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The influence of social relationships and leisure activity on adult cognitive functioning and risk of dementia: Longitudinal population-based studies
Umeå University, Faculty of Social Sciences, Department of Psychology.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Sociala relationers och fritidsaktiviteters påverkan på kognitiv funktion i vuxenliv och risk för demens : Longitudinella populationsbaserade studier (Swedish)
Abstract [en]

Today, as we live longer, dementia diseases are becoming more prevalent around the world. Thus, further knowledge of how to maintain levels of cognitive functioning in old age and how to identify factors that postpone the onset of dementia are of acute interest. Lifestyle patterns and social life are important aspects to consider in this regard.

This thesis includes three studies. Study I investigated the association between participation in various leisure activities in old age (≥65 years) and risk of incident all-cause dementia. Analyses of the total follow-up time period (15 years) showed that higher levels of “Social” and “Total” leisure activity were associated with decreased risk of dementia. In Study II, the aim was to investigate the association between various aspects of social relationships in old age (≥65 years) and risk of incidents of all-cause dementia and Alzheimer's disease. Results showed that over the total follow-up period (16 years) higher values on the relationship index were associated with reduced risk of both dementia and Alzheimer's disease. Visiting/visits of friends and acquaintances more than once a week was related to decreased risk for all-cause dementia, but not for Alzheimer's disease. However, in neither Study I nor II did any of these factors alter the risk of all-cause dementia or Alzheimer's disease when near-onset dementias were removed from the analyses (Study I, up to five years; Study II, up to three years).

In Study III the aim was to investigate the association between social network size and cognitive ability in a middle-aged (40–60 years) sample. The idea was that if social network size can moderate negative age-related influence on memory functions, it might also put an individual on a cognitive trajectory that is beneficial in old age. Results from longitudinal analyses showed that baseline network size was positively related to five-year changes in semantic memory and with changes in both semantic and episodic memory at the ten-year follow-up. Social network size was unrelated to changes in visuospatial performance.

Taken together, enrichment factors measured in old age (≥ 65 years) did not alter the risk of all-cause dementia or Alzheimer's disease when near-onset dementias were removed from the analyses. These results might reflect protective short-term effects or reverse causality, meaning that in the prodromal phase of dementia individuals tend to withdraw from activity. Social network size in middle age (40-60 years), however, appears to have beneficial long-term effects on cognitive functioning. The results highlight the importance of long follow-up periods and the need to adjust for the influences of reverse causality when investigating the impact of a socially and mentally active life on cognitive functioning.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2015. , 103 p.
Keyword [en]
Cognitive functioning, cognition, memory, dementia, Alzheimer’s disease, cognitive reserve, reverse causality, old age, middle age, leisure activity, social relationships, social network, longitudinal
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:umu:diva-101840ISBN: 978-91-7601-242-0 (print)OAI: oai:DiVA.org:umu-101840DiVA: diva2:805089
Public defence
2015-05-08, Norra Beteendevetarhuset, Hörsal 1031, Umeå universitet, Umeå, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2015-04-17 Created: 2015-04-14 Last updated: 2015-04-23Bibliographically approved
List of papers
1. Leisure Activity in Old Age and Risk of Dementia: a 15-Year Prospective Study
Open this publication in new window or tab >>Leisure Activity in Old Age and Risk of Dementia: a 15-Year Prospective Study
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2014 (English)In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 69, no 4, 493-501 p.Article in journal (Refereed) Published
Abstract [en]

Objectives. The aim of this study was to investigate whether leisure activity is associated with incident dementia in an older sample.

Method. We examined a sample of 1,475 elderly (>= 65 years) who were dementia free at baseline over a follow-up period of up to 15 years. In addition to analyses involving the total time period, separate analyses of three time periods were performed, 1-5, 6-10, and 11-15 years, following baseline measurement of leisure activity.

Results. After controlling for a variety of potential confounders, analyses of data for the total time period revealed that higher levels of "Total activity" and "Social activity," but not "Mental activity," were associated with decreased risk of dementia. However, analyses of the separate time periods showed that this association was only significant in the first time period, 1-5 years after baseline.

Discussion. The results from this study provide little support for the hypothesis that frequent engagement in leisure activities among elderly serve to protect against dementia diseases across a longer time frame. The finding of a relationship for the first time period, 1-5 years after baseline, could indicate short-term protective effects but could also reflect reverse causality.

