September 13, 2021
Numerous studies suggest that having a strong social network may be beneficial to protect the brain against the ravages of Alzheimer’s disease. Having a friend or family member who is a good and supportive listener may be particularly effective in bolstering the brain, a new study reports.
For the study, researchers looked at 2,171 older men and women who were part of the large and ongoing Framingham Study, which has been looking at the physical and cognitive health of three generations of people living in Massachusetts over many years. To be included in the study, participants had to be 45 years old or older; most were in their 60s during the study period. None had a diagnosis of Alzheimer’s disease or other forms of dementia, and none had had a stroke or other medical problems that would affect their memory and brain health.
All had undergone MRI brain scans to assess, for example, the size of their brains, a measure of brain health. Having reduced brain volume is tied to an increased risk of developing Alzheimer’s disease. They had also undergone periodic tests of thinking and memory skills, grouped under the name “cognitive tests.”
The researchers were interested in evaluating the idea of cognitive resilience. According to this theory, people may look like they have normal memory abilities and thinking skills, even though their brain may show changes typical of aging or Alzheimer’s disease. In addition to the hallmark amyloid plaques and neurofibrillary tau tangles of Alzheimer’s disease, other changes include a lower brain volume.
People with high levels of cognitive resilience are able to maintain normal memory and thinking skills far longer than their peers with low cognitive resilience. Cognitively they seem far “younger,” even though they may have similar physical changes to their brains than patients already diagnosed.
A variety of lifestyle factors may contribute to cognitive resilience and a lower risk of developing Alzheimer’s disease. These include many years of formal education; working in a job that requires complex thinking and analysis; engaging in hobbies and recreational activities that are mentally challenging, such as learning a new language or musical instrument, or engaging in puzzles; getting regular exercise; and eating a heart-healthy diet, such as a traditional Mediterranean-style diet.
Having a large social network has likewise been tied to higher cognitive resilience. A growing body of research suggests that social factors like loneliness and isolation are associated with a higher risk of cognitive decline and the brain changes typical of Alzheimer’s disease. Studies have found, for example, that older adults who have many friends and family members they feel they can count on are much less likely to develop dementia at a given age, even if their brains are shrunken or full of plaques and tangles.
For the study, the researchers focused on social support using a scientifically validated series of questions that measure the size of someone’s social network as well as the kind of support they get. They assessed five domains of social support:
- Supportive listening (“Can you count on anyone to listen to you when you need to talk?”)
- Advice (“Is there someone available to give you good advice about a problem?”)
- Love-affection (“Is there someone available to you who shows you love and affection?”)
- Emotional support (“Can you count on anyone to provide you with emotional support?”)
- Sufficient contact (“Do you have as much contact as you would like with someone you feel close to, someone in whom you can trust and confide?”)
Participants could answer with responses that ranged from: none of the time, a little of the time, some of the time, most of the time, or all of the time.
The researchers found that supportive listening was a uniquely critical factor in having high levels of cognitive resilience. Those who scored high on assessments of supportive listening, answering “most of the time” or “all of the time” to whether they had a friend or family member who they could count to listen when they needed to talk, scored highest on tests of memory and thinking skills. Their memory and thinking skills remained largely intact, even though their brains often showed signs of reduced brain volume and aging. The findings were published in JAMA Network Open.
The authors note that the study does not prove that having a good listener can protect against the onset Alzheimer’s disease. But the findings add to a growing body of evidence that social support is a critical factor in bolstering brain health throughout life.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Joel Salinas, MD, MBA, MSc; Adrienne O’Donnell, BA; Daniel J. Kojis, BA; et al: “Association of Social Support With Brain Volume and Cognition.” JAMA Network Open, August 16, 2021