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Study links seniors’ loneliness to higher risk of dementia

Loneliness may put people at risk of an Alzheimer’s-like dementia, a study reported Monday.
“People who described themselves as lonely were twice as likely to develop dementia,” says researcher Robert Wilson of the Rush University Medical Center in Chicago.

Source USA Today

By Kathleen Fackelmann, USA TODAY

Loneliness may put people at risk of an Alzheimer’s-like dementia, a study reported Monday.
“People who described themselves as lonely were twice as likely to develop dementia,” says researcher Robert Wilson of the Rush University Medical Center in Chicago.

Other studies have found that people who are unmarried and socially isolated are at higher risk for dementia, including Alzheimer’s. But this study is one of the first to show a link between loneliness — or the feelings of disconnection from other people — and a higher risk of developing dementia late in life, says Laurel Coleman, a spokeswoman for the Alzheimer’s Association and a geriatrician in Portland, Maine.

Wilson and his colleagues studied 823 people who were about 80 years old and had no sign of dementia at the start of the study. The team gave the recruits a loneliness quiz and tested them annually for signs of memory loss and confusion, two key signs of dementia and Alzheimer’s.

During the four-year study, 76 people developed an Alzheimer’s-like dementia, Wilson says. The risk of developing dementia increased about 51% for each one-point increase on the loneliness scale. People with the highest scores had 2.1 times the risk of developing dementia, a group of conditions that destroy brain cells and lead to mental confusion. Alzheimer’s is the most common form of dementia.

Autopsies were performed on 90 people who died during the study. The researchers found no link between loneliness and the development of the abnormal brain deposits that are the hallmark of Alzheimer’s.

That finding suggests loneliness might be triggering dementia through a novel mechanism — one that doesn’t lead to a brain riddled with deposits, Wilson says.

One theory is that people who are lonely over long periods of time might have higher levels of damaging stress hormones. The elevated stress hormones might lead to an accelerated aging of the brain — and perhaps to dementia, Wilson says.

Other research suggests lonely people are at risk of other health problems such as cancer and high blood pressure, says John Cacioppo of the University of Chicago. Still, he says, the new finding, which appears in February’s Archives of General Psychiatry, must be verified by additional research.

The findings didn’t change much when the team factored in markers of social isolation, such as infrequent participation in social events. That means that people who have a small number of good friends might be better off than those with a busy social schedule but chronic feelings of loneliness, Wilson says.

But lonely people often benefit from signing up for a new class or activity, Coleman says. Research shows that such activities might protect aging brain cells. And seniors who are out and about are more likely to make new friends, which might lessen feelings of loneliness, she says.


The Seven Stages of Alzheimer’s

Experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer’s disease and developed several methods of “staging” based on these patterns.

Source Alzheimer’s Association

The Seven Stages of Alzheimer’s

Staging systems provide useful frames of reference for understanding how the disease may unfold and for making future plans. But it is important to note that not everyone will experience the same symptoms or progress at the same rate. People with Alzheimer’s live an average of 8 years after diagnosis, but may survive anywhere from 3 to 20 years.

The framework for this section is a system that outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline. This framework is based on a system developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Within this framework, we have noted which stages correspond to the widely used concepts of mild, moderate, moderately severe and severe Alzheimer’s disease. We have also noted which stages fall within the more general divisions of early-stage, mid-stage and late-stage categories.

Stage 1:
No impairment (normal function)

Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.

Stage 2:
Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease.

Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Stage 3:
Mild cognitive decline

Early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms:

Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:

Word- or name-finding problems noticeable to family or close associates.

Decreased ability to remember names when introduced to new people.

Performance issues in social or work settings noticeable to family, friends or co-workers.

Reading a passage and retaining little material.

Losing or misplacing a valuable object.

Decline in ability to plan or organize.

Stage 4:
Moderate cognitive decline
(Mild or early-stage Alzheimer’s disease)

At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:

Decreased knowledge of recent occasions or current events.

Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s.

Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances.

Reduced memory of personal history.

The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations.

Stage 5:
Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer’s disease)

Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:

Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated.

Become confused about where they are or about the date, day of the week or season.

Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s.

Need help choosing proper clothing for the season or the occasion.

Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children.

Usually require no assistance with eating or using the toilet.

Stage 6:
Severe cognitive decline
(Moderately severe or mid-stage Alzheimer’s disease)

Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

Lose most awareness of recent experiences and events as well as of their surroundings.

Recollect their personal history imperfectly, although they generally recall their own name.

Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces.

Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet.

Experience disruption of their normal sleep/waking cycle.

Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly).

Have increasing episodes of urinary or fecal incontinence.

Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding.

Tend to wander and become lost.

Stage 7:
Very severe cognitive decline
(Severe or late-stage Alzheimer’s disease)

This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered.

Individuals need help with eating and toileting and there is general incontinence of urine.

Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

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