Reader Response: Associations of Social isolation and Loneliness With Later Dementia
Tjalling JHolwerda, MD, PhD, Amsterdam UMC, The Netherlands
Submitted July 01, 2022
The work by Shen et al. includes important findings on the consequences of social isolation and loneliness.1 Studying possible neuroanatomical correlates of these conditions is important as evidence on mechanisms underlying the association between loneliness, social isolation, and dementia is sparse. While the study has strengths, including the number of participants and the availability of structural MRI data, it also has limitations including the limited number of questions regarding loneliness and social isolation, the limited assessment of depressive symptoms, and the lack of repeated measurements of loneliness and social isolation.
Other studies have reported loneliness, but not social isolation to be associated with incident dementia.2 Structural and functional differences in the pre-frontal cortex, insula, hippocampus, amygdala, and posterior superior temporal cortex and differential activations of networks were found in lonely individuals, as well as a higher cortical amyloid burden in lonely cognitively normal older adults.3,4
Social isolation and loneliness are different constructs which possibly each have specific neural underpinnings and pathophysiological mechanisms underlying their association with cognitive decline and dementia. Further research on loneliness and social isolation as possible preclinical conditions is needed with repeated measurements on loneliness, social isolation, depression, and dementia.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Shen C, Rolls E, Cheng W, et al. Associations of Social Isolation and Loneliness With Later Dementia [published online ahead of print, 2022 Jun 8]. Neurology. 2022;10.1212/WNL.0000000000200583.
Holwerda TJ, Deeg DJ, Beekman AT, et al. Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL). J Neurol Neurosurg Psychiatry. 2014;85(2):135-142. doi:10.1136/jnnp-2012-302755
Lam JA, Murray ER, Yu KE, et al. Neurobiology of loneliness: a systematic review. Neuropsychopharmacology. 2021;46(11):1873-1887. doi:10.1038/s41386-021-01058-7
Donovan NJ, Okereke OI, Vannini P, et al. Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults. JAMA Psychiatry. 2016;73(12):1230-1237. doi:10.1001/jamapsychiatry.2016.2657
The work by Shen et al. includes important findings on the consequences of social isolation and loneliness.1 Studying possible neuroanatomical correlates of these conditions is important as evidence on mechanisms underlying the association between loneliness, social isolation, and dementia is sparse. While the study has strengths, including the number of participants and the availability of structural MRI data, it also has limitations including the limited number of questions regarding loneliness and social isolation, the limited assessment of depressive symptoms, and the lack of repeated measurements of loneliness and social isolation.
Other studies have reported loneliness, but not social isolation to be associated with incident dementia.2 Structural and functional differences in the pre-frontal cortex, insula, hippocampus, amygdala, and posterior superior temporal cortex and differential activations of networks were found in lonely individuals, as well as a higher cortical amyloid burden in lonely cognitively normal older adults.3,4
Social isolation and loneliness are different constructs which possibly each have specific neural underpinnings and pathophysiological mechanisms underlying their association with cognitive decline and dementia. Further research on loneliness and social isolation as possible preclinical conditions is needed with repeated measurements on loneliness, social isolation, depression, and dementia.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References