Factors Associated with Lower Social Activity in German Older Adults at Increased Risk of Dementia: A Cross-Sectional Analysis

Article type: Research Article

Authors: Buchholz, Maresa^{a; 1} | Zöllinger, Isabel^{b; 1} | Thyrian, Jochen René^{a; c; d} | Luppa, Melanie^e | Zülke, Andrea^e | Döhring, Juliane^f | Lunden, Laura^f | Sanftenberg, Linda^b | Brettschneider, Christian^g | Czock, David^h | Frese, Thomasⁱ | Gensichen, Jochen^b | Hoffmann, Wolfgang^{a; c} | Kaduszkiewicz, Hanna^f | König, Hans-Helmut^g | Wiese, Birgitt^j | Riedel-Heller, Steffi G.^{e; 2} | Blotenberg, Iris^{a; 2; *}

Affiliations: [a] German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany | [b] Institute of General Practice and Family Medicine, Ludwig Maximilian University Hospital, Ludwig Maximilian University Munich (LMU), Munich, Germany | [c] Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany | [d] University of Siegen, Faculty V: School of Life Sciences, Siegen, Germany | [e] Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany | [f] Institute of General Practice, University of Kiel, Kiel, Germany | [g] Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany | [h] Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, Heidelberg, Germany | [i] Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany | [j] MHH Information Technology, Hannover Medical School, Hannover, Germany

Correspondence: [*] Correspondence to: Dr. Iris Blotenberg, German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1–2, Greifswald D-17489, Germany. Tel.: +49 (0) 3834 86 19534; E-mail: iris.blotenberg@dzne.de.

Note: [1] These authors contributed equally to this work.

Note: [2] Shared last authors.

Abstract: Background: Studies demonstrate associations between low social activity in older adults and cognitive decline. Little has been investigated regarding which factors are associated with low social activity in older adults at increased risk of dementia. Objective: We investigate which sociodemographic, psychological, health-related, and environmental factors are associated with low social activity in older adults at increased risk of dementia. Additionally, we describe the stages of health behavior change, the types of social activities, and the duration of the current level of social activity. Methods: We used baseline data of 1,015 participants from the AgeWell.de trial. We conducted logistic and Poisson regression analyses to investigate factors associated with low social activity. We report descriptive statistics on the stages of change in the sample, the types of social activities most frequently pursued, and the duration of the current level of social activity. Results: Lower income, non-usage of public transport, depressive symptoms, cognitive, mobility, and hearing impairment were negatively associated with social activity. The majority of the sample was in the maintenance stage, followed by the precontemplation stage. The most common social activities were traveling and hobbies with others. Participants have maintained their current level of social activity for several years. Conclusions: We identified a lack of resources (income, transport), depressive symptoms and poorer health (cognitive, mobility and hearing impairment) as barriers to social activity. Interventions promoting social activity in older adults at risk of dementia may specifically target individuals with these risk factors. Low-threshold opportunities for social activity may be particularly beneficial.

Keywords: Alzheimer’s disease, dementia, lifestyle, older adults, prevention, risk factors, social engagement, social health, social participation, transtheoretical model

DOI: 10.3233/JAD-231226

Journal: Journal of Alzheimer's Disease, vol. 98, no. 4, pp. 1443-1455, 2024