Is Loneliness Linked to Dementia?

With the worrisome rise in new dementia cases among older people, and the disturbing implications this has for health care in future, researchers are taking a closer look at potential warning signs that might show how vulnerable old adults can be.   Along with various medical factors that can influence dementia risk, psychological factors including mental stimulation, quality of life, and quality of social interactions can influence the onset of mild cognitive impairments, or even full-blown dementia (whether Alzheimer's Disease or one of the less common types).    But can simply feeling lonely be a warning sign as well?

A new research study showing that loneliness, rather than simply living alone, may be a key factor in older people developing symptoms of dementia.   Published in a recent issue of the Journal of Neurology, Neurosurgery and Psychiatry, the study focused on more than two thousand older adults living in Amsterdam, aged 65-86 still living in the community.   The researchers, all associated with Amsterdam's Free University Medical Centre and ARKIN Mental Health Care,  assessed all of the study subjects over a three-year period. 

As part of their research design, the study researchers examined the 2173 study subjects for various health risk factors including genetic susceptibility, depression, demographic factors and mild cognitive impairment.   They also examined social networks and psychological factors such as social isolation.    About half of the study subjects lived alone and twenty percent reported strong feelings of loneliness.  Almost two-thirds of the study subjects were women.

According to lead researcher, Tjalling Jan Holwerda of ARKIN Mental Health Centre's Department of Psychiatry, analyses of the results showed that older people with feelings of loneliness were more likely to develop dementia even when other risk factors were ruled out.    Social isolation was not a significant predictor however.    The researchers made no distinction between the most common form of dementia, Alzheimer's disease, and other types of dementia in their study.

The authors concluded that feeling lonely rather than living alone was a major risk factor that deserves major clinical attention when testing for dementia.   Not only does the quality of social interactions matter for older adults, whether they live alone or not, but persistent feelings of loneliness in older adults may be an early sign of developing dementia.   As the researchers point out in their conclusions, "loneliness may be a behavioural reaction to diminished cognition" since people who are experiencing problems with memory or attention may become more withdrawn socially due to embarassment or general confusion about handling social situations.    Also, reduced social interaction can lead to a loss of sensory and cognitive stimulation that can worsen brain health and make older adults more vulnerable to dementia.    This could lead to a vicious circle with dementia contributing to loneliness and vice versa.  

The research also demonstrates that feeling lonely can be more complex than most people think.   Even people who are in supposedly healthy relationships can experience strong feelings of loneliness given the perceived quality of that relationship.   At the same time, even people living alone can avoid feeling lonely due to having a large network of friends and family members.   While the study authors warn that their results should not be misinterpreted to conclude that loneliness can cause dementia, they point out that strong feelings of loneliness can reflect significant vulnerability to dementia and that developing better social networks can be a useful way of reducing dementia risk as well as improving the overall quality of life. 






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