Robert S Wilson1,2,3, Ana W Capuano1,2,4, Carolina Sampaio4, Sue E Leurgans1,2, Lisa L Barnes1,2,3, Jose M Farfel1,4, David A Bennett1,2,4. 1. Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA. 2. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA. 3. Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA. 4. Instituto de Assistencia Medica ao Servidor Publico do Estado (IAMSPE), Sao Paulo, Brazil.
Abstract
OBJECTIVE: To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians. DESIGN: Cross-sectional clinical-pathological cohort study. SETTING: Medical center in Sao Paulo, Brazil. PARTICIPANTS: As part of the Pathology, Alzheimer's and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents. MEASUREMENTS: The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI). RESULTS: Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI. CONCLUSION: Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.
OBJECTIVE: To examine the link between social and emotional isolation and likelihood of dementia among older black and white Brazilians. DESIGN: Cross-sectional clinical-pathological cohort study. SETTING: Medical center in Sao Paulo, Brazil. PARTICIPANTS: As part of the Pathology, Alzheimer's and Related Dementias Study, we conducted uniform structured interviews with knowledgeable informants (72% children) of 1,493 older (age > 65) Brazilian decedents. MEASUREMENTS: The interview included measures of social isolation (number of family and friends in at least monthly contact with decedent), emotional isolation (short form of UCLA Loneliness Scale), and major depression plus the informant portion of the Clinical Dementia Rating Scale to diagnose dementia and its precursor, mild cognitive impairment (MCI). RESULTS: Decedents had a median social network size of 8.0 (interquartile range = 9.0) and a median loneliness score of 0.0 (interquartile range = 1.0). On the Clinical Dementia Rating Scale, 947 persons had no cognitive impairment, 122 had MCI, and 424 had dementia. In a logistic regression model adjusted for age, education, sex, and race, both smaller network size (odds ratio [OR] = 0.975; 95% confidence interval [CI]: 0.962, 0.989) and higher loneliness (OR = 1.145; 95% CI: 1.060, 1.237) were associated with higher likelihood of dementia. These associations persisted after controlling for depression (present in 10.4%) and did not vary by race. After controlling for depression, neither network size nor loneliness was related to MCI. CONCLUSION: Social and emotional isolation are associated with higher likelihood of dementia in older black and white Brazilians.
Authors: Joan Domènech-Abella; Elvira Lara; Maria Rubio-Valera; Beatriz Olaya; Maria Victoria Moneta; Laura Alejandra Rico-Uribe; Jose Luis Ayuso-Mateos; Jordi Mundó; Josep Maria Haro Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2017-02-02 Impact factor: 4.328
Authors: Nancy J Donovan; Qiong Wu; Dorene M Rentz; Reisa A Sperling; Gad A Marshall; M Maria Glymour Journal: Int J Geriatr Psychiatry Date: 2016-05-09 Impact factor: 3.485