Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis
PurposeSocial 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 t...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.834438/full |
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| author | Jessica Grothe Susanne Röhr Susanne Röhr Melanie Luppa Alexander Pabst Luca Kleineidam Luca Kleineidam Kathrin Heser Angela Fuchs Michael Pentzek Anke Oey Birgitt Wiese Dagmar Lühmann Hendrik van den Bussche Siegfried Weyerer Jochen Werle Dagmar Weeg Horst Bickel Martin Scherer Hans-Helmut König André Hajek Michael Wagner Michael Wagner Steffi G. Riedel-Heller |
| author_facet | Jessica Grothe Susanne Röhr Susanne Röhr Melanie Luppa Alexander Pabst Luca Kleineidam Luca Kleineidam Kathrin Heser Angela Fuchs Michael Pentzek Anke Oey Birgitt Wiese Dagmar Lühmann Hendrik van den Bussche Siegfried Weyerer Jochen Werle Dagmar Weeg Horst Bickel Martin Scherer Hans-Helmut König André Hajek Michael Wagner Michael Wagner Steffi G. Riedel-Heller |
| author_sort | Jessica Grothe |
| collection | DOAJ |
| description | PurposeSocial 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.MethodsAnalyses 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.ResultsExcluding 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).ConclusionIn 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. |
| first_indexed | 2024-04-13T18:58:06Z |
| format | Article |
| id | doaj.art-3c5f9a6d2e77411188b519f1d5af21ab |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-13T18:58:06Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-3c5f9a6d2e77411188b519f1d5af21ab2022-12-22T02:34:10ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-06-011310.3389/fpsyt.2022.834438834438Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk AnalysisJessica Grothe0Susanne Röhr1Susanne Röhr2Melanie Luppa3Alexander Pabst4Luca Kleineidam5Luca Kleineidam6Kathrin Heser7Angela Fuchs8Michael Pentzek9Anke Oey10Birgitt Wiese11Dagmar Lühmann12Hendrik van den Bussche13Siegfried Weyerer14Jochen Werle15Dagmar Weeg16Horst Bickel17Martin Scherer18Hans-Helmut König19André Hajek20Michael Wagner21Michael Wagner22Steffi G. Riedel-Heller23Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyMedical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyGlobal Brain Health Institute (GBHI), Trinity College Dublin, Dublin, IrelandMedical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyMedical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyDepartment of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Bonn, GermanyDepartment of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, GermanyInstitute of General Practice (ifam), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyInstitute of General Practice (ifam), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyInstitute of General Practice, Hannover Medical School, Hannover, GermanyInstitute of General Practice, Hannover Medical School, Hannover, GermanyDepartment of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyCentral Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyCentral Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Psychiatry, Technical University of Munich, Munich, GermanyDepartment of Psychiatry, Technical University of Munich, Munich, GermanyDepartment of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany0Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany0Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Bonn, GermanyMedical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyPurposeSocial 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.MethodsAnalyses 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.ResultsExcluding 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).ConclusionIn 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.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.834438/fullsocial isolationincident dementiaoldest-oldepidemiologycompeting risk analysislongitudinal study |
| spellingShingle | Jessica Grothe Susanne Röhr Susanne Röhr Melanie Luppa Alexander Pabst Luca Kleineidam Luca Kleineidam Kathrin Heser Angela Fuchs Michael Pentzek Anke Oey Birgitt Wiese Dagmar Lühmann Hendrik van den Bussche Siegfried Weyerer Jochen Werle Dagmar Weeg Horst Bickel Martin Scherer Hans-Helmut König André Hajek Michael Wagner Michael Wagner Steffi G. Riedel-Heller Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis Frontiers in Psychiatry social isolation incident dementia oldest-old epidemiology competing risk analysis longitudinal study |
| title | Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis |
| title_full | Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis |
| title_fullStr | Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis |
| title_full_unstemmed | Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis |
| title_short | Social Isolation and Incident Dementia in the Oldest-Old—A Competing Risk Analysis |
| title_sort | social isolation and incident dementia in the oldest old a competing risk analysis |
| topic | social isolation incident dementia oldest-old epidemiology competing risk analysis longitudinal study |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.834438/full |
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