Associations between social connections and cognition: a global collaborative individual participant data meta-analysis

著者: Suraj Samtani, Gowsaly Mahalingam, Ben C. P. Lam, Darren M. Lipnicki, Maria Fernanda Lima‐Costa, Sérgio Luís Blay, E. Costa, Xiao Shifu, Maëlenn Guerchet, Pierre‐Marie Preux, Antoine Gbessemehlan, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Ki-Woong Kim, Steffi G. Riedel‐Heller, Susanne Röhr, Alexander Pabst, Suzana Shahar, Katya Numbers, Mary Ganguli, Erin Jacobsen, Tiffany F. Hughes, Michael Crowe, Tze Pin Ng, Jane Maddock, Anna Marseglia, René J. F. Melis, Dorota Szczęśniak, Henrik Wiegelmann, Myrra Vernooij‐Dassen, Yun‐Hee Jeon, Perminder S. Sachdev, Henry Brodaty - The Lancet 2022 被引用: 127

BACKGROUND: Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis. METHODS: We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression. FINDINGS: =37·54-72·19%), suggesting robust results across studies. INTERPRETATION: Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline. FUNDING: EU Joint Programme-Neurodegenerative Disease Research grant, funded by the National Health and Medical Research Council Australia, and the US National Institute on Aging of the US National Institutes of Health.