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Social connections as determinants of cognitive health and as targets for social interventions in persons with or at risk of Alzheimer’s disease and related disorders: a scoping review

Published online by Cambridge University Press:  23 November 2023

Pallavi Joshi ,
Kyle Hendrie ,
Dylan J. Jester Open the ORCID record for Dylan J. Jester [Opens in a new window] ,
Dhweeja Dasarathy ,
Helen Lavretsky Open the ORCID record for Helen Lavretsky [Opens in a new window] ,
Benson S. Ku ,
Heather Leutwyler ,
John Torous ,
Dilip V. Jeste  and
Rajesh R. Tampi Open the ORCID record for Rajesh R. Tampi [Opens in a new window]
Pallavi Joshi
Affiliation:
Psychiatry Department, Banner University Medical Center, and University of Arizona College of Medicine, Phoenix, AZ, USA
Kyle Hendrie
Affiliation:
Psychiatry Department, Banner University Medical Center, and University of Arizona College of Medicine, Phoenix, AZ, USA
Dylan J. Jester
Affiliation:
Women’s Operational Military Exposure Network (WOMEN), VA Palo Alto Health Care System, Palo Alto, CA, USA
Dhweeja Dasarathy
Affiliation:
Vanderbilt School of Medicine, Nashville, TN, USA
Helen Lavretsky
Affiliation:
Department of Psychiatry, University of California, Los Angeles, CA, USA
Benson S. Ku
Affiliation:
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
Heather Leutwyler
Affiliation:
Department of Physiological Nursing, University of California, San Francisco, CA, USA
John Torous
Affiliation:
Department of Psychiatry, Beth Israel Deaconess medical Center and Harvard Medical School, Boston, MA, USA
Dilip V. Jeste
Affiliation:
Global Research Network on Social Determinants of Mental Health and Exposomics, La Jolla, CA, USA
Rajesh R. Tampi*
Affiliation:
Department of Psychiatry, Creighton University School of Medicine, Omaha, NE, USA
*
Correspondence should be addressed to: Rajesh R. Tampi, Department of Psychiatry, Creighton University School of Medicine, 7710 Mercy Road, Suite 601, Omaha, NE 68124, USA. Email: [email protected]
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Abstract

Background:

Social connections have a significant impact on health across age groups, including older adults. Loneliness and social isolation are known risk factors for Alzheimer’s disease and related dementias (ADRD). Yet, we did not find a review focused on meta-analyses and systematic reviews of studies that had examined associations of social connections with cognitive decline and trials of technology-based and other social interventions to enhance social connections in people with ADRD.

Study design:

We conducted a scoping review of 11 meta-analyses and systematic reviews of social connections as possible determinants of cognitive decline in older adults with or at risk of developing ADRD. We also examined eight systematic reviews of technology-based and other social interventions in persons with ADRD.

Study results:

The strongest evidence for an association of social connections with lower risk of cognitive decline was related to social engagement and social activities. There was also evidence linking social network size to cognitive function or cognitive decline, but it was not consistently significant. A number of, though not all, studies reported a significant association of marital status with risk of ADRD. Surprisingly, evidence showing that social support reduces the risk of ADRD was weak. To varying degrees, technology-based and other social interventions designed to reduce loneliness in people with ADRD improved social connections and activities as well as quality of life but had no significant impact on cognition. We discuss strengths and limitations of the studies included.

Conclusions:

Social engagement and social activities seem to be the most consistent components of social connections for improving cognitive health among individuals with or at risk for ADRD. Socially focused technology-based and other social interventions aid in improving social activities and connections and deserve more research.

Keywords

agingdigitalrobotslonelinesspetsmarital status
Type
Review Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 2: Issue Theme: Psycho-Bio-Social Risk Factors and Dementia , February 2024 , pp. 92 - 118
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of International Psychogeriatric Association

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Footnotes

Pallavi Joshi and Kyle Hendrie are co-first authors.

Dilip V. Jeste and Rajesh R. Tampi are co-senior authors.

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