Background: Social interaction is a lifestyle factor associated with a decreased risk of dementia in several studies. However, specific aspects of these social factors influencing dementia are unknown. This study aimed at evaluating the role of the distinct aspects of social support on the incidence of dementia in a community-based cohort of older people in Brazil. Methods: A total of 345 healthy and independent elderly subjects living in the community were followed by 12 years. Incident cases of dementia and probable Alzheimer's disease were defined by DSM-IV criteria and NINCDS-ADRDA criteria, respectively. Social variables evaluated were marital status, living arrangement, living children, living sibling, confidant and attending recreational groups. Sex, age, education, Mini-Mental State Examination (MMSE) score, depressive symptoms and family income were entered as co-variates in a Cox proportional hazard model. Results: The absence of confidant was the only social variable associated to higher risk of developing dementia (HR = 5.31; p < 0.001), even after adjustment for age (HR = 1.08; p = 0.048) and baseline MMSE score (HR = 0.79; p = 0.002). Conclusions: Our data suggest that to have a confidant could be an important lifestyle factor associated with dementia.

1.
Bassuk SS, Glass TA, Berkman LF: Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med 1999;131:165-173.
2.
Fratiglioni L, Paillard-Borg S, Winblad B: An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004;3:343-353.
3.
Holtzman RE, Rebok GW, Saczynski JS, Kouzis AC, Wilcox Doyle K, Eaton WW: Social network characteristics and cognition in middle-aged and older adults. J Gerontol B Psychol Sci Soc Sci 2004;59:P278-P284.
4.
Wang HX, Karp A, Winblad B, Fratiglioni L: Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol 2002;155:1081-1087.
5.
Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B: Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet 2000;355:1315-1319.
6.
Zunzunegui MV, Alvarado BE, Del Ser T, Otero A: Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. J Gerontol B Psychol Sci Soc Sci 2003;58:S93-S100.
7.
Helmer C, Damon D, Letenneur L, Fabrigoule C, Barberger-Gateau P, Lafont S, Fuhrer R, Antonucci T, Commenges D, Orgogozo JM, Dartigues JF: Marital status and risk of Alzheimer's disease: a French population-based cohort study. Neurology 1999;53:1953-1958.
8.
Karlamangla AS, Miller-Martinez D, Aneshensel CS, Seeman TE, Wight RG, Chodosh J: Trajectories of cognitive function in late life in the United States: demographic and socioeconomic predictors. Am J Epidemiol 2009;170:331-342.
9.
Bickel H, Cooper B: Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychol Med 1994;24:179-192.
10.
Lupien SJ, Nair NP, Brière S, Maheu F, Tu MT, Lemay M, McEwen BS, Meaney MJ: Increased cortisol levels and impaired cognition in human aging: implication for depression and dementia in later life. Rev Neurosci 1999;10:117-139.
11.
Rasmusson AM, Shi L, Duman R: Downregulation of BDNF mRNA in the hippocampal dentate gyrus after re-exposure to cues previously associated with footshock. Neuropsychopharmacology 2202;27:133-142.
12.
Seeman TE, Lusignolo TM, Albert M, Berkman L: Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychol 2001;20:243-255.
13.
Glei DA, Landau DA, Goldman N, Chuang YL, Rodríguez G, Weinstein M: Participating in social activities helps preserve cognitive function: an analysis of a longitudinal, population-based study of the elderly. Int J Epidemiol 2005;34:864-871.
14.
Yoshitake T, Kiyohara Y, Kato I, Ohmura T, Iwamoto H, Nakayama K, Ohmori S, Nomiyama K, Kawano H, Ueda K, et al: Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama study. Neurology 1995;45:1161-1168.
15.
Beard CM, Kokmen E, Offord KP, Kurland LT: Lack of association between Alzheimer's disease and education, occupation, marital status, or living arrangement. Neurology 1992;42:2063-2068.
16.
Berkman LF, Glass T, Brissette I, Seeman TE: From social integration to health: Durkheim in the new Millennium. Soc Sci Med 2000;51:843-857.
17.
Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, Tang Y, Bennett DA: Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry 2007;64:234-240.
18.
Neuvonen E, Rusanen M, Solomon A, Ngandu T, Laatikainen T, Soininen H, Kivipelto M, Tolppanen AM: Late-life cynical distrust, risk of incident dementia, and mortality in a population-based cohort. Neurology 2014;82:2205-2212.
19.
Rook KS: The negative side of social interaction: impact on psychological well-being. J Pers Soc Psychol 1984;46:1097-1108.
20.
Schuster TL, Kessler RC, Aseltine RH Jr: Supportive interactions, negative interactions, and depressed mood. Am J Community Psychology 1990;18:423-438.
21.
Chaves ML, Camozzato AL, Eizirik CL, Kaye J: Predictors of normal and successful aging among urban-dwelling elderly Brazilians. J Gerontol B Psychol Sci Soc Sci 2009;64:597-602.
22.
Dratcu L, da Costa Ribeiro L, Calil HM: Depression assessment in Brazil. The first application of the Montgomery-Asberg Depression Rating Scale. Br J Psychiatry 1987;150:797-800.
23.
Mari JJ, Williams P: A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. Br J Psychiatry 1986;148:23-26.
24.
American Psychiatric Association: Diagnostics and Statistical Manual of Mental Disorders, ed 4. Washington, APA, 1994.
25.
Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state'. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
26.
Chaves ML, Camozzato AL, Godinho C, Kochhann R, Schuh A, de Almeida VL, Kaye J: Validity of the clinical dementia rating scale for the detection and staging of dementia in Brazilian patients. Alzheimer Dis Assoc Disord 2007;21:210-217.
27.
Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914-919.
28.
Chaves ML, Camozzato AL, Godinho C, Piazenski I, Kaye J: Incidence of mild cognitive impairment and Alzheimer disease in Southern Brazil. J Geriatr Psychiatry Neurol 2009;22:181-187.
29.
Ganster DC, Victor B: The impact of social support on mental and physical health. Br J Med Psychol 1988;61:17-36.
30.
Waite L, Grayson D, Jorm AF, Creasey H, Cullen J, Bennett H, Casey B, Broe GA: Informant-based staging of dementia using the clinical dementia rating. Alzheimer Dis Assoc Disord 1999;13:34-37.
31.
Galvin JE, Roe CM, Xiong C, Morris JC: Validity and reliability of the AD8 informant interview in dementia. Neurology 2006;67:1942-1948.
32.
Berkman LF, Glass T, Brissette I, Seeman T: From social integration to health: Durkheim in the new Millennium. Soc Sci Med 2000;51:843-857.
33.
Steptoe A, Owen N, Kunz-Ebrecht SR, Brydon L: Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology 2004;29:593-611.
34.
Pinquart M, Duberstein PR: Association of social network with cancer mortality: a meta-analysis. Crit Rev Oncol Hematol 2010;75:122-137.
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