Can Loneliness Affect Your Cognitive Health?

by Women's Brain Health Initiative:No matter at what age, we have all experienced a sense of isolation and the sinking feeling of loneliness – whether you were not invited to go out with work colleagues for drinks, or you were not included in a group game of bridge or mah-jong, or you spent a holiday alone with no one to celebrate with.While we know that loneliness and social isolation can deprive us of happiness, several studies have shown that experiencing loneliness can also negatively impact our brain health.Living alone, suffering from isolation, or even living with others but feeling like you do not have someone to talk to can lead to depression, which can have serious implications for both your physicaland mental well-being. In fact, an Amsterdam-based study of the elderly, reported in the Journal of Neurology, Neurosurgery & Psychiatry in 2013, found that loneliness increases the risk of dementia in older adults by as much as 64%.“Research conducted over three years on more than 2,000 seniors living outside of a long-term care setting determined that loneliness was a significant factor when predicting an individual’s odds of developing dementia. Even after adjusting the findings for other factors such as age, initial cognitive functioning and socioeconomic status, the researchers found that lonely seniors were more likely to develop dementia than those who did not have these feelings.”Contributing Factors of Social Isolation & LonelinessAs we get older, our social options often get smaller, yet our pattern of dependency increases. For example, an older neighbour who is homebound (particularly during the wintertime) may lack interactions with others who could help oversee his or her daily routine and raise any necessary flags (such as ensuring that he or she is properly taking his or her medications). This is becoming a growing concern since some of the contributing factors of social isolation are the result of today’s rising trend of changing neighbourhoods – very different from the days when everyone knew their neighbours, church members, and even the mail carrier and together they would notice activity (or lack thereof) of people on their streets.On the other hand, there are individuals who become fiercely independent as they age, and do not like asking others for help or revealing their weaknesses for needing support, thereby pushing themselves into isolation and generating feelings of loneliness.Declines in mobility and physical limitations can also contribute to social isolation and loneliness.Some of the ScienceResearch has shown that healthy seniors with elevated brain levels of amyloid (a type of protein fragment associated with Alzheimer’s disease) seem more likely to feel lonely than those with lower levels of amyloid. More specifically, “for people who have high levels of amyloid — the people truly at high risk for Alzheimer’s — they were 7.5 times more likely to be lonely than non-lonely,” said lead researcher Dr. Nancy Donovan, director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital in Boston.Dr. Donovan also speculates that “the psychosocial stress of loneliness may cause inflammation that is harmful to the brain.” Dr. Donovan and her colleagues studied 8,300 men and women aged 65 and over and found that “those who reported feeling the loneliest had a 20% faster decline in mental ability than those who said they weren’t lonely. Depression also accelerated the decline. Interestingly, problems with memory did not predict loneliness, which implies that being lonely may be causing memory problems but memory problems don’t necessarily cause loneliness.”Preventing Loneliness & IsolationThere are a number of ways to avoid isolation and help support those individuals that you think may be at risk.Focus on Feelings: Surprisingly, living with other people does not prevent loneliness. In fact, the aforementioned Amsterdam-based study revealed that “older adults who reported feeling lonely were 250% more likely to have developed dementia over the course of the study than their non-lonely peers, no matter their living conditions. These results suggest that feelings of loneliness independently contribute to the risk of dementia in later life. Interestingly, the fact that ‘feeling lonely’ rather than ‘being alone’ was associated with dementia onset suggests that it is not the objective situation, but, rather, the perceived absence of social attachments that increases the risk of cognitive decline.”Take Up a Hobby: Keeping yourself busy and engaging in brain-stimulating activities such as painting, gardening or cooking can be incredibly beneficial, particularly if such activities are shared with another person. Enjoying more time outdoors for walks can also help break up the monotony of a quiet day or routine (not to mention the fresh air is great for your health and mind and can vastly improve your emotional state). Individuals can also consider owning a pet to encourage companionship, conversation, and comfort. Pet options can vary in responsibility from a dog or a cat to even a bird or fish.Some Ways to Help Reconnect: If you are concerned that someone you know is suffering from isolation, there are a number of ideas and resources available:Check with the local senior center. For individuals already living in senior living communities, participation in activities should be encouraged.Register for drop-in services such as “Meals on Wheels.”Participate in local mall walking clubs.Engage in social media. Many senior centers today have initiatives to help individuals understand the benefits of technology and teach the joys and simplicity of connecting with relatives (most often grandchildren and great grandchildren) through FaceTime, Facebook, Instagram, and texting. This basic social media training keeps individuals connected to their family and friends. Note, however, that it is critical to achieve the right balance of social media engagement because technology can also lead to social isolation (particularly amongst teenagers and younger adults – just ask their parents!).Encourage volunteer opportunities. Join a club or take a class to connect with other like-minded individuals.Make plans. Run errands with a friend, cook a recipe together, take time to fit social events into your schedule.Working on expanding your social networks will contribute to increased activity, mental stimulation, and improve overall brain health, and making those additional efforts when you are younger will be beneficial in later years.Another valuable resource comes from the UK where a national campaign to end loneliness was launched in 2011 (www.campaigntoendloneliness.org). The campaign, which is based on the premise that ending loneliness can create change, seeks to inspire “thousands of organisations and people to do more to tackle the health threat of loneliness in older age. The Campaign to End Loneliness is a network of national, regional and local organisations and people working together through community action, good practice, research and policy to ensure that loneliness is acted upon as a public health priority at national and local levels.”How Do You Know if You are at Risk?There is a recognized assessment tool that helps to measure an individual’s social support network, including family, friends and neighbours, called the Lubben Social Network Scale (LSNS). The LSNS consists of an equally weighted sum of ten items used to measure size, closeness, and frequency of contacts of a respondent’s social network, which typically takes five to ten minutes to complete. It was originally developed in 1988 and was revised in 2002 (LSNS-R), along with an abbreviated version (LSNS-6) to meet clinicians’ needs for brevity, and an expanded version (LSNS-18) for basic social and health science research-oriented purposes.Dr. Lubben is a leading expert in social gerontology who focuses on social support networks among older populations. Dr. Lubben is the director of the Center of Excellence in Geriatric Social Work and the founding director for the Institute on Aging at Boston College. His research considers “social isolation as a behavioural health risk among older adults.”The LSNS is most often used with older adults, as well as caregivers in various settings (such as assisted living, doctors’ offices, hospitals, and community centers). The assessment tool has been translated into multiple languages and has been an integral part of studies across the globe.What is Your LSNS Score?LUBBEN SOCIAL NETWORK SCALE – 6 (LSNS-6)SCORING:The total score is calculated by finding the sum of all the items. For the LSNS-6, the score ranges between 0 and 30, with a higher score indicating more social engagement.FAMILY: Considering the people you are related to by birth, marriage, adoption, etc.

1. How many relatives do you see or hear from at least once a month? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more
2. How many relatives do you feel at ease with that you can talk about private matters? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more
3. How many relatives do you feel close to such that you could call on them for help? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more

FRIENDSHIPS: Considering all of your friends including those who live in your neighborhood.

4. How many of your friends do you see or hear from at least once a month? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more
5. How many friends do you feel at ease with that you can talk about private matters? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more
6. How many friends do you feel close to such that you could call on them for help? 0 = none; 1 = one; 2 = two; 3 = three or four; 4 = five through eight; 5 = nine or more

Loneliness and social isolation do not have to be an inevitable part of growing older. As research continues to emphasize the important link between one’s social network and physical and mental health, new resources are being made available to the public, and the conversation continues to grow, it is encouraging to know that we will not have to face these challenges alone.Source: MIND OVER MATTER