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Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing
- Gowsaly Mahalingam, Suraj Samtani, Ben Chun Pan Lam, Darren M Lipnicki, Maria Fernanda Lima-Costa, Sergio Luis Blay, Erico Castro-Costa, Xiao Shifu, Maëlenn Guerchet, Pierre-Marie Preux, Antoine Gbessemehlan, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Themis Dardiotis, Ki-Woong Kim, Steffi Riedel-Heller, Susanne Röhr, Alexander Pabst, Suzana Shahar, Katya Numbers, Mary Ganguli, Tiffany F. Hughes, Ching-Chou H. Chang, Michael Crowe, Tze Pin Ng, Xinyi Gwee, Denise Qian Ling Chua, representatives from SHARED work packages, Joanna Rymaszewska, Karin Wolf-Ostermann, Anna-Karin Welmer, Jean Stafford, Myrra Vernooij-Dassen, Yun-Hee Jeon, Perminder S Sachdev, Henry Brodaty
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 16-17
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Background:
Good social connections are proposed to positively influence the course of cognitive decline by stimulating cognitive reserve and buffering harmful stress-related health effects. Prior meta-analytic research has uncovered links between social connections and the risk of poor health outcomes such as mild cognitive impairment, dementia, and mortality. These studies have primarily used aggregate data from North America and Europe with limited markers of social connections. Further research is required to explore these associations longitudinally across a wider range of social connection markers in a global setting.
Research Objective:We examined the associations between social connection structure, function, and quality and the risk of our primary outcomes (mild cognitive impairment, dementia, and mortality).
Method:Individual participant-level data were obtained from 13 longitudinal studies of ageing from across the globe. We conducted survival analysis using Cox regression models and combined estimates from each study using two-stage meta-analysis. We examined three social constructs: connection structure (living situation, relationship status, interactions with friends/family, community group engagement), function (social support, having a confidante) and quality (relationship satisfaction, loneliness) in relation to the risks of three primary outcomes (mild cognitive impairment, dementia, and mortality). In our partially adjusted models, we included age, sex, and education and in fully adjusted models used these variables as well as diabetes, hypertension, smoking, cardiovascular risk, and depression.
Preliminary results of the ongoing study:In our fully adjusted models we observed: a lower risk of mild cognitive impairment was associated with being married/in a relationship (vs. being single), weekly community group engagement (vs. no engagement), weekly family/friend interactions (vs. not interacting), and never feeling lonely (vs. often feeling lonely); a lower risk of dementia was associated with monthly/weekly family/friend interactions and having a confidante (vs. no confidante); a lower risk of mortality was associated with living with others (vs. living alone), yearly/monthly/weekly community group engagement, and having a confidante.
Conclusion:Good social connection structure, function, and quality are associated with reduced risk of incident MCI, dementia, and mortality. Our results provide actionable evidence that social connections are required for healthy ageing.
Determinants of incident dementia in different old age groups: results of the prospective AgeCoDe/AgeQualiDe study
- Tobias Luck, Alexander Pabst, Susanne Roehr, Birgitt Wiese, Marion Eisele, Kathrin Heser, Dagmar Weeg, Angela Fuchs, Christian Brettschneider, Jochen Werle, Silke Mamone, Hendrik van den Bussche, Horst Bickel, Michael Pentzek, Hans-Helmut Koenig, Siegfried Weyerer, Wolfgang Maier, Martin Scherer, Michael Wagner, Steffi G. Riedel-Heller
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- Journal:
- International Psychogeriatrics / Volume 32 / Issue 5 / May 2020
- Published online by Cambridge University Press:
- 23 December 2019, pp. 645-659
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Objectives:
To examine the impact of determinants of incident dementia in three different old age groups (75–79, 80–84, 85+years) in Germany.
Design:Multicenter prospective AgeCoDe/AgeQualiDe cohort study with baseline and nine follow-up assessments at 1.5-year intervals.
Setting:Primary care medical record registry sample.
Participants:General practitioners’ (GPs) patients aged 75+years at baseline.
Measurements:Conduction of standardized interviews including neuropsychological assessment and collection of GP information at each assessment wave. We used age-stratified competing risk regression models (accounting for the competing event of mortality) to assess determinants of incident dementia and age-stratified ordinary least square regressions to quantify the impact of identified determinants on the age at dementia onset.
Results:Among 3027 dementia-free GP patients, n = 704 (23.3%) developed dementia during the 13-year study period. Worse cognitive performance and subjective memory decline with related worries at baseline, and the APOE ε4 allele were associated independently with increased dementia risk in all three old age groups. Worse cognitive performance at baseline was also associated with younger age at dementia onset in all three age groups. Other well-known determinants were associated with dementia risk and age at dementia onset only in some or in none of the three old age groups.
