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

Frontiers in Psychiatry

卷:13

André Hajek¹  Hans-Helmut König¹  Siegfried Weyerer²  Jochen Werle²  Kathrin Heser³  Martin Scherer⁴  Hendrik van den Bussche⁴  Dagmar Lühmann⁴  Horst Bickel⁵  Dagmar Weeg⁵  Michael Wagner⁶  Luca Kleineidam⁶  Susanne Röhr⁷  Michael Pentzek⁸  Angela Fuchs⁸  Anke Oey⁹  Birgitt Wiese⁹  Jessica Grothe¹⁰  Alexander Pabst¹⁰  Melanie Luppa¹⁰  Steffi G. Riedel-Heller¹⁰ 

[1] 0Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;

[2] Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;

[3] Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany;

[4] Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;

[5] Department of Psychiatry, Technical University of Munich, Munich, Germany;

[6] German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany;

[7] Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland;

[8] Institute of General Practice (ifam), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany;

[9] Institute of General Practice, Hannover Medical School, Hannover, Germany;

[10] Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany;

关键词: social isolation;    incident dementia;    oldest-old;    epidemiology;    competing risk analysis;    longitudinal study;   

DOI  :  10.3389/fpsyt.2022.834438

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown