Could greater social engagement protect against Alzheimer’s disease-related cognitive decline?

Written by Ilana Landau, Editor

New research has found that high levels of amyloid-β — the Alzheimer’s disease-associated protein — together with low social engagement induced more severe cognitive decline over a 3-year period.

There is a known correlation between poor social engagement and increased dementia risk. Now, a new study has observed that, in elderly individuals, a combination of high levels of amyloid-β protein and poor social engagement are associated with greater cognitive decline over 3 years.

Nancy Donovan, Chief of the Division of Geriatric Psychiatry at the Brigham and Women’s Hospital (MA, USA) and senior study author, stated: “Social engagement and cognitive function are related to one another and appear to decline together…This means that social engagement may be an important marker of resilience or vulnerability in older adults at risk of cognitive impairment.”

Researchers evaluated 217 individuals, aged 63—89, enrolled in the Harvard Aging Study — a longitudinal study looking for early signs of Alzheimer’s disease. All participants had regular baseline cognitive function, as assessed using the Preclinical Alzheimer Cognitive Composite (PACC).

A proportion of subjects presented with high, baseline levels of the Alzheimer’s disease-associated protein amyloid-β — measured using Pittsburgh compound B-PET imaging.

Participants’ baseline social engagement was evaluated through standard surveys such as the Community Healthy Activities Model Program for Seniors questionnaire.

Participants’ cognitive function, amyloid-β levels and social engagement were re-assessed after 3 years.

Patients that presented with normal cognitive function and high levels of amyloid-β at baseline, but had low social engagement, displayed steeper cognitive decline over the 3-year study period, compared with similar individuals who had high social engagement.

Slower cognitive decline was observed in patients with low baseline levels of amyloid-β with low social engagement, compared to those with low amyloid-β levels and high social engagement.

The authors concluded that low levels of social engagement may serve as an indicator of neurocognitive vulnerability in elderly persons who are have both normal cognitive function and early signs of Alzheimer’s disease pathogenesis.

Understanding social engagement variation and its effects in elderly persons may help with earlier diagnosis of Alzheimer’s disease and advances in evidence-based disease management.

Donovan stated: “We want to understand the breadth of this issue in older people and how to intervene to protect high-risk individuals and preserve their health and well-being…”

Further studies, with longer study lengths that also evaluate the effects of digital communication are needed to extend the finding of this study.


Biddle KD, d’Oleire Uquillas F, Jacobs HIL et al. Social Engagement and Amyloid-β-Related Cognitive Decline in Cognitively Normal Older Adults. Am. J. Geriatr. Psychiatry; (ePub ahead of print) (2019)