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Social network structure and dementing processes
Author(s) -
Zhang Yun,
Natale Ginny,
Clouston Sean
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.047315
Subject(s) - dementia , hazard ratio , demography , cohort , incidence (geometry) , gerontology , social network (sociolinguistics) , medicine , cohort study , psychology , confidence interval , disease , sociology , physics , political science , law , optics , social media
Background How are components of individual social relationships associated with the dementing process? We examined associations between social network structure on incidence of mild cognitive impairment (MCI) and conversion to probable dementia, and on mortality rate. Method We utilized six waves of a nationally representative cohort of residents aged over 65 years and older in the United States (2011‐2016; National Health and Aging Trends Study; NHATS). Respondents were categorized into normal cognition, MCI, or probable dementia. Four‐status multi‐state survival models (MSMs) were used to provide multivariable‐adjusted measures, fit with a misclassification matrix, assessed effects of social network structure on the dementing process. Result Eligible NHATS participants (N=6,078) were mostly female (58.42%), and the majority were Non‐Hispanic white (68.99%). At baseline, the average age was 77.49±7.79 years and respondents reported an average number of 1.93 ±1.31 members of their social networks. In multivariable‐adjusted MSMs accounting for age, sex, education and race/ethnicity, having larger social networks was associated with lower hazards of conversion from MCI to probable dementia (adjusted Hazard Ratio (aHR): 0.82; 95%C.I.=[0.67‐0.99]). Having at least one friend within social network was associated with lower hazards of conversion from MCI to dementia (aHR=0.48 [0.33‐0.71]) but was associated with higher risk of mortality in the MCI group (aHR=2.58 [1.47‐4.51]). Finally, participants with at least one college graduate in their social network reported lower incidence of dementia (aHR=0.37 [0.26‐0.51]). Conclusion Our study is one of the first studies exploring effects of social network structure on the dementing process in a nationally representative prospective cohort of older adults. We found that having at least one friend, a larger social network, or having a college graduate within social network was associated with lower risk of MCI or conversion to dementia. We also reveal substantial disparities in cognitive dementing by education and race/ethnicity as well as clustering risks for low‐educated families.