The Effect of Social Interaction on Alzheimer’s Disease (AD)

1. The Effect of Social Interaction on Alzheimer’s Disease (AD) Lori Cuevas

2. Background on AD • AD is the most common irreversible dementia. • AD first diagnosed in 1906 by Dr. Alois Alzheimer.

3. Background on AD (cont’d) • Symptoms of AD include: • Memory loss, confusion, impaired judgment, personality changes, disorientation, and loss of language skills. • The known effects of AD on brain tissue: • Overall shrinkage of brain tissue. • Amyloid plaques and neurofibrillary tangles.

4. http://www.ahaf.org/alzdis/about/BrianAlzheimer.htm

5. http://www.ahaf.org/alzdis/about/BrianAlzheimer.htm

6. Question: • How does social interaction effect the onset and progression of AD? • Research findings suggest that Social interactions effect parts of the body (e.g., immune function). • Is there research indicating social interaction effects cognitive decline in older persons?

7. Influence of Social Network on Occurrence of Dementia: A Community-based Longitudinal Study Fratiglioni, Wang, Ericson, Maytan, & Winbald, 2000

8. Subjects • 1203 non-demented people living in the Kungsholmen district of Stockholm, Sweden. • 75 years or over as of October, 1987 • Good cognition – defined by Mini-Mental State Examination Score (MMSE) above 23

9. Method • Longitudinal based cohort study (1987-89) • Participants participated in interview at beginning of study to determine social network as a(n): • “poor social network” • “limited social network” • “Moderate social network” • “Extensive social network”

10. Method (cont’d) • 3 years after baseline interview (1991-1993) physical and psychological examinations were conducted to determine cognitive decline. • 3 step diagnostic process for determining dementia

11. Results • After 3 years there was a diagnosis of 176 incident dementia cases • 126 of AD type • 32 of vascular dementia type

12. Findings (cont’d.) • Overall, when all components combined, a poor or limited social network increased the risk of dementia by 60%.

13. Follow-up study Late-Life Engagement in Social and Leisure Activities Is Associated with a Decreased Risk of Dementia: A Longitudinal Study from the Kungsholmen Project Wang, Karp, Winblad, & Fratiglioni, 2002

14. Follow-up Study • Data from 1987 project was used to determine whether engagement in different activities 6.4 years before dementia diagnosis was related to decreased incidence of AD. • Adjusted for age, sex, education, cognitive functioning, comorbidity, depressive symptoms, and physical functioning at first examination.

15. Results • Number of individuals with dementia at the 6 year mark after first interview was 123. • Indication that the adjusted relative risks of dementia associated with participation in social activity was nearly the same as the effects of participation in mentally stimulating activities.

16. Conclusions • Social interaction plays a role as a predictive risk factor in the rate of incidence of AD among older individuals • Today more than 4.5 million American’s have AD. By the year 2050, it is estimated that the number could increase to 14 million.

17. Potential Drawback to These Studies • Correlational Designs. • Therefore, it can not be said conclusively that it is the social interaction and not the effects of cognitive stimulation that effects AD.

18. Questions for Future Study • Is it possible to determine conclusively that social interaction effects AD when separated from the effects of cognitive stimulation? • Once diagnosed with AD, do social interactions effect the rate of progression at the various stages of the disease? If so, how? • What is the effect of life long social engagement versus late life engagement only on AD?