BRAIN BOOST:

how social connections are essential for keeping dementia at bay

When it comes to maintaining brain health and warding off dementia, there are myriad things we’ve been told will help. But, says Dr Sanjay Gupta in this extract from his book Keep Sharp: Build a Better Brain at Any Age,

one of the most crucial steps is also one of the most enjoyable – spending time with others.

The paradox of our era is that we are hyperconnected through digital media yet increasingly drifting apart from each other and suffer from loneliness because we lack authentic connection. This absence of real connection is epidemic, and medicine is increasingly recognising it as having dire physical, mental and emotional consequences, especially among older adults.

People with fewer social connections have disrupted sleep patterns, altered immune systems, more inflammation, and higher levels of stress hormones. In a 2016 study, isolation was found to increase the risk of heart disease by 29 per cent and stroke by 32 per cent.

Another analysis that pooled data from 70 studies and 3.4 million people found that individuals who were mostly on their own had a 30 per cent higher risk of dying in the next seven years, and that this effect was largest in middle age (younger than 65).

Loneliness accelerates cognitive decline in older adults. The data speaks to me. It tells me to pay attention to nurturing my relationships as much as I nurture my health through diet and exercise.

Picture this

Neuroimaging studies have been particularly revealing in this new area of brain science. A couple of investigations have been carried out by AARP Foundation Experience Corps, a program that links older adults with kids who are not reading at grade level yet. The program aims to be mutually beneficial; it helps older adults engage in the community as tutors, while children learn the skills they need to do well in school.

Remarkably, fMRI (functional magnetic resonance imaging) showed that the adults in the program improved their cognition over a span of two years and even reversed declines in brain volume in regions vulnerable to dementia (e.g. the hippocampus).

Another study, the Synapse Project, also used fMRI in a randomised trial to compare the difference between putting one group of older adults through challenging activities together, such as quilting or digital photography, and another group that just socialised.

The results? fMRI analysis revealed that those who were engaged in the challenging activities gained improved cognition and brain function that were not seen in the socialising-only group.

Finally, the Rush University Memory and Aging Project has shown that those with larger social networks were better protected against the cognitive declines related to Alzheimer’s disease than the people with a smaller group of friends. Engaging socially in a group, particularly when centred around a challenging activity, seems to be the most protective.

The physical effect

The pain of loneliness has really captured my attention.

A remarkable study led by Naomi Eisenberger, an associate professor of social psychology at UCLA, found that being excluded triggered activity in some of the same regions of the brain that register physical pain. Feelings of exclusion lead to feelings of loneliness.

This makes evolutionary sense because throughout our history, survival has been about social groups and companionship. Staying close to the tribe brought access to shelter, food, water, and protection. Separation from the group meant danger.

Loneliness doesn’t discriminate; it can affect people who are single and living alone as much as individuals surrounded by people and living in a family unit. And it affects city dwellers as much as people living in rural areas.

Connection for protection

For over 80 years, researchers in the now-famous Harvard Study of Adult Development have been tracking how health is influenced by connections between people. They started recording data in 1938 during the Great Depression, following the health of 268 Harvard sophomores, and what they’ve found contains lessons for all of us.

The study is currently led by Dr Robert Waldinger, a psychiatrist at Massachusetts General Hospital and a professor of psychiatry at

“Loneliness has been shown to accelerate cognitive decline in older adults.”

Harvard Medical School. His TED talk on the subject, What Makes a Good Life? has been viewed more than 29 million times. Waldinger’s findings are attractive because they debunk commonly held myths about health and happiness. That is, that health and happiness are not about wealth, fame, or working harder. They are about good relationships. Period.

According to Dr Waldinger, “We’ve learned three big lessons about relationships. The first is that social connections are really good for us, and that loneliness kills. It turns out that people who are more socially connected to family, to friends, to community, are happier, they’re physically healthier, and they live longer than people who are less well connected. And the experience of loneliness turns out to be toxic.

“People who are more isolated than they want to be from others find that they are less happy, their health declines earlier in midlife, their brain functioning declines sooner and they live shorter lives than people who are not lonely.”

Quality over quantity

Harvard’s Adult Development study has also discovered that it is not just the number of friends you have, and it’s not necessarily whether you’re in a committed relationship; rather, it’s the quality of your close relationships that matters.

In terms of the brain, “being in a securely attached relationship to another person in your 80s is protective. One of the key ingredients was that people in relationships where they really feel they can count on the other person in times of need had their memories stay sharper longer. And the people in relationships where they feel they really can’t count on the other one, those are the people who experience earlier memory decline.”

Waldinger encourages people to lean into relationships with family, friends, and community. It could be as simple as spending more time with loved ones or reaching out to someone you haven’t spoken to in years but has a place in your heart.

And you can make new friends however old you are. As we age, we lose connections due to deaths, challenges with mobility, and geographical separation. Our social networks can shrink from the effects of retirement or an illness. Seeking out new connections can counter those developments.

Embrace technology

When I meet older folks who learn how to use a computer and tools like email, social media, and search functions, they seem to have a greater sense of independence and appear happier than the people who stay offline. I know that stands in contrast to how a lot of people view technology, but there are plenty of studies to back this up. The Internet affords us many opportunities to learn and connect with others. There’s even some evidence demonstrating that digital engagement can have positive effects on cognitive abilities in later life that is on par with in-person communication.

An Australian study involving more than 5000 older men found that those who use computers have a lower risk of receiving a diagnosis of dementia by up to eight and a half years, and an experimental study conducted in the US revealed that older adults performed about 25 per cent better on memory tasks after learning to use Facebook.

The triple threat

When I interviewed UCLA’s Gary Small, he suggested the “triple threat”: take a walk with a friend or neighbour and have a chat about what worries you. The combination of the exercise, in-person interaction, and talking through your anxieties is a wonder drug to the brain.

Dan Johnston at BrainSpan added a great point about the foundation of relationships: “You have to have a good brain to have good relationships.” There’s a beautiful circle of success here: good relationships boost the brain, and a healthy brain boosts relationships.

Finally, don’t underestimate the power of appropriate touch. Hand holding has been found to decrease levels of the stress hormone cortisol. A friendly touch can be calming.

The simple act of touching another human is a way of connecting with others to protect ourselves.

“It’s not just the number of friends you have, and it’s not necessarily whether you’re in a committed relationship; rather, it’s the quality of your close relationships that matters.”

– Dr Sanjay Gupta