Conclusions:This study provides further evidence for the age-specific importance of determinants of incident dementia in old age. Such specifics have to be considered more strongly particularly with regard to potential approaches of early detection and prevention of dementia.
Effects of psychological eating behaviour domains on the association between socio-economic status and BMI
- Antje Löffler, Tobias Luck, Francisca S Then, Claudia Luck-Sikorski, Alexander Pabst, Peter Kovacs, Yvonne Böttcher, Jana Breitfeld, Anke Tönjes, Annette Horstmann, Markus Löffler, Christoph Engel, Joachim Thiery, Arno Villringer, Michael Stumvoll, Steffi G Riedel-Heller
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- Journal:
- Public Health Nutrition / Volume 20 / Issue 15 / October 2017
- Published online by Cambridge University Press:
- 24 July 2017, pp. 2706-2712
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Objective
The current study investigates potential pathways from socio-economic status (SES) to BMI in the adult population, considering psychological domains of eating behaviour (restrained eating, uncontrolled eating, emotional eating) as potential mediators stratified for sex.
DesignData were derived from the population-based cross-sectional LIFE-Adult-Study. Parallel-mediation models were conducted to obtain the total, direct and indirect effects of psychological eating behaviour domains on the association between SES and BMI for men and for women.
SettingLeipzig, Germany.
SubjectsWe studied 5935 participants aged 18 to 79 years.
ResultsUncontrolled eating mediated the association between SES and BMI in men only and restrained eating in both men and women. Emotional eating did not act as mediator in this relationship. The total effect of eating behaviour domains on the association between SES and BMI was estimated as β=−0·03 (se 0·02; 95 % CI −0·062, −0·003) in men and β=−0·18 (se 0·02; 95 % CI −0·217, −0·138) in women.
ConclusionsOur findings do not indicate a strong overall mediation effect of the eating behaviour domains restrained eating, uncontrolled eating and emotional eating on the association between SES and BMI. Further research on other pathways of this association is strongly recommended. Importantly, our findings indicate that, independent from one’s social position, focusing on psychological aspects in weight reduction might be a promising approach.
Subjective cognitive decline is longitudinally associated with lower health-related quality of life
- Susanne Roehr, Tobias Luck, Alexander Pabst, Horst Bickel, Hans-Helmut König, Dagmar Lühmann, Angela Fuchs, Steffen Wolfsgruber, Birgitt Wiese, Siegfried Weyerer, Edelgard Mösch, Christian Brettschneider, Tina Mallon, Michael Pentzek, Michael Wagner, Silke Mamone, Jochen Werle, Martin Scherer, Wolfgang Maier, Frank Jessen, Steffi G. Riedel-Heller, for the AgeCoDe study group
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- Journal:
- International Psychogeriatrics / Volume 29 / Issue 12 / December 2017
- Published online by Cambridge University Press:
- 24 July 2017, pp. 1939-1950
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Background:
Subjective cognitive decline (SCD), the potentially earliest notable manifestation of preclinical Alzheimer's disease and other dementias, was consistently associated with lower quality of life in cross-sectional studies. The aim of this study was to investigate whether such an association persists longitudinally – particularly with health-related quality of life (HRQoL) in older individuals without cognitive impairment.
Methods:Data were derived from follow-up 2–6 of the prospective Germany Study on Ageing, Cognition and Dementia in Primary Care (AgeCoDe) covering a total six-year observation period. We used linear mixed effects models to estimate the effect of SCD on HRQoL measured by the EQ-5D visual analogue scale (EQ VAS).
Results:Of 1,387 cognitively unimpaired individuals aged 82.2 years (SD = 3.2) on average, 702 (50.6%) reported SCD and 230 (16.6%) with SCD-related concerns. Effect estimates of the linear mixed effects models revealed lower HRQoL in individuals with SCD (unadjusted: –3.7 points on the EQ VAS, 95%CI = –5.3 to –2.1; SE = 0.8; p < 0.001; adjusted: –2.9 points, 95%CI = –3.9 to –1.9; SE = 0.5; p < 0.001) than in individuals without SCD. The effect was most pronounced in SCD with related concerns (unadjusted: –5.4, 95%CI = –7.6 to –3.2; SE = 1.1; p < 0.001; adjusted: –4.3, 95%CI = –5.8 to –2.9, SE = 0.7; p < 0.001).
Conclusion:SCD constitutes a serious issue to older cognitively unimpaired individuals that is depicted in persisting lower levels of HRQoL beyond depressive symptoms and functional impairment. Therefore, SCD should be taken seriously in clinical practice.