Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL)
Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL)
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DOI：
10.1136/jnnp-2012-302755
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发表时间：
2014-02-01
影响因子：
11
通讯作者：
Schoevers, Robert A.
中科院分区：
文献类型：
--
作者：
Holwerda, Tjalling Jan;Deeg, Dorly J. H.;Schoevers, Robert A.
背景阿尔茨海默病和其他痴呆症的已知危险因素包括医疗条件、遗传脆弱性、抑郁症、人口因素和轻度认知障碍。孤独感和社会孤立感在痴呆中的作用还不是很清楚，包括这些危险因素的前瞻性研究也很少。方法我们对2173名非痴呆社区老年人进行了一项队列研究，检验了社会隔离(独居、未婚、没有社会支持)、孤独感和痴呆症事件之间的关系。在评估痴呆症的诊断时，参与者被跟踪了3年(老年精神状态(GMS)计算机辅助分类自动老年检查(AGECAT))。结果在调整其他危险因素后，有孤独感的老年人比无孤独感的老年人更易患痴呆(OR1.64，95%CI 1.05~2.56)。在多因素分析中，社会隔离与痴呆风险不相关。结论孤独而不是孤独与晚年临床痴呆的风险增加相关，可以被认为是一个主要的危险因素，独立于血管疾病、抑郁和其他混杂因素，值得临床关注。孤独感可能预示着痴呆症的前驱阶段。更好地了解孤独感的背景可能有助于我们识别易受伤害的人，并制定干预措施，以改善有痴呆风险的老年人的结果。
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 3years 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.