Associations between social connections and cognition: a global collaborative individual participant data meta-analysis

Samtani, Suraj; Mahalingam, Gowsaly; Lam, Ben C. P.; Lipnicki, Darren M.; Lima‐Costa, Maria Fernanda; Blay, Sérgio Luís; Castro-Costa, Érico; Xiao, Shifu; Guerchet, Maëlenn; Preux, Pierre‐Marie; Gbessemehlan, Antoine; Skoog, Ingmar; Najar, Jenna; Sterner, Therese Rydberg; Scarmeas, Nikolaos; Kim, Ki Woong; Riedel‐Heller, Steffi G.; Röhr, Susanne; Pabst, Alexander; Shahar, Suzana; Numbers, Katya; Ganguli, Mary; Jacobsen, Erin; Hughes, Tiffany F.; Crowe, Michael; Ng, Tze Pin; Maddock, Jane; Marseglia, Anna; Melis, René J.F.; Szczęśniak, Dorota; Wiegelmann, Henrik; Vernooij‐Dassen, Myrra; Jeon, Yun‐Hee; Sachdev, Perminder S.; Brodaty, Henry

doi:10.1016/s2666-7568(22)00199-4

Cited by 39 publications

(32 citation statements)

References 43 publications

(72 reference statements)

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“…When focusing on pooled estimates from our study, findings support conclusions from previous research suggesting distinct relationships between markers of social health and cognitive domains [15,21]. Findings for structural markers of social health (marital or cohabitation status, social network size, contact frequency) were mixed -all were associated with executive function, and network size was also associated with processing speed.…”

Section: Discussionsupporting

confidence: 86%

“…The studies and countries chosen are part of the SHARED consortium (https://www.shared-dementia.eu/) which were sampled from the general population, contained the necessary exposure and outcome measures and multiple timepoints required to examine decline, and were homogeneous enough to pool findings and examine replication. This paper further builds on a recent study that examined a similar question in different studies involving fewer timepoints and greater heterogeneity of populations sampled from the COSMIC consortium [21].…”

Section: Introductionmentioning

confidence: 95%

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Social health and change in cognitive capability among older adults: findings from four European longitudinal studies

Maddock

Gallo

Wolters

et al. 2022

Preprint

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We examined associations between structural and functional aspects of social health, and subsequent trajectories of cognitive capability (memory, executive functioning, and processing speed).Using data from 16,858 participants (mean age 65.8 years; 56% female) from the National Survey for Health and Development (NSHD), the English Longitudinal Study of Aging (ELSA), the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), and the Rotterdam Study, we applied multilevel models to examine social health in relation to cognitive capability and the rate of cognitive decline.Those who were married/cohabiting scored 0.07SD (95%CI:0.00,0.14; heterogeneity I2=79%) higher on executive functioning compared to those who lived alone. Associations with memory and processing speed were also heterogeneous (I2>75%); for example, being married was associated with better memory in ELSA (0.05SD 95%CI:0.02,0.08) and SNAC-K (0.13SD 95%CI:0.06,0.20) but not in NSHD nor Rotterdam. Those with larger network sizes (≥6 people) scored higher on executive functioning and processing speed tests, whereas those with frequent social contacts performed better on executive functioning tasks only. Higher participation in social activities and greater perceived positive/less negative social support were associated with higher scores on all cognitive domains. Associations between social health and the rate of cognitive decline varied by social health marker, cognitive domain and study; generally, better social health was associated with a slowing of decline (<0.02 SD/year).Various measures of social health are related to cognitive capability in different ways. These findings may guide future studies to determine if promoting social health at old age may deter cognitive decline.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 95%

Social health and change in cognitive capability among older adults: findings from four European longitudinal studies

Maddock

Gallo

Wolters

et al. 2022

Preprint

Self Cite

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“…SHARED involves several studies with the aim to unravel the interplay between social health and biological and psychological factors. Studies include the development of a conceptual framework for social health, epidemiological studies (41,42), a systematic review on factors influencing cognitive health (17), a Group Model Building (GMB) study (43), a current study to identify 1 www.interdem.org 2 https://www.shared-dementia.eu/ social health measures and an ongoing qualitative study. The conceptual framework was iteratively developed by the interdisciplinary Social Health Stream of SHARED, consisting of a team of 11 experts, and discussed with the whole consortium.…”

Section: Development Of Conceptual Framework Study Contextmentioning

confidence: 99%

“…But does it work like that? We explore the feasibility, meaning the applicability, of the conceptual framework through its use in the following studies of the SHARED project: the review of epidemiological studies ( 17 ), the epidemiological associations between social health and cognitive functioning in the SHARED data bases ( 41 , 42 ) and a Group Model Building (GMB) ( 43 ).…”

Section: Exploration Of Potential Feasibility Of the Conceptual Frame...mentioning

confidence: 99%

“…The review of reviews includes 314 studies with social factors constituting 10% of all identified factors ( 17 ). The epidemiological studies use data bases of five ( 41 ) and 13 longitudinal cohort studies ( 42 ). These studies are scrutinized to identify social health markers using the conceptual framework.…”

Section: Exploration Of Potential Feasibility Of the Conceptual Frame...mentioning

confidence: 99%

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Recognition of social health: A conceptual framework in the context of dementia research

Vernooij‐Dassen

Verspoor²,

Samtani³

et al. 2022

Front. Psychiatry

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ObjectiveThe recognition of dementia as a multifactorial disorder encourages the exploration of new pathways to understand its origins. Social health might play a role in cognitive decline and dementia, but conceptual clarity is lacking and this hinders investigation of associations and mechanisms. The objective is to develop a conceptual framework for social health to advance conceptual clarity in future studies.ProcessWe use the following steps: underpinning for concept advancement, concept advancement by the development of a conceptual model, and exploration of its potential feasibility. An iterative consensus-based process was used within the international multidisciplinary SHARED project.Conceptual frameworkUnderpinning of the concept drew from a synthesis of theoretical, conceptual and epidemiological work, and resulted in a definition of social health as wellbeing that relies on capacities both of the individual and the social environment. Consequently, domains in the conceptual framework are on both the individual (e.g., social participation) and the social environmental levels (e.g., social network). We hypothesize that social health acts as a driver for use of cognitive reserve which can then slow cognitive impairment or maintain cognitive functioning. The feasibility of the conceptual framework is demonstrated in its practical use in identifying and structuring of social health markers within the SHARED project.DiscussionThe conceptual framework provides guidance for future research and facilitates identification of modifiable risk and protective factors, which may in turn shape new avenues for preventive interventions. We highlight the paradigm of social health in dementia as a priority for dementia research.

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Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life

Lennon,

Lam,

Lipnicki

et al. 2023

JAMA Netw Open

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ImportanceThe utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested.ObjectivesTo assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age &gt;60 years) with dementia and the moderating factors of age, sex, and racial group.Data Source and Study SelectionLongitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece).Data Extraction and SynthesisParticipants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines.Main Outcomes and MeasuresThe key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group.ResultsThe analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses.Conclusions and RelevanceThis individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.

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Associations between social connections and cognition: a global collaborative individual participant data meta-analysis

Cited by 39 publications

References 43 publications

Social health and change in cognitive capability among older adults: findings from four European longitudinal studies

Social health and change in cognitive capability among older adults: findings from four European longitudinal studies

Recognition of social health: A conceptual framework in the context of dementia research

Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life

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