Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies

Lara, Elvira; Martín‐María, Natalia; Torre‐Luque, Alejandro de la; Koyanagi, Ai; Vancampfort, Davy; Izquierdo, Ana; Miret, Marta

doi:10.1016/j.arr.2019.03.002

Cited by 190 publications

(159 citation statements)

References 71 publications

(104 reference statements)

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“…These risk factors include physical inactivity and obesity, together with unbalanced diets, tobacco use, harmful use of alcohol, diabetes mellitus and mid-life hypertension [86,87]. In addition, other potentially modifiable risk factors are more specific to dementia and include social isolation, low educational attainment, cognitive inactivity and mid-life depression [88,89]. Reducing the level of exposure of elderly populations, and individuals in general, to these potentially modifiable risk factors can strengthen the capacity of urbanites to make healthier choices and follow lifestyle patterns that foster good mental health and wellbeing.…”

Section: Dementia-friendly Cities and Biophilic Design For Healthy Comentioning

confidence: 99%

Designing Urban Green Blue Infrastructure for Mental Health and Elderly Wellbeing

2019

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The main objective of this essay is to illustrate the state-of-the-art on ‘mental health-sensitive’ open space design in the built environment. Urban Green Blue Infrastructure can contribute to urbanites’ mental health and wellbeing as well as healthy aging, while providing co-benefits balancing the negative impacts of climate change, through the provision of integrated ecosystem services. There are a number of ways that exposure to and affiliation with Nature have shown to support mental health, but we are still missing the necessary evidence of the actual benefits achieved, as well as the key performance indicators and metrics to monitor and adapt our open space to the growing urban challenges. After introducing the key concepts of degenerative mental disorders as they are growing in the urban environment, and the emerging green blue infrastructure design approach, the authors present international case studies describing how evidence-based design and Nature-based Solutions have been found to be beneficial, especially to those diagnosed with mental disorders. Subsequently, in a comparative critical analysis, the authors look closer at a number of design solutions capable, at different scales, to support healthy aging through exposure to, and affiliation with, biodiversity.

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Section: Dementia-friendly Cities and Biophilic Design For Healthy Comentioning

confidence: 99%

Designing Urban Green Blue Infrastructure for Mental Health and Elderly Wellbeing

2019

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“…Previous studies have suggested that being alone or never married, low frequency of interactions, small social network size, or negative experiences of social support predict steeper cognitive decline . Moreover, a recent meta‐analysis of longitudinal population‐based studies found evidence that loneliness is also associated with an increased risk of dementia …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Moreover, a recent meta-analysis of longitudinal population-based studies found evidence that loneliness is also associated with an increased risk of dementia. 9 Although the correlation between loneliness and objective measures of social isolation appears small to moderate, 10 both concepts should be examined together in order to capture a more complete picture of individuals' social context. 11,12 Earlier studies on social factors and cognitive decline in middle-and older-aged adults have commonly followed a single measurement approach.…”

Section: Introductionmentioning

confidence: 99%

Are loneliness and social isolation associated with cognitive decline?

Lara

Caballero

Rico-Uribe

et al. 2019

Int J Geriat Psychiatry

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229

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Objective This study aimed to examine the association of loneliness and social isolation on cognition over a 3‐year follow‐up period in middle‐ and older‐aged adults. Methods Data from a Spanish nationally representative sample were analyzed (n = 1691; aged 50 years or older). Loneliness, social isolation, and cognition (immediate recall, delayed recall, verbal fluency, forward digit span, backward digit span, and a composite cognitive score) were assessed both at baseline and at follow‐up. Adjusted generalized estimating equations models were performed. Results Loneliness was significantly associated with lower scores in the composite cognitive score, immediate and delayed recall, verbal fluency, and backward digit span (B = −0.14 to B = −3.16; P < .05) and with a more rapid decline from baseline to follow‐up in two out of six cognitive tests. Higher social isolation was associated with lower scores in the composite cognitive score, verbal fluency, and forward digit span (B = −0.06 to B = −0.85; P < .05). The effect of loneliness and social isolation on cognition remained significant after the exclusion of individuals with depression. Conclusions Both loneliness and social isolation are associated with decreased cognitive function over a 3‐year follow‐up period. The development of interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction.

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“…Older people are particularly vulnerable to loneliness. Loneliness is highly associated with some devastating consequences in older age, such as depression, increased mortality risk or dementia development . A major effort should be made to tackle loneliness impact, by means of promoting participation and social network enrichment in the community.…”

Section: Discussionmentioning

confidence: 99%

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Torre‐Luque

Sánchez-Niubò

et al. 2019

Acta Psychiatr Scand

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Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study de la Torre-Luque A, de la Fuente J, Sanchez-Niubo A, et al. Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study.Aims: To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. Methods: Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health -Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. Results: Almost 85% of participants showed no depression, but prevalence became lower over time (B = À0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). Conclusions: The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence. Significant outcomes• Most of older adults did not show any episode of clinically relevant symptoms of depression over time.• Almost one in four older individuals who showed a first episode of symptoms showed either episode persistence or episode recurrence later in life.• Loneliness was the most relevant factor in predicting symptom episode emergence and persistence. Limitations• This is an epidemiological study focused on providing a coarse-grained picture of late-life depression symptom dynamics.• Despite our large sample from multiple countries across the globe, cultural issues were not controlled in this study.

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Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies

Cited by 190 publications

References 71 publications

Designing Urban Green Blue Infrastructure for Mental Health and Elderly Wellbeing

Designing Urban Green Blue Infrastructure for Mental Health and Elderly Wellbeing

Are loneliness and social isolation associated with cognitive decline?

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

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