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Association of social isolation, loneliness, and genetic risk with incidence of dementia: UK Biobank cohort study

By Marko Elovainio, Jari Lahti, Matti Pirinen, Laura Pulkki-Råback, Anni Malmberg, Jari Lipsanen, Marianna Virtanen, Mika Kivimäki, Christian Hakulinen

Posted 27 Feb 2020
medRxiv DOI: 10.1101/2020.02.25.20027177

ObjectiveTo examine the associations of social isolation and loneliness with incident dementia by level of genetic risk. DesignProspective population-based cohort study. Setting and participants155 074 men and women (mean age 64.1, SD 2.9 years) from the UK Biobank Study, recruited between 2006 and 2010. Main exposuresSelf-reported social isolation and loneliness, and polygenic risk score for Alzheimers disease with low (lowest quintile), intermediate (quintiles 2 to 4), and high (highest quintile) risk categories. Main outcomeIncident all-cause dementia ascertained using electronic health records. ResultsOverall, 8.6% of participants reported that they were socially isolated and 5.5% were lonely. During a mean follow-up of 8.8 years (1.36 million person-years), 1444 (0.9% of the total sample) were diagnosed with dementia. Social isolation, but not loneliness, was associated with increased risk of dementia (hazard ratio 1.62, 95% confidence interval 1.38 to 1.90). Of the participants who were socially isolated and had high genetic risk, 4.2% (2.9% to 5.5%) were estimated to develop dementia compared with 3.1% (2.7% to 3.5%) in participants who were not socially isolated but had high genetic risk. The corresponding estimated incidence in the socially isolated and not isolated were 3.9% (3.1% to 4.6%) and 2.5% (2.2% to 2.6%) in participants with intermediate genetic risk. ConclusionSocially isolated individuals are at increased risk of dementia at all levels of genetic risk. What is already known on this topicO_LISocial isolation and loneliness have been associated with increased risk of dementia C_LIO_LIIt is not known whether this risk is modified or confounded by genetic risk of dementia C_LI What this study addsO_LIThis is the first study to show that social isolation is associated with increased risk of dementia across the spectrum of genetic risk C_LIO_LILoneliness, although considered as a significant risk for multiple health problems, seems to be associated with dementia only when combined with high genetic risk C_LI

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