Dec 11, 2012

Feelings of Loneliness, Not Social Isolation, Predict Dementia

Feeling lonely rather than being alone is associated with an increased risk of clinical dementia in later life and can be considered a major risk factor independent of other factors.

Alzheimer's Reading Room

People who feel lonely are much more likely than those who do not feel lonely to develop dementia in old age.

Those who suffer from loneliness have a 64% greater risk of dementia, according to a study that appears in the Journal of Neurology, Neurosurgery and Psychiatry.

The key here is that scientist are differentiating loneliness from social isolation. Feeling lonely is the key variable, not social isolation.
"These results suggest that feelings of loneliness independently contribute to the risk of dementia in later life. Interestingly, the fact that 'feeling lonely' rather than 'being alone' was associated with dementia onset suggests that it is not the objective situation but, rather, the perceived absence of social attachments that increases the risk of cognitive decline."

I intend to write more on these findings. For now, here is the summary of the research findings.

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Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL)

The Background.

Known risk factors for Alzheimer's disease and other dementias include medical conditions, genetic vulnerability, depression, demographic factors and mild cognitive impairment.

The role of feelings of loneliness and social isolation in dementia is less well understood, and prospective studies including these risk factors are scarce.

The Methodology.

We tested the association between social isolation (living alone, unmarried, without social support), feelings of loneliness and incident dementia in a cohort study among 2173 non-demented community-living older persons. Participants were followed for 3 years when a diagnosis of dementia was assessed (Geriatric Mental State (GMS) Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT)).

Logistic regression analysis was used to examine the association between social isolation and feelings of loneliness and the risk of dementia, controlling for sociodemographic factors, medical conditions, depression, cognitive functioning and functional status.

The Results.

After adjustment for other risk factors, older persons with feelings of loneliness were more likely to develop dementia (OR 1.64, 95% CI 1.05 to 2.56) than people without such feelings. Social isolation was not associated with a higher dementia risk in multivariate analysis.

The Conclusions.

Feeling lonely rather than being alone is associated with an increased risk of clinical dementia in later life and can be considered a major risk factor that, independently of vascular disease, depression and other confounding factors, deserves clinical attention.

Feelings of loneliness may signal a prodromal stage of dementia.

A better understanding of the background of feeling lonely may help us to identify vulnerable persons and develop interventions to improve outcome in older persons at risk of dementia.

Journal of Neurology, Neurosurgery and Psychiatry,

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Original content Bob DeMarco, the Alzheimer's Reading Room