Loneliness, cerebrovascular and Alzheimer's disease pathology, and cognition

Author:

Lao Patrick1,Young Christina B.2,Ezeh Chima1,Lacayo Bayardo1,Seblova Dominika3,Andrews Ryan M.45,Gibbons Laura6,Kraal A. Zarina1,Turney Indira1,Deters Kacie D.7,Dotson Vonetta8,Manly Jennifer J.1,Barnes Lisa L.9,Zahodne Laura B.10

Affiliation:

1. Department of Neurology Columbia University New York New York USA

2. Department of Neurology and Neurological Sciences Stanford University School of Medicine Stanford California USA

3. Second Faculty of Medicine Charles University Prague Prague Czech

4. Department of Epidemiology Boston University Boston Massachusetts USA

5. Department of Biometry and Data Management Leibniz Institute for Prevention Research and Epidemiology—BIPS Bremen Germany

6. General Internal Medicine School of Medicine University of Washington Seattle Washington USA

7. Department of Integrative Biology and Physiology College of Life Sciences University of California Los Angeles Los Angeles California USA

8. Department of Psychology and Gerontology Institute Georgia State University Atlanta Georgia USA

9. Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA

10. Department of Psychology University of Michigan Ann Arbor Michigan USA

Abstract

AbstractINTRODUCTIONLoneliness has a rising public health impact, but research involving neuropathology and representative cohorts has been limited.METHODSInverse odds of selection weights were generalized from the autopsy sample of Rush Alzheimer's Disease Center cohorts (N = 680; 89 ± 9 years old; 25% dementia) to the US‐representative Health and Retirement Study (N = 8469; 76 ± 7 years old; 5% dementia) to extend external validity. Regressions tested cross‐sectional associations between loneliness and (1) Alzheimer's disease (AD) and cerebrovascular pathology; (2) five cognitive domains; and (3) relationships between pathology and cognition, adjusting for depression.RESULTSIn weighted models, greater loneliness was associated with microinfarcts, lower episodic and working memory in the absence of AD pathology, lower working memory in the absence of infarcts, a stronger association of infarcts with lower episodic memory, and a stronger association of microinfarcts with lower working and semantic memory.DISCUSSIONLoneliness may relate to AD through multiple pathways involving cerebrovascular pathology and cognitive reserve.Highlights Loneliness was associated with worse cognition in five domains. Loneliness was associated with the presence of microinfarcts. Loneliness moderated cognition–neuropathology associations. Transportability methods can provide insight into selection bias.

Funder

National Institute on Aging

Alzheimer's Association

Publisher

Wiley

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