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. 2022 Jun 10:13:834438.
doi: 10.3389/fpsyt.2022.834438. eCollection 2022.

Social Isolation and Incident Dementia in the Oldest-Old-A Competing Risk Analysis

Jessica Grothe  1 , Susanne Röhr  1   2 , Melanie Luppa  1 , Alexander Pabst  1 , Luca Kleineidam  3   4 , Kathrin Heser  3 , Angela Fuchs  5 , Michael Pentzek  5 , Anke Oey  6 , Birgitt Wiese  6 , Dagmar Lühmann  7 , Hendrik van den Bussche  7 , Siegfried Weyerer  8 , Jochen Werle  8 , Dagmar Weeg  9 , Horst Bickel  9 , Martin Scherer  7 , Hans-Helmut König  10 , André Hajek  10 , Michael Wagner  3   4 , Steffi G Riedel-Heller  1
Affiliations

Social Isolation and Incident Dementia in the Oldest-Old-A Competing Risk Analysis

Jessica Grothe et al. Front Psychiatry. .

Abstract

Purpose: Social isolation is considered a risk factor for dementia. However, less is known about social isolation and dementia with respect to competing risk of death, particularly in the oldest-old, who are at highest risk for social isolation, dementia and mortality. Therefore, we aimed to examine these associations in a sample of oldest-old individuals.

Methods: Analyses were based on follow-up (FU) 5-9 of the longitudinal German study AgeCoDe/AgeQualiDe. Social isolation was assessed using the short form of the Lubben Social Network Scale (LSNS-6), with a score ≤ 12 indicating social isolation. Structured interviews were used to identify dementia cases. Competing risk analysis based on the Fine-Gray model was conducted to test the association between social isolation and incident dementia.

Results: Excluding participants with prevalent dementia, n = 1,161 individuals were included. Their mean age was 86.6 (SD = 3.1) years and 67.0% were female. The prevalence of social isolation was 34.7% at FU 5, 9.7% developed dementia and 36.0% died during a mean FU time of 4.3 (SD = 0.4) years. Adjusting for covariates and cumulative mortality risk, social isolation was not significantly associated with incident dementia; neither in the total sample (sHR: 1.07, 95%CI 0.65-1.76, p = 0.80), nor if stratified by sex (men: sHR: 0.71, 95%CI 0.28-1.83, p = 0.48; women: sHR: 1.39, 95%CI 0.77-2.51, p = 0.27).

Conclusion: In contrast to the findings of previous studies, we did not find an association between social isolation and incident dementia in the oldest-old. However, our analysis took into account the competing risk of death and the FU period was rather short. Future studies, especially with longer FU periods and more comprehensive assessment of qualitative social network characteristics (e.g., loneliness and satisfaction with social relationships) may be useful for clarification.

Keywords: competing risk analysis; epidemiology; incident dementia; longitudinal study; oldest-old; social isolation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Sample selection flowchart.
See this image and copyright information in PMC

References

    1. United Nations Department Department of Economic and Social Affairs . Population Division World Population Ageing 2019: Highlights. New York, NY: United Nations, Department of Economic and Social Affairs; (2019).
    1. Kawas CH, Kim RC, Sonnen JA, Bullain SS, Trieu T, Corrada MM. Multiple pathologies are common and related to dementia in the oldest-old: the 90+ study. Neurology. (2015) 85:535–42. 10.1212/WNL.0000000000001831 - DOI - PMC - PubMed
    1. Reitz C, Brayne C, Mayeux R. Epidemiology of Alzheimer's disease. Nat Rev Neurol. (2011) 7:137–52. 10.1038/nrneurol.2011.2 - DOI - PMC - PubMed
    1. Roehr S, Luck T, Bickel H, Brettschneider C, Ernst A, Fuchs A, et al. . Mortality in incident dementia—results from the German study on aging, cognition, and dementia in primary care patients. Acta Psychiatr Scand. (2015) 132:257–69. 10.1111/acps.12454 - DOI - PubMed
    1. Prince M, Ali G-C, Guerchet M, Prina AM, Albanese E, Wu Y-T. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther. (2016) 8:23. 10.1186/s13195-016-0188-8 - DOI - PMC - PubMed

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