social engagement

Low social engagement linked to cognitive decline & dementia risk

  • A very large, very long-running British study found that higher social contact at age 60 was associated with a significantly lower risk of developing dementia.
  • A 3-year study of older adults found that lower social engagement was only associated with greater cognitive decline in those with higher amyloid-beta levels.

Socially active 60-year-olds face lower dementia risk

Data from the Whitehall II study, tracking 10,228 participants for 30 years, found that increased social contact at age 60 is associated with a significantly lower risk of developing dementia later in life. Someone who saw friends almost daily at age 60 was 12% less likely to develop dementia than someone who only saw one or two friends every few months.

While previous studies have found a link between social contact and dementia risk, the long follow-up in the present study strengthens the evidence that social engagement could protect people from dementia (rather than precursors of dementia bringing about a decline in social engagement).

https://www.eurekalert.org/pub_releases/2019-08/ucl-sa6073119.php

Low social engagement plus high amyloid linked to cognitive decline

A three-year study of 217 healthy older adults (63-89) enrolled in the Harvard Aging Brain Study, has found that higher amyloid-beta levels in combination with lower social engagement was associated with greater cognitive decline over three years. Lower social engagement wasn’t associated with cognitive decline in those with a lower amyloid-beta burden.

https://www.eurekalert.org/pub_releases/2019-06/bawh-scl062819.php

Reference: 

Sommerlad, A., Sabia, S., Singh-Manoux, A., Lewis, G., & Livingston, G. (2019). Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study. PLOS Medicine, 16(8), e1002862. https://doi.org/10.1371/journal.pmed.1002862

Biddle, K et al, "Social Engagement and Amyloid-b-Related Cognitive Decline in Cognitively Normal Older Adults." American Journal of Geriatric Psychiatry. DOI: https://doi.org/10.1016/j.jagp.2019.05.005

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Hearing loss linked to increased cognitive decline & dementia risk

  • A very large Taiwanese study found that adults with hearing loss had a higher dementia risk, and this was particularly so for those aged 45-64.
  • A very large Japanese study found that a dramatically greater proportion of older adults (65+) with hearing loss reported memory loss, compared to much fewer of those without hearing loss.
  • A very large study found that older adults (50+) who used hearing aids for hearing loss showed better performance on tests of working memory and attention compared with those who didn't use hearing aids for their hearing loss.
  • A large long-running study found that, while hearing impairment was associated with accelerated cognitive decline in older adults (mean age 73.5), the impact might be lessened by higher education.
  • A very large 8-year study found that hearing loss was associated with higher risk of subjective cognitive decline in older men (62+).
  • A very small study suggests that cognitive problems in some older adults may derive directly from hearing impairments, and may be fixed by addressing this.
  • A large, long-running study found that eating a healthy diet was associated with a lower risk of acquired hearing loss in women.

Hearing loss linked to increased dementia risk

A Taiwanese study involving 16,270 adults, of whom half had newly diagnosed hearing loss, found that those with hearing loss had a higher risk of dementia, particularly among those aged 45-64. Six comorbidities (cerebrovascular disease, diabetes, anxiety, depression, alcohol-related illnesses, and head injury) were also significantly associated with a higher dementia risk.

Among the study participants, 1,868 developed dementia during the 13-year study period.

https://www.eurekalert.org/pub_releases/2019-07/jn-hld072919.php

Hearing loss linked to limitations, distress, and memory loss in older people

Data from the 2016 Comprehensive Survey of Living Conditions of Japan has found that, of those 137,723 respondents who were aged 65 or older, about 9% reported hearing loss. There were substantial differences between those with hearing loss and those without:

  • 28.9% of those with hearing loss reported limitations in outdoor activities such as shopping or travel, vs. 9.5% of those without hearing loss
  • 39.7% of those with hearing loss reported psychological distress, vs 19.3%
  • 37.7% of those with hearing loss reported memory loss, vs only 5.2% of those without hearing loss.

https://www.eurekalert.org/pub_releases/2019-07/uot-hlt071919.php

Wearing hearing aid may help protect brain in later life

Data from the PROTECT online study of 25,000 older adults (50+) has found that those who wear a hearing aid for age-related hearing problems maintain better brain function over time than those who do not.

Participants undertook annual cognitive tests over two years. After that time, the group who wore hearing aids performed better in measures assessing working memory and aspects of attention than those who did not.

