Pre-dementia: Social engagement may help restore cognition

• Researchers investigated the effects of social engagement and various lifestyle factors on dementia onset and cognitive improvement after a diagnosis of mild cognitive impairment.
• They found that both lifestyle factors and social engagement predict typical cognitive abilities.
• They also found that social engagement alone predicts cognitive improvement 5 years after being diagnosed with mild cognitive impairment (MCI).
• Further research is needed to understand the underlying mechanisms behind the findings.

Research shows that loneliness and isolation predict cognitive decline and the onset of dementia, whereas social engagement protects against dementia onset.

Other studies show that lifestyle factors such as increased physical activity, a cognitively-active lifestyle, and a healthy Mediterranean-like diet may also reduce the risk of cognitive decline.

While research has shown that social and lifestyle factors may help delay cognitive decline, few studies have evaluated their relative effects and how they change over time.

Recently, researchers examined how various social and lifestyle factors influenced cognitive abilities over a 5-year period.

They found that out of all social and lifestyle factors assessed, social engagement was the only significant predictor of being cognitively typical by the end of the study period.

“The brain is an amazing organ and is responsible for everything we think, feel and do,” said Dr. Susan Kohlhaas, director of research at Alzheimer’s Research U.K., “Yet the diseases that cause dementia jeopardize all of this.”

“In this work, researchers investigated how the level of involvement in social activities is linked to early memory and thinking problems in a condition known as MCI, which is often a precursor for dementia. The researchers found that those with MCI who are more socially connected are more likely to have improved brain health years later,” she added.

The research was presented at Alzheimer’s Research U.K.’s Conference in Brighton earlier this month.

Data analysis 

For the study, the researchers used the second and third waves of data from the National Social Life, Health, and Aging Project (NSHAP), collected in 2010–2011 and 2015–2016, respectively.

Participants included 2,192 middle-aged and older Americans. Cognitive ability was assessed via the Montreal Cognitive Assessment (MoCA), a screening tool that differentiates cognitive changes from normal aging, MCI, and early dementia.

Social engagement was asked via questionnaire and included items such as frequency of volunteer work, attendance at meetings and organized groups, and socializing with friends and relatives.

Lifestyle factors were also assessed via survey and included smoking status and history, alcohol consumption, and participation in vigorous physical activity.

The researchers used demographic factors including age, sex, and household income as control variables.

When examining the data from 2015–2016 in isolation, the researchers found that social engagement, being a past but not a current smoker, and drinking alcohol significantly correlated with typical cognitive abilities.

The researchers further found that people with MCI in the second wave who had more social engagement were more likely to be cognitively typical by the third wave than those who had less social engagement.

They added that none of the lifestyle factors were linked to any significant results.

Use it or lose it

As for what causes cognitive impairment, Dr. Kohlhaas said, “A decline in memory and thinking is caused by a complex mix of age, genetics, and lifestyle factors. We know keeping connected is a pillar of good brain health and that midlife is increasingly being identified as a key time in people’s lives when we can act.”

To explain the link between cognitive improvement and social engagement, Dr. Maryam Afzal, Ph.D., a research associate at the University of Bristol, not involved in the study, told Medical News Today:

“Having to use complex neuron pathways to keep social interactions active – remembering names and events linked to each person you interact with could be exercising the brain. You need to use it or lose it!”

The researchers concluded that while both social and lifestyle factors are essential for later-life cognition, social engagement alone is linked to cognitive improvement over time for people with MCI.

The results, says Dr. Afzal, echo previous findings that suggest strong social relationships positively impact longevity. She said that these results thus strengthen the case for a link between social engagement and cognitive protection.

However, both Dr. Afzal and Dr. Kohlhaas agree that further research is needed to confirm the findings as the link between MCI and dementia onset is still not certain.

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