital status and risk of Alzheimer’s disease: a French population-based cohort study. Neurology, 53, 19531958. doi:10.1212/WNL.53.9.1953CrossRefGoogle ScholarPubMed
Hertzog, C., Hultsch, D. F. and Dixon, R. A. (1999). On the problem of detecting effects of lifestyle on cognitive change in adulthood: reply to Pushkar et al. (1999). Psychology and Aging, 14, 528534. doi:10.1037//0882-7974.14.3.528.CrossRefGoogle Scholar
Holt-Lunstad, J., Smith, T. B. and Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7, e1000316. doi:10.1371/journal.pmed.1000316.CrossRefGoogle ScholarPubMed
Holwerda, T. al. (2012). Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam study of the elderly (AMSTEL). Journal of Neurology, Neurosurgery, and Psychiatry, 85, 135142. doi:10.1136/jnnp-2012-302755.CrossRefGoogle Scholar
Johansson, al. (2010). Midlife psychological stress and risk of dementia: a 35-year longitudinal population study. Brain: A Journal of Neurology, 133, 22172224.CrossRefGoogle ScholarPubMed
McKeith, al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium. Neurology, 65, 18631872. doi: 10.1212/01.wnl.0000187889.17253.b1.CrossRefGoogle ScholarPubMed
Nilsson, L.-G., Adolfsson, R., Bäckman, L., de Frias, C. M., Molander, B. and Nyberg, L. (2004). Betula: a prospective cohort study on memory, health and aging. Aging, Neuropsychology, and Cognition, 11, 134148. doi:10.1080/13825580490511026.CrossRefGoogle Scholar
Nilsson, al. (1997). The Betula prospective cohort study: memory, health, and aging. Aging, Neuropsychology, and Cognition, 4, 132. doi:10.1080/13825589708256633.CrossRefGoogle Scholar
Pillai, J. and Verghese, J. (2009). Social networks and their role in preventing dementia. Indian Journal of Psychiatry, 51, 18.Google ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401. doi: 10.1177/014662167700100306.CrossRefGoogle Scholar
Rascovsky, al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 134, 24562477. doi: 10.1093/brain/awr179.CrossRefGoogle ScholarPubMed
Rönnlund, M., Sundström, A., Adolfsson, R. and Nilsson, L.-G. (in press). Subjective memory impairment in older adults predicts future dementia independent of baseline memory performance: Evidence from the Betula prospective cohort study. Alzheimers & Dementia. Epublished ahead of print, doi:10.1016/j.jalz.2014.11.006CrossRefGoogle Scholar
Saczynski, J. al. (2006). The effect of social engagement on incident dementia: the Honolulu-Asia Aging Study. American Journal of Epidemiology, 163, 433440. doi:10.1093/aje/kwj061.CrossRefGoogle ScholarPubMed
Scarmeas, N. and Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25, 625633. doi:10.1076/jcen.25.5.625.14576.CrossRefGoogle Scholar
Small, S. A., Perara, G., DeLaPaz, R., Mayeux, R. and Stern, Y. (1999). Differential regional dysfunction of the hippocampal formation among elderly with memory decline and Alzheimer's disease. Annals of Neurology, 45, 466472. doi: 10.1002/1531-8249(199904)45:4<466::AID-ANA8>3.0.CO;2-Q.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Sörman, D. E., Sundström, A., Rönnlund, M., Adolfsson, R. and Nilsson, L.-G. (2014). Leisure activity in old age and risk of dementia: a 15-year prospective study. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 69, 493501. doi:10.1093/geronb/gbt056.CrossRefGoogle ScholarPubMed
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448460. doi:10.1017/S1355617702813248.CrossRefGoogle ScholarPubMed
Sundström, A., Westerlund, O., Mousavi-Nasab, H., Adolfsson, R. and Nilsson, L.-G. (2014). The relationship between marital and parental status and risk of dementia. International Psychogeriatrics, 26, 19. doi: 10.1017/S1041610213002652.CrossRefGoogle Scholar
Tay, L., Tan, K., Diener, E. and Gonzalez, E. (2013). Social relations, health behaviors, and health outcomes: a survey and synthesis. Applied Psychology: Health and Well-Being, 5, 2878. doi:10.1111/aphw.12000.Google ScholarPubMed
Uchino, B. N. (2006). Social support and health: a review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29, 377387. doi:10.1007/s10865-006-9056-5.CrossRefGoogle ScholarPubMed
Wilson, R. al. (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64, 234240. doi:10.1001/archpsyc.64.2.234.CrossRefGoogle ScholarPubMed
Ybarra, al. (2008). Mental exercising through simple socializing: social interaction promotes general cognitive functioning. Personality and Social Psychology Bulletin, 34, 248259. doi:10.1177/0146167207310454.CrossRefGoogle ScholarPubMed
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