The findings were presented at the 2019 annual Alzheimer's Association International Conference, Los Angeles.

https://www.eurekalert.org/pub_releases/2019-07/uoe-wha071219.php

Hearing loss linked to greater cognitive decline but education mitigates effect

A large, long-running study, involving 1,164 older adults (mean age 73.5), found that, while hearing impairment was associated with accelerated cognitive decline, the impact might be lessened by higher education.

The study found that almost half of the participants (49.8%) had mild hearing impairment, with 16.8% suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse performance on the MMSE and the Trail-Making Test, Part B. Hearing impairment was also associated with greater decline in performance over time, for both the mildly and more severely impaired.

However, the association of mild hearing impairment with rate of cognitive decline was found only among those without a college education, while moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level.

Somewhat surprisingly, degree of social engagement did not affect the association of hearing impairment with cognitive decline.

https://www.eurekalert.org/pub_releases/2019-02/uoc--wac021219.php

Male hearing loss linked to cognitive decline

An eight-year longitudinal study among 10,107 older men (62+) found that hearing loss was associated with higher risk of subjective cognitive decline.

Compared with men with no hearing loss, the relative risk of cognitive decline was 30% higher among men with mild hearing loss, 42% higher among men with moderate hearing loss, and 54% higher among men with severe hearing loss but who did not use hearing aids. While those who did use hearing aids showed a reduced risk of cognitive decline (37%), this wasn’t statistically significant (not enough men in these groups, I assume).

The men were all health professionals. Subjective cognitive function was assessed using a six-item questionnaire, which was administered three times, at four-yearly intervals.

https://www.eurekalert.org/pub_releases/2019-01/bawh-etc012819.php

Signs of memory problems could be symptoms of hearing loss instead

A very small study found that 11 out of 20 participants being evaluated for cognitive concerns had some form of mild to severe hearing loss, but only 4 of them used hearing aids. A quarter of the participants didn’t show any signs of memory loss due to a brain disorder. It’s suggested that, for some, cognitive problems may derive directly from hearing impairments, and can be fixed by addressing this issue.

Hearing loss is the third most common chronic health condition in older adults, which is experienced by 50% of individuals over the age of 65 and 90% of people over the age of 80. It takes an average of 10 years before people seek treatment and fewer than 25% of those who need hearing aids will buy them.

https://www.eurekalert.org/pub_releases/2019-01/bcfg-som011819.php

Healthy diet may lower risk of hearing loss in women

A large, long-running study (the Nurses' Health Study II ) has found that eating a healthy diet was associated with a lower risk of acquired hearing loss in women. Women whose diets most closely resembled the AMED or DASH dietary patterns had an approximately 30% lower risk of moderate or worse hearing loss, compared with women whose diets resembled these dietary patterns the least.

The Alternate Mediterranean diet (AMED) diet includes extra virgin olive oil, grains, legumes, vegetables, fruits, nuts, fish and moderate intake of alcohol. The Dietary Approaches to Stop Hypertension (DASH) diet is high in fruits and vegetables and low-fat dairy, and low in sodium.

https://www.eurekalert.org/pub_releases/2018-05/bawh-hdm051118.php

Reference: 

[4479] Liu, C-M., & Lee C. Tzu- Chi
(2019).  Association of Hearing Loss With Dementia.
JAMA Network Open. 2(7), e198112 - e198112.

Iwagami, M., Kobayashi, Y., Tsukazaki, E., Watanabe, T., Sugiyama, T., Wada, T., … Tamiya, N. (2019). Associations between self-reported hearing loss and outdoor activity limitations, psychological distress and self-reported memory loss among older people: Analysis of the 2016 Comprehensive Survey of Living Conditions in Japan. Geriatrics & Gerontology International, 19(8), 747–754. https://doi.org/10.1111/ggi.13708

Alattar, A. A., Bergstrom, J., Laughlin, G. A., Kritz-Silverstein, D., Richard, E. L., Reas, E. T., … McEvoy, L. K. (n.d.). Hearing impairment and cognitive decline in older, community-dwelling adults. The Journals of Gerontology: Series A. https://doi.org/10.1093/gerona/glz035

Curhan, S et al. Longitudinal study of hearing loss and subjective cognitive function decline in men. Alzheimer's & Dementia DOI: 10.1016/j.jalz.2018.11.004

Dupuis, K., Yusupov, I., Vandermorris, S., Murphy, K., Rewilak, D., Stokes, K., & Reed, M. (2019). Considering Age-Related Hearing Loss in Neuropsychological Practice: Findings from a Feasibility Study. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 38(2), 245-252. doi:10.1017/S0714980818000557

[4480] Curhan, S. G., Wang M., Eavey R. D., Stampfer M. J., & Curhan G. C.
(2018).  Adherence to Healthful Dietary Patterns Is Associated with Lower Risk of Hearing Loss in Women.
The Journal of Nutrition. 148(6), 944 - 951.

