Social networks in mild-to-moderate Alzheimer disease: longitudinal relationships with dementia severity, cognitive function, and adverse events
Social networks in mild-to-moderate Alzheimer disease: longitudinal relationships with dementia severity, cognitive function, and adverse events
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DOI：
10.1080/13607863.2020.1745146
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发表时间：
2020-04-06
影响因子：
3.4
通讯作者：
Kennelly, Sean P.
中科院分区：
文献类型：
--
作者：
Dyer, Adam H.;Murphy, Claire;Kennelly, Sean P.
目的：不良的社交网络与晚年认知能力下降、痴呆和其他不良健康后果的可能性更大有关。然而，这些关系在已确诊的阿尔茨海默病（AD）患者中探索得很差，他们可能代表了一个特别脆弱的群体。方法：分析NILVAD研究的数据。我们在基线和18个月时评估了轻度-中度AD老年人的社交网络（Lubben社交网络量表[LSNS]）、认知（阿尔茨海默病评估量表[ADAS-Cog]）和痴呆严重程度（临床痴呆评分，方框总和[CDR-Sb]）。结果：纳入了464名轻度至中度AD参与者（73.1 ± 8.3岁; 61.9%为女性）。在基线时，不良的社交网络与更严重的痴呆症严重程度显著相关，但与更严重的认知障碍无关。而不是一个贫穷的社会网络预测更大的认知能力下降超过18个月，更大的基线痴呆严重程度预测社会网络下降超过18个月（β：-0.22，-0.42--0.02，p = 0.034）。最后，不良社交网络与发生严重不良事件的可能性显著增加相关（IRR：1.41，1.06 - 1.89，p = 0.019）。讨论：随着痴呆症的进展，患有AD的老年人更有可能经历社交网络的下降。此外，社交网络差与发生严重不良事件的可能性更大相关。这些发现增加了对AD中社交网络、痴呆进展和不良事件之间复杂关系的新见解，并强调了在AD中发展和维持社交网络的重要性。
Objectives: Poor social networks are associated with a greater likelihood of cognitive decline, dementia, and other adverse health outcomes in later life. However, these relationships have been poorly explored in those with established Alzheimer Disease (AD), who may represent a particularly vulnerable group. Methods: Analysis of data from the NILVAD study. We assessed social networks (Lubben Social Network Scale [LSNS]), cognition (Alzheimer's disease Assessment Scale [ADAS-Cog]) and dementia severity (Clinical Dementia Rating, Sum of Boxes [CDR-Sb]) in older adults with mild-moderate AD at baseline and at 18 months. Results: 464 participants with mild-to-moderate AD were included (73.1 +/- 8.3 years; 61.9% female). At baseline, a poor social network was significantly associated with a greater dementia severity, but not greater cognitive impairment. Rather than a poor social network predicting greater cognitive decline over 18 months, a greater baseline dementia severity predicted a decline in social network over 18 months (beta: -0.22, -0.42 - -0.02, p = 0.034). Finally, a poor social network was associated with a significantly increased likelihood of experiencing serious adverse events (IRR: 1.41, 1.06-1.89, p = 0.019). Discussion: As dementia progresses, older adults with AD are more likely to experience a decline in social network. Further, having a poor social network was associated with a greater likelihood of experiencing serious adverse events. These findings add novel insight into the complex relationship between social networks, dementia progression and adverse events in AD, and underscore the importance of developing and maintaining social networks in AD.