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      Social isolation, cognitive reserve, and cognition in healthy older people

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          Abstract

          There is evidence to suggest that social isolation is associated with poor cognitive health, although findings are contradictory. One reason for inconsistency in reported findings may be a lack of consideration of underlying mechanisms that could influence this relationship. Cognitive reserve is a theoretical concept that may account for the role of social isolation and its association with cognitive outcomes in later life. Therefore, we aimed to examine the relationship between social isolation and cognition in later life, and to consider the role of cognitive reserve in this relationship. Baseline and two year follow-up data from the Cognitive Function and Ageing Study–Wales (CFAS-Wales) were analysed. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG), and cognitive reserve was assessed using a proxy measure of education, occupational complexity, and cognitive activity. Linear regression modelling was used to assess the relationship between social isolation and cognition. To assess the role of cognitive reserve in this relationship, moderation analysis was used to test for interaction effects. After controlling for age, gender, education, and physically limiting health conditions, social isolation was associated with cognitive function at baseline and two year follow-up. Cognitive reserve moderated this association longitudinally. Findings suggest that maintaining a socially active lifestyle in later life may enhance cognitive reserve and benefit cognitive function. This has important implications for interventions that may target social isolation to improve cognitive function.

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          Most cited references23

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          The Lothian Birth Cohort 1936: a study to examine influences on cognitive ageing from age 11 to age 70 and beyond

          Background Cognitive ageing is a major burden for society and a major influence in lowering people's independence and quality of life. It is the most feared aspect of ageing. There are large individual differences in age-related cognitive changes. Seeking the determinants of cognitive ageing is a research priority. A limitation of many studies is the lack of a sufficiently long period between cognitive assessments to examine determinants. Here, the aim is to examine influences on cognitive ageing between childhood and old age. Methods/Design The study is designed as a follow-up cohort study. The participants comprise surviving members of the Scottish Mental Survey of 1947 (SMS1947; N = 70,805) who reside in the Edinburgh area (Lothian) of Scotland. The SMS1947 applied a valid test of general intelligence to all children born in 1936 and attending Scottish schools in June 1947. A total of 1091 participants make up the Lothian Birth Cohort 1936. They undertook: a medical interview and examination; physical fitness testing; extensive cognitive testing (reasoning, memory, speed of information processing, and executive function); personality, quality of life and other psycho-social questionnaires; and a food frequency questionnaire. They have taken the same mental ability test (the Moray House Test No. 12) at age 11 and age 70. They provided blood samples for DNA extraction and testing and other biomarker analyses. Here we describe the background and aims of the study, the recruitment procedures and details of numbers tested, and the details of all examinations. Discussion The principal strength of this cohort is the rarely captured phenotype of lifetime cognitive change. There is additional rich information to examine the determinants of individual differences in this lifetime cognitive change. This protocol report is important in alerting other researchers to the data available in the cohort.
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            Successful aging.

            Substantial increases in the relative and absolute number of older persons in our society pose a challenge for biology, social and behavioral science, and medicine. Successful aging is multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function, and sustained engagement in social and productive activities. Research has identified factors predictive of success in these critical domains. The stage is set for intervention studies to enhance the proportion of our population aging successfully.
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              Cognitive reserve in aging.

              Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer's disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer's disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer's disease and other age-related problems.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: Methodology
                Role: InvestigationRole: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 August 2018
                2018
                : 13
                : 8
                : e0201008
                Affiliations
                [1 ] Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, United Kingdom
                [2 ] University of Exeter Medical School, Exeter, United Kingdom
                [3 ] Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, United Kingdom
                [4 ] MRC Biostatistics Unit, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
                [5 ] Dementia Services Development Centre Wales, School of Healthcare Sciences, Bangor University, Bangor, United Kingdom
                [6 ] Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
                [7 ] PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
                [8 ] Centre for Research Excellence in Promoting Cognitive Health, Australian National University, Canberra, Australia
                Nathan S Kline Institute, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ¶ Complete membership of the author group can be found in the Acknowledgments

                Author information
                http://orcid.org/0000-0002-1728-2388
                Article
                PONE-D-18-05687
                10.1371/journal.pone.0201008
                6097646
                30118489
                86d8dd9a-4db8-4438-8491-208161f79144
                © 2018 Evans et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 February 2018
                : 6 July 2018
                Page count
                Figures: 1, Tables: 3, Pages: 14
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000320, Alzheimer's Society;
                Award ID: AS-DTC-2014-027
                Award Recipient :
                The work was supported by the following: Brayne, C., Stephan, B., Wharton, S., Clare, L., Badger, S., Arthur, T., Bennett, K., McCracken, C., Phillips, J., & Melzer, D. Transdisciplinary training for dementia research in CFAS (The Alzheimer’s Society CFAS Doctoral Training Centre). 2015 – 2018. AS-DTC-2014-027. R.T Woods, L.Clare, G.Windle, V. Burholt, J. Philips, C. Brayne, C. McCracken, K. Bennett, F. Matthews. Maintaining function and well-being in later life: a longitudinal cohort study (the CFAS Wales study). ESRC (RES-060-25-0060) and HEFCW.
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                Custom metadata
                Data are from the Cognitive Function and Ageing Study - Wales and available at: Woods, R.T., Burholt, V., Brayne, C., Bennett, K.M. (2017). Cognitive Function and Ageing Study - Wales: Waves 1-2, 2011-2016. [data collection]. UK Data Service. SN: 8281, http://doi.org/10.5255/UKDA-SN-8281-1.

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