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Old honeybees can regain youthful cognition when they return to youthful duties

August, 2012
  • A honey bee study shows how old foraging bees quickly start to decline cognitively, and how this can be reversed in some if they return to more social domestic duties in the hive.

I often talk about the importance of attitudes and beliefs for memory and cognition. A new honey bee study provides support for this in relation to the effects of aging on the brain, and suggests that this principle extends across the animal kingdom.

Previous research has shown that bees that stay in the nest and take care of the young remain mentally competent, but they don’t nurse for ever. When they’re older (after about 2-3 weeks), they become foragers, and foraging bees age very quickly — both physically and mentally. Obviously, you would think, bees ‘retire’ to foraging, and their old age is brief (they begin to show cognitive decline after just two weeks).

But it’s not as simple as that, because in artificial hives where worker bees are all the same age, nurse bees of the same age as foragers don’t show the same cognitive and sensory decline. Moreover, nurse bees have been found to maintain their cognitive abilities for more than 100 days, while foragers die within 18 days and show cognitive declines after 13-15 days (although their ability to assess sweetness remains intact).

The researchers accordingly asked a very interesting question: what happens if the foragers return to babysitting?

To achieve this, they removed all of the younger nurse bees from the nest, leaving only the queen and babies. When the older, foraging bees returned to the nest, activity slowed down for several days, and then they re-organized themselves: some of the old bees returned to foraging; others took on the babysitting and housekeeping duties (cleaning, building the comb, and tending to the queen). After 10 days, around half of these latter bees had significantly improved their ability to learn new things.

This cognitive improvement was also associated with a change in two specific proteins in their brains: one that has been associated with protection against oxidative stress and inflammation associated with Alzheimer disease and Huntington disease in humans (Prx6), and another dubbed a “chaperone” protein because it protects other proteins from being damaged when brain or other tissues are exposed to cell-level stress.

Precisely what it is about returning to the hive that produces this effect is a matter of speculation, but this finding does show that learning impairment in old bees can be reversed by changes in behavior, and this reversal is correlated with specific changes in brain protein.

Having said this, it shouldn’t be overlooked that only some of the worker bees showed this brain plasticity. This is not, apparently, due to differences in genotype, but may depend on the amount of foraging experience.

The findings add weight to the idea that social interventions can help our brains stay younger, and are consistent with growing evidence that, in humans, social engagement helps protect against dementia and age-related cognitive impairment.

The (probably) experience-dependent individual differences shown by the bees is perhaps mirrored in our idea of cognitive reserve, but with a twist. The concept of cognitive reserve emphasizes that accumulating a wealth of cognitive experience (whether through education or occupation or other activities) protects your brain from the damage that might occur with age. But perhaps (and I’m speculating now) we should also consider the other side of this: repeated engagement in routine or undemanding activities may have a deleterious effect, independent of and additional to the absence of more stimulating activities.

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How cognitive reserve helps protect seniors from cognitive decline

May, 2012
  • Greater cognitive activity doesn’t appear to prevent Alzheimer’s brain damage, but is associated with more neurons in the prefrontal lobe, as well as other gender-specific benefits.

Data from the very large and long-running Cognitive Function and Ageing Study, a U.K. study involving 13,004 older adults (65+), from which 329 brains are now available for analysis, has found that cognitive lifestyle score (CLS) had no effect on Alzheimer’s pathology. Characteristics typical of Alzheimer’s, such as plaques, neurofibrillary tangles, and hippocampal atrophy, were similar in all CLS groups.

However, while cognitive lifestyle may have no effect on the development of Alzheimer's pathology, that is not to say it has no effect on the brain. In men, an active cognitive lifestyle was associated with less microvascular disease. In particular, the high CLS group showed an 80% relative reduction in deep white matter lesions. These associations remained after taking into account cardiovascular risk factors and APOE status.

This association was not found in women. However, women in the high CLS group tended to have greater brain weight.

In both genders, high CLS was associated with greater neuronal density and cortical thickness in Brodmann area 9 in the prefrontal lobe (but not, interestingly, in the hippocampus).

