Highlights
- •What is the primary question addressed by this study? Do cognitive decline and social disengagement co-occur in cognitively normal older adults and are these changes related to brain amyloid-β, a pathologic marker of Alzheimer's disease?
- •What is the main finding of this study? In a longitudinal study of 217 community-dwelling, cognitively normal older adults, lower baseline social engagement was associated with steeper cognitive decline in those with higher amyloid-β levels. Lower-range but normal baseline cognitive performance was associated with decline in social engagement independent of amyloid-β level.
- •What is the meaning of the finding? Cognitive abilities and social function are related processes in older adults. Level of social engagement contributes to cognitive change in the high-risk group of older adults who are unimpaired but have evidence of Alzheimer's pathologic change.
Abstract
Objective
Public health recommendations promote social engagement to reduce risk of cognitive
decline and dementia. The objective of this study was to evaluate the longitudinal
associations of social engagement and cognition in cognitively normal older adults
with varying levels of neocortical amyloid-β, the Alzheimer's disease (AD) pathologic
marker.
Methods
Two hundred seventeen men and women, age 63–89 underwent assessments for social engagement
and cognitive performance at baseline and 3 years later using the Community Healthy
Activities Model Program for Seniors questionnaire and the Preclinical Alzheimer Cognitive
Composite (PACC). Amyloid-β was measured using Pittsburgh compound B-PET. Multivariable
regression models estimated main and interactive effects of baseline social engagement
and amyloid-β on cognitive change. Reciprocal models estimated main and interactive
effects of baseline cognitive performance and amyloid-β on change in social engagement.
Results
Baseline social engagement was associated with PACC change as a modifier but not as
a main effect. Lower baseline social engagement was associated with greater amyloid-β-related
PACC decline, while higher baseline social engagement was associated with relative
preservation of PACC scores (β = 0.05, p = 0.03). Reciprocally, lower baseline PACC
score was associated with decline in social engagement score (β = 1.1, p = 0.02).
This association was not modified by amyloid-β, and there was no direct association
of amyloid-β with change in social engagement.
Conclusions
Low social engagement may be a marker of neurocognitive vulnerability in older adults
who are cognitively normal but have evidence of AD pathophysiologic change. Understanding
changes in social engagement in older adults may lead to earlier diagnosis of AD and
advances in evidence-based prevention and treatment.
Key Words
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Article info
Publication history
Published online: May 09, 2019
Accepted:
May 7,
2019
Received in revised form:
May 7,
2019
Received:
March 5,
2019
Footnotes
Previous Presentation: A portion of this work was presented at the 21st Alzheimer's Association International Conference July 21–26, 2018, Chicago, IL, oral session on Clinical Neuropsychiatry and Behavioral Neurology: Presymptomatic and Prodromal States, Biddle KD, d'Oleire Uquillas F, Zide B, Jacobs HIL, Kirn DR, Rentz DM, Johnson KA, Sperling RA, Donovan NJ. “Amyloid-β, Cognition and Social Activity in Cognitively Normal Older Adults.” This work was also presented at the American Association for Geriatric Psychiatry 2019 Annual Meeting, Atlanta, Georgia, March 1–4, 2019, session on New Insights into Loneliness and Its Treatment in Older Adults. Biddle KD, d'Oleire Uquillas F, Zide B, Jacobs HIL, Kirn DR, Rentz DM, Johnson KA, Sperling RA, Donovan NJ. “Longitudinal Associations of Amyloid-β, Cognition and Social Activity in Cognitively Normal Older Adults.”
Identification
Copyright
© 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