Place, publisher, year, edition, pages
Oxford University Press, 2014
Keyword
Cognitive aging, Dementia, Leisure activities, Lifestyle, Longitudinal
National Category
Psychology Other Health Sciences
Identifiers
urn:nbn:se:umu:diva-79204 (URN)10.1093/geronb/gbt056 (DOI)000338009000001 ()23766435 (PubMedID)2-s2.0-84902162889 (Scopus ID)
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2017-12-06Bibliographically approved
2. Social relationships and risk of dementia: a population-based study
Open this publication in new window or tab >>Social relationships and risk of dementia: a population-based study
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2015 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 27, no 8, 1391-1399 p.Article in journal (Refereed) Published
Abstract [en]

Background: The objective was to examine whether aspects of social relationships in old age are associated with all-cause dementia and Alzheimer's disease (AD).

Methods: We studied 1,715 older adults (≥ 65 years) who were dementia-free at baseline over a period of up to 16 years. Data on living status, contact/visit frequency, satisfaction with contact frequency, and having/not having a close friend were analyzed using Cox proportional hazards regressions with all-cause dementia or AD as the dependent variable. To control for reverse causality and to identify potential long-term effects, we additionally performed analyses with delayed entry.

Results: We identified 373 incident cases of dementia (207 with AD) during follow-up. The variable visiting/visits from friends was associated with reduced risk of all-cause dementia. Further, a higher value on the relationships index (sum of all variables) was associated with reduced risk of all-cause dementia and AD. However, in analyses with delayed entry, restricted to participants with a survival time of three years or more, none of the social relationship variables was associated with all-cause dementia or AD.

Conclusions: The results indicate that certain aspects of social relationships are associated with incident dementia or AD, but also that these associations may reflect reverse causality. Future studies aimed at identifying other factors of a person's social life that may have the potential to postpone dementia should consider the effects of reverse causality.

Place, publisher, year, edition, pages
Cambridge University Press, 2015
Keyword
dementia, Alzheimer's disease, longitudinal, social relationships, social network
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-101778 (URN)10.1017/S1041610215000319 (DOI)000361384500014 ()25779679 (PubMedID)
Available from: 2015-04-10 Created: 2015-04-10 Last updated: 2017-12-04Bibliographically approved
3. Social network size and cognitive functioning in middle-aged adults: cross-sectional and longitudinal associations
Open this publication in new window or tab >>Social network size and cognitive functioning in middle-aged adults: cross-sectional and longitudinal associations
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2017 (English)In: Journal of Adult Development, ISSN 1068-0667, E-ISSN 1573-3440, Vol. 24, no 2, 77-88 p.Article in journal (Refereed) Published
Abstract [en]

The objective of the present study was to examine relations between social network size and three cognitive abilities (episodic memory, semantic memory, visuospatial ability) in middle-aged adults. We analyzed cross-sectional data on social network size and cognitive functioning that were available for 804 participants aged 40–60 years. In addition, we examined 5- and 10-year follow-up measurements of cognitive functioning that were available for 604 and 255 participants, respectively. Cross-sectional analyses revealed a positive association between social network size and each of the three cognitive abilities. Baseline network size was positively related to 5-year changes in semantic memory, and to 10-year changes in semantic as well as episodic memory, but was unrelated to changes in visuospatial performance. A minor portion of the sample (n = 131) had 10-year follow-up data on network size. Cross-lagged panel correlations revealed that baseline network size was associated with follow-up measurement in cognitive functioning (episodic memory, semantic memory), whereas baseline cognitive performance was unrelated to future network size. Together, the results demonstrate a small but positive relation between network size and declarative memory abilities, in line with models proposing a cognitive reserve built up by factors such as the increased cognitive stimulation associated with a more extensive social network.

Keyword
Cognition, Longitudinal, Cross-sectional, Social network, Cognitive reserve
National Category
Psychology Public Health, Global Health, Social Medicine and Epidemiology Sociology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-101832 (URN)10.1007/s10804-016-9248-3 (DOI)000399825300001 ()
Note

Originally published in manuscript form.

Available from: 2015-04-14 Created: 2015-04-14 Last updated: 2017-05-30Bibliographically approved

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