Cognitive lifestyle score is produced from years of education, occupational complexity coded according to social class and socioeconomic grouping, and social engagement based on frequency of contact with relatives, neighbors, and social events.

The findings provide more support for the ‘cognitive reserve’ theory, and shed some light on the mechanism, which appears to be rather different than we imagined. It may be that the changes in the prefrontal lobe (that we expected to see in the hippocampus) are a sign that greater cognitive activity helps you develop compensatory networks, rather than building up established ones. This would be consistent with research suggesting that older adults who maintain their cognitive fitness do so by developing new strategies that involve different regions, compensating for failing regions.

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Higher levels of social activity decrease the risk of cognitive decline

May, 2011
  • More evidence indicating that a lack of engagement in social activities increases the rate of cognitive decline in older adults.

Adding to the growing evidence that social activity helps prevent age-related cognitive decline, a longitudinal study involving 1,138 older adults (mean age 80) has found that those who had the highest levels of social activity (top 10%) experienced only a quarter of the rate of cognitive decline experienced by the least socially active individuals (bottom 10%). The participants were followed for up to 12 years (mean of 5 years).

Social activity was measured using a questionnaire that asked participants whether, and how often, in the previous year they had engaged in activities that involve social interaction—for example, whether they went to restaurants, sporting events or the teletract (off-track betting) or played bingo; went on day trips or overnight trips; did volunteer work; visited relatives or friends; participated in groups such as the Knights of Columbus; or attended religious services.

Analysis adjusted for age, sex, education, race, social network size, depression, chronic conditions, disability, neuroticism, extraversion, cognitive activity, and physical activity.

There has been debate over whether the association between social activity and cognitive decline is because inactivity leads to impairment, or because impairment leads to inactivity. This study attempted to solve this riddle. Participants were evaluated yearly, and analysis indicates that the inactivity precedes decline, rather than the other way around. Of course, it’s still possible that there are factors common to both that affect social engagement before showing up in a cognitive test. But even in such a case, it seems likely that social inactivity increases the rate of cognitive decline.

Reference: 

[2228] James, B. D., Wilson R. S., Barnes L. L., & Bennett D. A.
(2011).  Late-Life Social Activity and Cognitive Decline in Old Age.
Journal of the International Neuropsychological Society. FirstView, 1 - 8.

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Sharpening your brain through talking

November, 2010
  • Indications that talking provides mental stimulation that helps sharpen your brain are supported and explained by new evidence that particular types of conversation are beneficial.

Following on from earlier research suggesting that simply talking helps keep your mind sharp at all ages, a new study involving 192 undergraduates indicates that the type of talking makes a difference. Engaging in brief (10 minute) conversations in which participants were simply instructed to get to know another person resulted in boosts to their executive function (the processes involved in working memory, planning, decision-making, and so on). However when participants engaged in conversations that had a competitive edge, their performance showed no improvement. The improvement was limited to executive function; neither processing speed nor general knowledge was affected.

Further experiments indicated that competitive discussion could boost executive function — if the conversations were structured to allow for interpersonal engagement. The crucial factor seems to be the process of getting into another person’s mind and trying to see things from their point of view (something most of us do naturally in conversation).

The findings also provide support for the social brain hypothesis — that we evolved our larger brains to help us deal with large social groups. They also support earlier speculations by the researcher, that parents and teachers could help children improve their intellectual skills by encouraging them to develop their social skills.

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Depression increases risk of dementia

August, 2010
  • New data from a large long-running study provides more conclusive evidence that depression is indeed a risk factor for dementia.

Data from the long-running Framingham Heart Study has revealed that depression significantly increased the risk of developing dementia. Of the 125 people (13%) who were classified as having depression at the start of the study, 21.6% had developed dementia by the end of the study (17 years later). This compares to around 16.6% of those who weren’t depressed. When age, gender, education, homocysteine, and APOE gene status were taken into account, depressed participants had a more than 50% increased risk of developing dementia. Moreover, for each 10-point increase on the self-report scale used to measure depression (CES-D), there was a significant increase in the dementia risk. These findings, from one of the largest and longest population-based studies, should clarify the inconsistent results from earlier research.

There are several possible ways depression might increase the risk of dementia — for example, through the brain inflammation or the increased level of certain proteins that occurs during depression; or through the effects on lifestyle (reduced exercise, social engagement, poor diet).

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