Summary: An association has been discovered between cognitive decline and social engagement in older adults. Older people who are less socially active have a greater accumulation of amyloid beta and increased cognitive decline over a three-year span, compared to more socially active peers.
Source: Brigham and Women’s Hospital
Social relationships are essential to aging well; research has shown an association between lack of social engagement and increased risk of dementia. A new study by investigators from Brigham and Women’s Hospital found that higher brain amyloid-β in combination with lower social engagement in elderly men and women was associated with greater cognitive decline over three years. The results of the study were published last month in the American Journal of Geriatric Psychiatry.
“Social engagement and cognitive function are related to one another and appear to decline together,” said senior author Nancy Donovan, MD, chief of the Division of Geriatric Psychiatry at the Brigham. “This means that social engagement may be an important marker of resilience or vulnerability in older adults at risk of cognitive impairment.”
The investigators sampled 217 men and women enrolled in the Harvard Aging Brain Study, a longitudinal observational study looking for early neurobiological and clinical signs of Alzheimer’s disease. The participants, aged 63-89, were cognitively normal, but some individuals showed high levels of amyloid-β protein, a pathologic hallmark of Alzheimer’s disease detected with neuroimaging techniques.
The investigators used standard questionnaires and examinations to assess participants’ social engagement (including activities such as spending time with friends and family and doing volunteer work) and cognitive performance at baseline and three years later.
Social engagement was particularly relevant to cognition in participants with evidence of Alzheimer’s disease brain changes. The researchers report that, among cognitively normal older adults with high levels of amyloid-β, those who had lower social engagement at baseline showed steeper cognitive decline than those who were more socially engaged. This association was not observed in those with low amyloid-β.
Donovan and her team used a standard measure of social engagement that did not capture all the intricacies of digital communication or the qualitative aspects of relationships. They reported that a more contemporary and comprehensive assessment of social engagement could be a valuable outcome measure in future clinical trials of Alzheimer’s disease.
The team cited that future studies with follow-up periods longer than three years may further gauge cognitive decline over time and help untangle the complex mechanisms of Alzheimer’s disease progression.
“We want to understand the breadth of this issue in older people and how to intervene to protect high-risk individuals and preserve their health and well-being,” said Donovan.
Funding: Funding for this work was provided by National Institute on Aging (R21 AG054953), and the Harvard Aging Brain Study (NIA P01 AG036694, AG046396). Donovan has received salary support from Eisai and Eli Lilly. She has served as a paid consultant to Avanir. Co-authors also report receiving fees from pharmaceutical companies that manufacture drugs for the treatment of Alzheimer’s disease. For a full list of disclosures please see the paper.
Source:
Brigham and Women’s Hospital
Media Contacts:
Mark Murphy – Brigham and Women’s Hospital
Image Source:
The image is in the public domain.
Original Research: Closed access
“Social Engagement and Amyloid-b-Related Cognitive Decline in Cognitively Normal Older Adults”. Biddle, K et a.
American Journal of Geriatric Psychiatry. doi:10.1016/j.jagp.2019.05.005
Abstract
Social Engagement and Amyloid-b-Related Cognitive Decline in Cognitively Normal Older Adults
Objective
Public health recommendations promote social engagement to reduce risk of cognitive decline and dementia. The objective of this study was to evaluate the longitudinal associations of social engagement and cognition in cognitively normal older adults with varying levels of neocortical amyloid-β, the Alzheimer’s disease (AD) pathologic marker.
Methods
Two hundred seventeen men and women, age 63–89 underwent assessments for social engagement and cognitive performance at baseline and 3 years later using the Community Healthy Activities Model Program for Seniors questionnaire and the Preclinical Alzheimer Cognitive Composite (PACC). Amyloid-β was measured using Pittsburgh compound B-PET. Multivariable regression models estimated main and interactive effects of baseline social engagement and amyloid-β on cognitive change. Reciprocal models estimated main and interactive effects of baseline cognitive performance and amyloid-β on change in social engagement.
Results
Baseline social engagement was associated with PACC change as a modifier but not as a main effect. Lower baseline social engagement was associated with greater amyloid-β-related PACC decline, while higher baseline social engagement was associated with relative preservation of PACC scores (β = 0.05, p = 0.03). Reciprocally, lower baseline PACC score was associated with decline in social engagement score (β = 1.1, p = 0.02). This association was not modified by amyloid-β, and there was no direct association of amyloid-β with change in social engagement.
Conclusions
Low social engagement may be a marker of neurocognitive vulnerability in older adults who are cognitively normal but have evidence of AD pathophysiologic change. Understanding changes in social engagement in older adults may lead to earlier diagnosis of AD and advances in evidence-based prevention and treatment.
