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Social Disengagement and Incident Cognitive Decline in Community-Dwelling Elderly Persons

Shari S. Bassuk, ScD; Thomas A. Glass, PhD; and Lisa F. Berkman, PhD
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From Harvard School of Public Health, Boston, Massachusetts.

Acknowledgments: The authors thank David Wypij, PhD; Jane Murphy, PhD; and Donna Spiegelman, ScD, for their helpful comments on earlier versions of the manuscript.

Grant Support: By grants from the National Institute on Aging (R01-AG11042, N01-AG02105, and N01-AG12102) and by a National Research Service Award (T32-AG00251) (Dr. Bassuk).

Requests for Reprints: Shari S. Bassuk, ScD, Department of Health and Social Behavior, Harvard School of Public Health, 1637 Tremont Street, Boston, MA 02120; e-mail, sbassuk@hsph.harvard.edu.

Current Author Addresses: Dr.Bassuk: Department of Health and Social Behavior, Harvard School of Public Health, 1637 Tremont Street, Boston, MA 02120

Drs. Glass and Berkman: Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Ann Intern Med. 1999;131(3):165-173. doi:10.7326/0003-4819-131-3-199908030-00002
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Social engagement, which is defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. Associations between a socially engaged lifestyle and higher scores on memory and intelligence tests have been observed among community-dwelling older persons (15). Short-term interventions to foster social and intellectual engagement have enhanced cognition among nursing home residents (6) and patients with dementia (7). In animal studies (8), mature rodents exposed to complex social and inanimate environments showed better maze-learning ability than those in sparser surroundings. Social engagement challenges persons to communicate effectively and participate in complex interpersonal exchanges. Besides providing a dynamic environment that requires the mobilization of cognitive faculties, social engagement may also indicate a commitment to community and family and engender a health-promoting sense of purpose and fulfillment. Another putative benefit of social engagement is greater availability of emotional support from relatives and friends. Lack of such support can predict adverse health outcomes (9), but its influence on cognitive decline has not been examined.

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