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Cited by 1,363Dementia and Cognitive Impairment ResearchHealth disparities and outcomesAlzheimer's disease research and treatments

Loneliness and Risk of Alzheimer Disease

Wilson, Robert S., Krueger, Kristin R., Arnold, Steven E., Schneider, Julie A., Kelly, Jeremiah F., Barnes, Lisa L., Tang, Yuxiao, Bennett, David A.·2007·Archives of General Psychiatry
DOI 10.1001/archpsyc.64.2.234
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Abstract

CONTEXT: Social isolation in old age has been associated with risk of developing dementia, but the risk associated with perceived isolation, or loneliness, is not well understood. OBJECTIVE: To test the hypothesis that loneliness is associated with increased risk of Alzheimer disease (AD). DESIGN: Longitudinal clinicopathologic cohort study with up to 4 years of annual in-home follow-up. PARTICIPANTS: A total of 823 older persons free of dementia at enrollment were recruited from senior citizen facilities in and around Chicago, Ill. Loneliness was assessed with a 5-item scale at baseline (mean +/- SD, 2.3 +/- 0.6) and annually thereafter. At death, a uniform postmortem examination of the brain was conducted to quantify AD pathology in multiple brain regions and the presence of cerebral infarctions. MAIN OUTCOME MEASURES: Clinical diagnosis of AD and change in previously established composite measures of global cognition and specific cognitive functions. RESULTS: During follow-up, 76 subjects developed clinical AD. Risk of AD was more than doubled in lonely persons (score 3.2, 90th percentile) compared with persons who were not lonely (score 1.4, 10th percentile), and controlling for indicators of social isolation did not affect the finding. Loneliness was associated with lower level of cognition at baseline and with more rapid cognitive decline during follow-up. There was no significant change in loneliness, and mean degree of loneliness during the study was robustly associated with cognitive decline and development of AD. In 90 participants who died and in whom autopsy of the brain was performed, loneliness was unrelated to summary measures of AD pathology or to cerebral infarction. CONCLUSION: Loneliness is associated with an increased risk of late-life dementia but not with its leading causes.

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  • Social-network size was not related to dementia risk in two studies.

    “social-network size was not related to dementia risk in two studies”

    From Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced? (2008) · cites this paper as Wilson, Krueger, et al., 2007

  • Clinical-pathologic results to date do not indicate an association between social engagement indicators and Alzheimer's disease pathology.

    “results to date do not indicate an association between indicators of social engagement and Alzheimer's disease pathology”

    From Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced? (2008) · cites this paper as Wilson, Krueger, et al., 2007

  • A more recent study found no association between social-network size and dementia risk, but loneliness was related to increased dementia incidence after controlling for network size and social activity.

    “A more recent study found no association between social-network size and dementia risk, but feeling lonely was related to increased incidence of dementia even after controlling for social-network size and frequency of social activity”

    From Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced? (2008) · cites this paper as Wilson, Krueger, et al., 2007

  • Few previous studies have considered potentially reciprocal associations between cognitive ability and loneliness over time.

    “Whereas previous studies have examined loneliness as a potential predictor of cognitive decline (Gow & Mortensen, 2016; Shankar et al., 2013; Wilson et al., 2007), few have considered the potentially reciprocal associations between cognitive ability and loneliness over time.”

    From Longitudinal Associations Between Loneliness and Cognitive Ability in the Lothian Birth Cohort 1936 (2019) · cites this paper as Wilson et al., 2007

  • Perceived social isolation predicts cognitive decline and Alzheimer's disease risk, even when social network size and social activity frequency are statistically controlled.

    “Wilson et al.35 reported that perceived social isolation predicted cognitive decline and risk for Alzheimer’s disease (AD). Importantly, perceived isolation persisted in predicting each of these outcomes even when social network size and frequency of social activity were statistically held constant.”

    From Social isolation (2011) · cites this paper as [35]

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Authors
Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L. L., Tang, Y., & Bennett, D. A.
Affiliations
  • Rush University Medical Center (US)
  • University of Pennsylvania (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2007-02-01
Volume
64
Issue
2
Pages
234
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.64.2.234
OpenAlex
W2138720796
Cited by
1,363
References
51
Citations by year
2026: 46 · 2025: 98 · 2024: 93 · 2023: 94 · 2022: 125 · 2021: 149 · 2020: 110 · 2019: 85 · 2018: 68 · 2017: 67 · 2016: 73 · 2015: 70 · 2014: 69 · 2013: 44 · 2012: 42
FWCI
17.72
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (R01AG017917, R01AG024480)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
loneliness, Alzheimer's disease, dementia risk, cognitive decline, social isolation, older adults, postmortem neuropathology, cerebral infarction, late-onset dementia
MeSH terms
Aged, 80 and over, Alzheimer Disease, Brain, Cerebral Infarction, Cognition Disorders, Female, Follow-Up Studies, Humans, Loneliness, Longitudinal Studies, Male, Neuropsychological Tests, Personality Inventory, Risk Factors, Social Isolation, Cohort Studies, Comorbidity

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