Association of Social Support With Brain Volume and Cognition

Salinas, Joel; O’Donnell, Adrienne; Kojis, Daniel; Pase, Matthew P.; DeCarli, Charles; Rentz, Dorene M.; Berkman, Lisa F.; Beiser, Alexa S.; Seshadri, Sudha

doi:10.1001/jamanetworkopen.2021.21122

Cited by 36 publications

(22 citation statements)

References 68 publications

(158 reference statements)

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“…To characterize age differences in the association of loneliness with dementia risk, the primary dementia analysis was performed for the entire sample and stratified by age group: <80 and ≥80 years of age. The decision to characterize age differences by stratifying the sample at 80 years of age was made a priori and based on knowledge of extant literature reporting associations of loneliness with greater cortical amyloid and regional tau accumulation using PET imaging, 14,15 previous FS investigations suggesting that loneliness-related dementia risk 10,39 and risk of neurocognitive markers of early ADRD vulnerability 42 varied between younger and older adults, and loneliness prevalence estimates demonstrating a slight increase by age for young-old adults (age 65-79 years) and a more notable increase for oldest-old adults ≥80 years of age. 43 For the primary dementia analysis, overall and by age, Cox proportional hazards regression models estimated age-, sex-, and education-adjusted hazard ratios for 10-year dementia risk comparing participants who were lonely with those who were not lonely.…”

Section: Discussionmentioning

confidence: 99%

Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline

et al. 2022

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Background and Objective:Loneliness is common and its prevalence is rising. The relationship of loneliness with subsequent dementia and the early preclinical course of Alzheimer disease and related dementia (ADRD) remains unclear. Thus, the primary objective of this study was to determine the association of loneliness with 10-year all-cause dementia risk and early cognitive and neuroanatomic imaging markers of ADRD vulnerability.Methods:Retrospective analysis of prospectively collected data from the population-based Framingham Study cohorts (09/09/1948-12/31/2018). Eligible participants had loneliness assessed and were dementia-free at baseline. Loneliness was recorded using the Center for Epidemiologic Studies Depression Scale; defined conservatively as feeling lonely ≥3 days in the past week. The main outcomes were incident dementia over a 10-year period, cognition, and MRI brain volumes and white-matter injury.Results:Of 2308 participants (mean age, 73 [SD, 9] years; 56% women) who met eligibility in the dementia sample, 14% (329/2308) developed dementia; 6% (144/2308) were lonely. Lonely (versus not lonely) adults had higher 10-year dementia risk (age-, sex-, and education-adjusted hazard ratio, 1.54; 95% CI, 1.06-2.24). Lonely participants younger than age 80 without APOE ε4 alleles had a three-fold greater risk (adjusted hazard ratio, 3.03; 95% CI, 1.63-5.62). Among 1875 persons without dementia who met eligibility in the cognition sample (mean age, 62 [SD, 9] years; 54% women), loneliness associated with poorer executive function, lower total cerebral volume, and greater white-matter injury.Discussion:Over 10 years of close clinical dementia surveillance in this cohort study, loneliness was associated with increased dementia risk; this tripled in adults whose baseline risk would otherwise be relatively low based on age and genetic risk, representing a majority of the US population. Loneliness was also associated with worse neurocognitive markers of ADRD vulnerability, suggesting an early pathogenic role. These findings may have important clinical and public health implications given observed loneliness trends.Classification of Evidence:This study provides Class I evidence that loneliness increases the 10-year risk of developing dementia.

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Section: Discussionmentioning

confidence: 99%

Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline

et al. 2022

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“…Cognitive resilience was defined as the modification of total cerebral volume's association with cognition. The results showed that social support in the form of supportive listening was associated with greater cognitive resilience, independently modifying the association between lower total cerebral volume and poorer cognitive function that would otherwise indicate increased AD vulnerability at the preclinical stage [432].…”

Section: Social Engagementmentioning

confidence: 93%

Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia

et al. 2021

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Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensively studied with mounting evidence supporting the role of these determinants in the development of cognitive decline and dementia, which is a chief cause of disability globally. Several dietary patterns, foods, and nutrients have been investigated in this regard, with some encouraging and other disappointing results. This review presents the current evidence for the effects of dietary patterns, dietary components, some supplements, physical activity, sleep patterns, and social engagement on the prevention or delay of the onset of age-related cognitive decline and dementia.

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“…Therefore, CBT may be a useful in normalizing the structural and functional changes associated with mental health disorders [ 64 , 65 ] or following childhood trauma. Similarly, psychotherapies [ 66 , 67 ] and evidence-based treatment [ 68 ] led to observable functional and structural changes in depressed patients and a positive relationship between total cerebral volume and availability of ‘supportive listening’ in depressed adults was observed [ 69 ]. Potentially, treatment options targeting the neurobiological differences identified in this cohort could be used preventatively following trauma.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of brain structure and metabolism in currently depressed adults with a history of childhood trauma

et al. 2022

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Structural differences in the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), hippocampus, and amygdala were reported in adults who experienced childhood trauma; however, it is unknown whether metabolic differences accompany these structural differences. This multimodal imaging study examined structural and metabolic correlates of childhood trauma in adults with major depressive disorder (MDD). Participants with MDD completed the Childhood Trauma Questionnaire (CTQ, n = 83, n = 54 female (65.1%), age: 30.4 ± 14.1) and simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI). Structure (volume, n = 80, and cortical thickness, n = 81) was quantified from MRI using Freesurfer. Metabolism (metabolic rate of glucose uptake) was quantified from dynamic 18 F-fluorodeoxyglucose (FDG)-PET images ( n = 70) using Patlak graphical analysis. A linear mixed model was utilized to examine the association between structural/metabolic variables and continuous childhood trauma measures while controlling for confounding factors. Bonferroni correction was applied. Amygdala volumes were significantly inversely correlated with continuous CTQ scores. Specifically, volumes were lower by 7.44 mm 3 (95% confidence interval [CI]: –12.19, –2.68) per point increase in CTQ. No significant relationship was found between thickness/metabolism and CTQ score. While longitudinal studies are required to establish causation, this study provides insight into potential consequences of, and therefore potential therapeutic targets for, childhood trauma in the prevention of MDD. This work aims to reduce heterogeneity in MDD studies by quantifying neurobiological correlates of trauma within MDD. It further provides biological targets for future interventions aimed at preventing MDD following trauma. To our knowledge, this is the first simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) study to assess both structure and metabolism associated with childhood trauma in adults with MDD.

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Association of Social Support With Brain Volume and Cognition

Cited by 36 publications

References 68 publications

Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline

Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline

Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia

Evaluation of brain structure and metabolism in currently depressed adults with a history of childhood trauma

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