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      Social Isolation and Cognitive Function in Later Life: A Systematic Review and Meta-Analysis

      research-article
      a , * , a , a , b , a , c , d , e
      ,
      Journal of Alzheimer's Disease
      IOS Press
      Aging, cognition, cognitive reserve, social isolation

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          Abstract

          Background:

          There is some evidence to suggest that social isolation may be associated with poor cognitive function in later life. However, findings are inconsistent and there is wide variation in the measures used to assess social isolation.

          Objective:

          We conducted a systematic review and meta-analysis to investigate the association between social isolation and cognitive function in later life.

          Methods:

          A search for longitudinal studies assessing the relationship between aspects of social isolation (including social activity and social networks) and cognitive function (including global measures of cognition, memory, and executive function) was conducted in PsycInfo, CINAHL, PubMed, and AgeLine. A random effects meta-analysis was conducted to assess the overall association between measures of social isolation and cognitive function. Sub-analyses investigated the association between different aspects of social isolation and each of the measures of cognitive function.

          Results:

          Sixty-five articles were identified by the systematic review and 51 articles were included in the meta-analysis. Low levels of social isolation characterized by high engagement in social activity and large social networks were associated with better late-life cognitive function ( r = 0.054, 95% CI: 0.043, 0.065). Sub-analyses suggested that the association between social isolation and measures of global cognitive function, memory, and executive function were similar and there was no difference according to gender or number of years follow-up.

          Conclusions:

          Aspects of social isolation are associated with cognitive function in later life. There is wide variation in approaches to measuring social activity and social networks across studies which may contribute to inconsistencies in reported findings.

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          Most cited references100

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          On the use of beta coefficients in meta-analysis.

          This research reports an investigation of the use of standardized regression (beta) coefficients in meta-analyses that use correlation coefficients as the effect-size metric. The investigation consisted of analyzing more than 1,700 corresponding beta coefficients and correlation coefficients harvested from published studies. Results indicate that, under certain conditions, using knowledge of corresponding beta coefficients to input missing correlations (effect sizes) generally produces relatively accurate and precise population effect-size estimates. Potential benefits from applying this knowledge include smaller sampling errors because of increased numbers of effect sizes and smaller non-sampling errors because of the inclusion of a broader array of research designs.
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            Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies.

            It is unclear to what extent poor social relationships are related to the development of dementia. A comprehensive systematic literature search identified 19 longitudinal cohort studies investigating the association between various social relationship factors and incident dementia in the general population. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random-effects meta-analysis. Low social participation (RR: 1.41 (95% CI: 1.13-1.75)), less frequent social contact (RR: 1.57 (95% CI: 1.32-1.85)), and more loneliness (RR: 1.58 (95% CI: 1.19-2.09)) were statistically significant associated with incident dementia. The results of the association between social network size and dementia were inconsistent. No statistically significant association was found for low satisfaction with social network and the onset of dementia (RR: 1.25 (95% CI: 0.96-1.62). We conclude that social relationship factors that represent a lack of social interaction are associated with incident dementia. The strength of the associations between poor social interaction and incident dementia is comparable with other well-established risk factors for dementia, including low education attainment, physical inactivity, and late-life depression.
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              The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review

              Background Social relationships, which are contingent on access to social networks, promote engagement in social activities and provide access to social support. These social factors have been shown to positively impact health outcomes. In the current systematic review, we offer a comprehensive overview of the impact of social activities, social networks and social support on the cognitive functioning of healthy older adults (50+) and examine the differential effects of aspects of social relationships on various cognitive domains. Methods We followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, and collated data from randomised controlled trials (RCTs), genetic and observational studies. Independent variables of interest included subjective measures of social activities, social networks, and social support, and composite measures of social relationships (CMSR). The primary outcome of interest was cognitive function divided into domains of episodic memory, semantic memory, overall memory ability, working memory, verbal fluency, reasoning, attention, processing speed, visuospatial abilities, overall executive functioning and global cognition. Results Thirty-nine studies were included in the review; three RCTs, 34 observational studies, and two genetic studies. Evidence suggests a relationship between (1) social activity and global cognition and overall executive functioning, working memory, visuospatial abilities and processing speed but not episodic memory, verbal fluency, reasoning or attention; (2) social networks and global cognition but not episodic memory, attention or processing speed; (3) social support and global cognition and episodic memory but not attention or processing speed; and (4) CMSR and episodic memory and verbal fluency but not global cognition. Conclusions The results support prior conclusions that there is an association between social relationships and cognitive function but the exact nature of this association remains unclear. Implications of the findings are discussed and suggestions for future research provided. Systematic review registration PROSPERO 2012: CRD42012003248. Electronic supplementary material The online version of this article (10.1186/s13643-017-0632-2) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                J Alzheimers Dis
                J. Alzheimers Dis
                JAD
                Journal of Alzheimer's Disease
                IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )
                1387-2877
                1875-8908
                24 October 2018
                13 August 2019
                2019
                : 70
                : Suppl 1 , International Research Network on Dementia Prevention
                : S119-S144
                Affiliations
                [a ] Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter , Exeter, UK
                [b ] Institute of Public Health, University of Cambridge , Cambridge, UK
                [c ] University of Exeter Medical School , Exeter, UK
                [d ] Wellcome Centre for Cultures and Environments of Health, University of Exeter , Exeter, UK
                [e ] Centre for Research Excellence in Promoting Cognitive Health, University of New South Wales , Sydney, Australia
                Author notes
                [* ]Correspondence to: Isobel E.M. Evans, University of Exeter, St Lukes Campus, Heavitree Road, South Cloisters, Exeter, EX1 2LU, UK. Tel.: +44 01392 726754; E-mail: i.evans@ 123456exeter.ac.uk .
                Article
                JAD180501
                10.3233/JAD-180501
                6700717
                30372678
                4c9a4892-6681-488b-aa2f-841e8e2c9493
                © 2019 – IOS Press and the authors. All rights reserved

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 August 2018
                Categories
                Research Article

                aging,cognition,cognitive reserve,social isolation
                aging, cognition, cognitive reserve, social isolation

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