Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL)
Abstract
BACKGROUND: Known risk factors for Alzheimer's disease and other dementias include medical conditions, genetic vulnerability, depression, demographic factors and mild cognitive impairment. The role of feelings of loneliness and social isolation in dementia is less well understood, and prospective studies including these risk factors are scarce. METHODS: We tested the association between social isolation (living alone, unmarried, without social support), feelings of loneliness and incident dementia in a cohort study among 2173 non-demented community-living older persons. Participants were followed for 3 years when a diagnosis of dementia was assessed (Geriatric Mental State (GMS) Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT)). Logistic regression analysis was used to examine the association between social isolation and feelings of loneliness and the risk of dementia, controlling for sociodemographic factors, medical conditions, depression, cognitive functioning and functional status. RESULTS: After adjustment for other risk factors, older persons with feelings of loneliness were more likely to develop dementia (OR 1.64, 95% CI 1.05 to 2.56) than people without such feelings. Social isolation was not associated with a higher dementia risk in multivariate analysis. CONCLUSIONS: Feeling lonely rather than being alone is associated with an increased risk of clinical dementia in later life and can be considered a major risk factor that, independently of vascular disease, depression and other confounding factors, deserves clinical attention. Feelings of loneliness may signal a prodromal stage of dementia. A better understanding of the background of feeling lonely may help us to identify vulnerable persons and develop interventions to improve outcome in older persons at risk of dementia.
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Loneliness has health-related impacts even when social isolation is controlled for.
“This is consistent with previous research that shows that loneliness has health-related impacts even when social isolation is controlled for [42,43].”
Social isolation is associated with poorer cognitive outcomes.
“There is evidence to suggest that social isolation is associated with poor cognitive health, although findings are contradictory.”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [26]
Findings on the association between social isolation and cognitive health are inconsistent.
“although findings are contradictory”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [26]
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Robinson, E., Dickins, M., Lad, L., Beard, S., McGill, D., Hayes, J., Fabri, A. M., Wade, H., Meyer, C., & Lowthian, J. A. (2024) · The Gerontologist · doi:10.1093/geront/gnae034 · Cited by 2 · see citing works
- Authors
- Holwerda, T. J., Deeg, D. J. H., Beekman, A. T. F., van Tilburg, T. G., Stek, M. L., Jonker, C., & Schoevers, R. A.
- Affiliations
- Arkin (NL)
- Amsterdam Public Health (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Holwerda, T. J.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2012-12-10
- Volume
- 85
- Issue
- 2
- Pages
- 135-142
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2169719947
- Cited by
- 633
- References
- 50
- Citations by year
- 2026: 32 · 2025: 43 · 2024: 65 · 2023: 61 · 2022: 72 · 2021: 89 · 2020: 68 · 2019: 56 · 2018: 39 · 2017: 30 · 2016: 30 · 2015: 22 · 2014: 16 · 2013: 9 · 2012: 1
- FWCI
- 10.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- VU Research Portal (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- loneliness, social isolation, dementia risk, dementia onset, older adults, social support, living alone, prodromal dementia, Alzheimer's disease, community-dwelling older adults
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Humans, Loneliness, Male, Netherlands, Risk Factors, Social Isolation, Prevalence
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