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Johns Hopkins Study Confirms a Link Between Social Isolation and the Odds of Developing Dementia

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When we picture aging adults who are termed “socially isolated,” our first image may be of the forgotten residents who daily line the hallways of American nursing homes. While it’s true that these images are all too common, the fact is that millions of American seniors – as many as one in four – fits the description of living day by day in a state of social isolation. Many of these seniors are no doubt living near you, down the hall in a nearby apartment or across the street in a neighboring home.

Repeated studies have demonstrated the risk factors associated with a lack of social stimulation. The most recent data comes from two just-published studies done at the Johns Hopkins School of Medicine, described in this HealthDay article, that confirms the reality that the condition many of us fear the most – dementia – may be linked to a lack of social connection. One study documents the reality of the risks of isolation, while the other, as a hopeful counterpoint, provides solid evidence that technology can play a significant role in making isolated seniors feel more connected.

Reporter Cara Murez wrote the HealthDay article .

Bad News, Good News on Social Isolation Among Seniors

In her HealthDay article, Murez begins, “Social isolation is a substantial risk factor for dementia in older adults, according to a pair of studies that add evidence to past research on this threat. But these new studies offer a potential solution: using technology to encourage older adults to text and email to stay in touch.”

In other words, there’s bad news and perhaps some good news in these studies. But for context, and with no small bit of hope, Murez adds, “Although the studies don’t prove lack of regular social contact causes dementia, researchers said they do strengthen observations that isolation increases the risk. They suggested that relatively simple steps to increase social support may reduce that risk.” In other words, isolation is clearly reversible.

Social Isolation is Related to Loneliness, but Not the Same

Before diving more deeply into the Johns Hopkins studies, we checked out the website for the National Institute on Aging for a clearer definition of social isolation. Experts say it’s different from being lonely.

“The number of older adults age 65 and older is growing, and many are socially isolated and regularly feel lonely,” says the NIA. “Loneliness and social isolation are different, but related. Loneliness is the distressing feeling of being alone or separated. Social isolation is the lack of social contacts and having few people to interact with regularly. You can live alone and not feel lonely or socially isolated, and you can feel lonely while being with other people.”

Social Isolation: The Reality for 1 in 4 Seniors

Murez cites a troubling statistic: she states that “1 in 4 people over age 65 in the United States is socially isolated.” With that as background, she discusses the Johns Hopkins research on the topic.

She explains, “ The first study, published this month in the Journal of the American Geriatrics Society , used data collected on more than 5,000 Medicare beneficiaries for a long-term study of health and aging trends that began in 2011. Participants were asked to complete an annual two-hour, in-person interview to assess their mental functioning, health status and overall well-being.”

At the start, about 23 percent reported social isolation and showed no signs of dementia. But after nine years, 21 percent of participants had developed dementia, and the researchers found that the risk was 27 percent higher among socially isolated adults.

But this problem is fixable, according to a senior author of both studies. Dr. Thomas Cudjoe, an assistant medical professor at Johns Hopkins, says, “Social connections matter for our cognitive health, and it is potentially easily modifiable for older adults without the use of medication.”

“Socially isolated older adults have smaller social networks, live alone and have limited participation in social activities,” said study co-author Alison Huang, a senior research associate at Johns Hopkins. “One possible explanation is that having fewer opportunities to socialize with others decreases cognitive engagement as well, potentially contributing to increased risk of dementia.”


Technology Can Help Reduce Isolation

 In the other study [also published in the Journal of the American Geriatrics Society ] , researchers found that communications technology, such as telephones and email, lowered the risk for social isolation,” Murez writes. “To research this, they used data from participants in the same nationwide health and aging study. They found that more than 70 percent of seniors who were not socially isolated at their initial appointment had a working cellphone and/or computer.”

The participants with phones or a computer regularly used text or email to communicate with others, leading to the statistic that adults who had consistent access to technology had a 31 percent lower risk for social isolation.

“This study shows that access and use of simple technologies are important factors that protect older adults against social isolation, which is associated with significant health risks,” says Dr. Mfon Umoh, a postdoctoral fellow in geriatric medicine who led the technology study. “This is encouraging, because it means simple interventions may be meaningful.”

Murez concludes her article by noting, “More work is needed to identify people at risk and to create tools to minimize that risk, researchers said. Future research should focus on risks based on biological sex, physical limitations, race and income level.”

Lessons from “The Nun Study”

Much has been learned about dementia from an unlikely source – a study dating back to 1997 of a group of nuns. You’ll find several articles about this study online, but this one from the Atlas Obscura website provides a good overview. The most revealing finding was the discovery that the physiological signs of dementia, including deposits in the brain that are associated with Alzheimer’s disease, do not necessarily mean a patient will show outward signs of mental decline.

The Atlas Obscura article describes one of the nuns in the study, a woman named Sister Mary. “After Sister Mary’s death at 102, a lab examined her brain. She had been alert and without memory loss; but instead of looking at a healthy brain, scientists saw one riddled with visible knots of protein—an indication of full-blown Alzheimer’s disease.”  Researchers offer several theories about why Sister Mary and others of her order remained mentally alert despite evidence of brain deterioration, but most agree that a life of purpose, lived in community, played a major part.

Reversing Alzheimer’s Through Lifestyle Changes

Another example of encouraging research, this time coming out of UCLA, also shows at least some promising evidence that, for some people, changes to lifestyle and diet can slow and even reverse cognitive decline. The simple changes involved reducing processed foods, increasing consumption of healthy foods associated with the Mediterranean Diet, getting regular exercise and developing better sleep patterns. Study participants also learned to reduce stress through yoga and meditation.

While the study was small, results were encouraging. “Nine of the ten participants experienced improvement in their memories within six months of the study,” says the article on Alzheimer’s.net. “Six individuals who had already quit their jobs or were considering quitting were able to return to work with improved performance. The one patient who did not improve had been diagnosed with late-stage Alzheimer’s disease.”

Rajiv’s take-away: while dementia is frightening, fatalism about dementia can lead to the worst possible outcomes. “People can have dementia but can live with it as if they don’t have dementia,” he observes. “The key is to stay meaningfully engaged, and socially active. Then make the kind of changes cited in the UCLA study. For many,” he concludes, “symptoms of dementia can actually be reversed. Don’t just settle for the traditional fatalistic answers!” 

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(originally reported at https://consumer.healthday.com)

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