IS LONELINESS LINKED TO THE DEVELOPMENT OF DEMENTIA?
Social isolation is increasingly being identified as a risk factor for the earlier onset of dementia. Along with alcohol abuse and depression, a recently published study from the Journal of the American Medical Association (JAMA) documents loneliness as one of a number of risk factors correlated with early- or youth-onset dementia . This study surveyed over 356,000 people from U.K. and the Netherlands to produce their data. The authors state that the problems of loneliness and isolation aren’t just contributory to mental health difficulties but are tied to dementia and early death. According to Harvard Health Publishing, this plays a role in the diminishing life expectancy in the U.S. seen since the Covid pandemic when being socially isolated greatly increased in the population. They now consider social isolation to be an urgent medical and public health threat that will have profoundly negative consequences for our society, as it is related to two other major problems, substance abuse and to suicide.
SOCIAL ISOLATION IS A RISK FACTOR FOR DEMENTIA IN OLDER ADULTS- WAYS TO REDUCE THE RISK
According to the National Institute on Aging as reported by the National Institutes of Health, 25% of our elderly population experiences social isolation. Although the studies that have been done cannot be said to establish a direct cause and effect between social isolation and the development of dementia, the evidence seems to indicate a connection. It has been seen in observational studies that for those who have already been diagnosed with dementia, the dementia worsens with social isolation, which is defined as a lack of interactions with people on a regular basis as well as general lack of social contact. This all suggests that a relatively simple effort to help those with dementia is to support social interactions for those affected.
Thomas Cudjoe, M.D., M.P.H., is an assistant professor of Medicine at the Johns Hopkins University School of Medicine. He was the senior researcher on two recently published studies which support his conclusion that “social connections matter for our cognitive health, and the risk of social isolation is potentially modifiable for older adults.” One of the two studies published in the Journal of the American Geriatrics Society, analyzed data collected on over 5,000 Medicare beneficiaries for a period of greater than nine years. All of those whose data was analyzed were over 65 years of age. They completed a two-hour, in-person meeting every year when their health status and their cognitive function was evaluated. At the beginning of the study interviews, before any diagnosis of dementia had been made among the 5,000 participants, 23% were assessed as being socially isolated. At the end of the nine-year study period 21% of the participants had developed dementia. Data revealed that over the nine years of the study those who were found to be socially isolated had a 27% greater likelihood of developing dementia compared to those who were not socially isolated.
Alison Huang, Ph.D., M.P.H., a researcher at the Johns Hopkins Bloomberg School of Public Health explained, “One possible explanation is that having fewer opportunities to socialize with others decreases cognitive engagement as well, potentially contributing to increased risk of dementia.” She also observed, “socially isolated older adults have smaller social networks, live alone and have limited participation in social activities.”
Another study was done to assess whether interventions to reduce social isolation could be helpful in preventing dementia. For this study published in the Journal of the American Geriatrics Society. researchers evaluated measuring older adults use of their telephone and e-mail communications as a measure of whether they were socially isolated. They found that greater than 70% of people above 65 years of age who were not socially isolated at the beginning of the study used a cellphone and/or computer, and also regularly used email or texting to initiate communication with others. Mfon Umoh,M.D., PhD., specialist in Geriatric Medicine says, “Basic communications technology is a great tool to combat social isolation. This study shows that access and use of simple technologies are important factors that protect older adults against social isolation, which is associated with significant health risks. This is encouraging because it means simple interventions may be meaningful.”
At the end of the four-year research period these people had a 31% lower risk for social isolation than the rest of the study subjects . Further studies are needed to see if it can be consistently shown that their use of such technologies will show a difference in dementia by these individuals when compared to when these devices were not used by other study subjects.
SOCIAL ISOLATION AS A SOCIAL PROBLEM
Due to social restrictions implemented for the COVID-19 pandemic social isolation became increasingly recognized as a problem that would affect the health of millions of people.
Researchers using data from over 350,000 people under the age of 65 in the UK Biobank were tasked do look for the factors that might promote early onset dementia. Study authors said, “Increased risk of early-onset dementia was associated with low socioeconomic status, apolipoprotein E status, alcohol use disorder, social isolation, vitamin D deficiency, high C-reactive protein levels, hearing impairment, orthostatic hypotension, stroke, diabetes, heart disease, and depression.”
In U.S in 2021 American life expectancy fell for the second year in a row. The effects of social isolation undoubtedly played a major role in that. U.S. Surgeon General Vivek Murthy, the Department of Health and Human Services has established national framework for combating the epidemic of loneliness and they have officially classified it as a major public health threat. Problems such as depression, drug and alcohol addiction are all clearly linked to isolation and this makes it an urgent society-wide problem. The Dept. Of Human Health and Services (HHS) says, “The physical health consequences of poor or insufficient connection include a 29% increased risk of heart disease, a 32% increased risk of stroke, and a 50% increased risk of developing dementia for older adults. Additionally, lacking social connection increases risk of premature death by more than 60%.
They write in their guidance, “Social connection is beneficial for individual health and also improves the resilience of our communities. Evidence shows that increased connection can help reduce the risk of serious health conditions such as heart disease, stroke, dementia, and depression. Communities where residents are more connected with one another fare better on several measures of population health, community safety, community resilience when natural disasters strike, prosperity, and civic engagement.”