研究结果表明，更小的灰质体积与更高的社会隔离程度相关。社会隔离程度更深的人，与学习和思维相关脑区内的灰质可能更少。

　　翻译 阿金

　　2022 年 6 月 8 日发表的一篇研究论文指出，社会隔离（social isolation）与负责认知的脑区体积变小、以及更高的痴呆症风险相关。该文章在线发表在美国神经病学会（American Academy of Neurology）的期刊《神经病学》（Neurology）上。

　　“社会隔离是一个严肃的公共卫生问题，常常与老年人相关，但尚未得到充分重视。”该论文作者之一、复旦大学的冯建峰博士说道。“在新冠疫情的背景之下，社会隔离，或者说与社交网络隔绝的状态，变得更严重了。找出那些被社会孤立的人，提供资源帮助他们在社区内建立人际关系，这一任务比以往任何时候都更重要。”

　　研究调查了 462 619 名英国人，他们在研究开始时的平均年龄为 57 岁，并且在疫情流行之前已经被跟踪调查了近 12 年。其中有 41 886 人（9%）报告处在社会隔离状态，还有 29 036 人（6%）报告有孤独感。在研究期间，4998 鹿骨全蝎丸好得快购买 人患上了痴呆症（dementia）。

　　研究人员收集了来自受试者的问卷调查数据，以及包括 MRI 数据在内的各种身体与生物测量数值。受试者还参加了思维和记忆测试，以评估他们的认知功能。对于社会隔离情况，研究人员提出了三个关于社会关系的问题：是否与人同居，是否每月与朋友家人至少见一次面，是否参加社交活动，例如每周至少一次的俱乐部活动、会议或者志愿者工作。如果回答中至少有两个否定答案， 那就判断受试者处于社会隔离状态。

　　在 41 886 名处在社会隔离状态的受试者中，649 人（1.55%）患上了老年痴呆症，与此相比，420 733 名没有社会隔离的受试者中只有 4349 人患上痴呆症（1.03%）。

　　研究人员调整了其他影响因素，包括年龄、性别、社会经济地位、酒精摄入、吸烟以及其他精神健康状况包括抑郁和孤独感，随后发现社会隔离个体，大脑中与学习和思维相关区域的脑区灰质体积更小。他们还发现，与没有社会隔离的人相比，前者患上痴呆症的概率高出 26%。此外，研究人员还调查了孤独感，但经调整，发现与痴呆症没有强烈相关性。

　　“自我报告社会隔离程度更深的人的脑体积变化显著，而且还与认知和痴呆症相关联。”冯博士说道，“鉴于这一结果，社会隔离可能是痴呆症风险升高的早期指标。”

　　而该研究的一个局限是受试者报告的健康状况较少，与普通居民相比，独居的情况也较少，所以结果可能无法推广到全体人口。

　　论文信息

　　【标题】Associations of Social Isolation and Loneliness With Later Dementia

　　【作者】Chun Shen, Edmund Rolls, Wei Cheng, Jujiao Kang, Guiying Dong, Chao Xie, Xing-Ming Zhao, Barbara Sahakian, Jianfeng Feng

　　【时间】2022年6月8日

　　【期刊】Neurology

　　【摘要】

　　Objective好的快颈肩腰腿痛鹿骨胶

　　To investigate the independent associations of social isolation and loneliness with incident dementia and to explore the potential neurobiological mechanisms.

　　Methods

　　We utilized the UK Biobank cohort to establish Cox proportional hazard models with social isolation and loneliness as separate exposures. Demographic (sex, age and ethnicity), socioeconomic (education level, household income and Townsend deprivation index), biological (BMI, APOE genotype, diabetes, cancer, cardiovascular disease and other disabilities), cognitive (speed of processing and visual memory), behavioral (current smoker, alcohol intake and physical activity), and psychological (social isolation or loneliness, depressive symptoms and neuroticism) factors measured at baseline were adjusted. Then, voxel-wise brain-wide association analyses were used to identify gray matter volumes (GMV) associated with social isolation and with loneliness. Partial least squares regression was performed to test the spatial correlation 香港颈肩腰腿痛好的快 of 好得快又名鹿骨全蝎丸GMV differences and gene expression using the Allen Human Brain Atlas.

　　Results

　　We included 462,619 participants (mean age at baseline 57.0 years [SD 8.1]). With a mean follow-up of 11.7 years (SD 1.7), 4,998 developed all-cause dementia. Social isolation was associated with a 1.26-fold increased risk of dementia (95% CI, 1.15-1.37) independently of various risk factors including loneliness and depression (i.e., full adjustment). However, the fully adjusted hazard ratio for dementia related to loneliness was 1.04 (95% CI, 0.94-1.16); and 75% of this relationship was attributable to depressive symptoms. Structural MRI data were obtained from 32,263 participants (mean age 63.5 years [SD 7.5]). Socially isolated individuals had lower GMVs in temporal, frontal and other (e.g., hippocampal) regions. Mediation analysis showed that the identified GMVs partly mediated 好的快颈肩腰腿痛官网 the association between social isolation at baseline and cognitive function at follow-up. Social isolation-related lower GMVs were related to under-expression of genes that are down-regulated in Alzheimer’s disease and to genes that are involved in mitochondrial dysfunction and oxidative phosphorylation.

　　Conclusion

　　Social isolation is a risk factor for dementia that is independent of loneliness and many other covariates. Social isolation-related brain structural differences coupled with different molecular functions also support the associations of social isolation with cognition and dementia. Social isolation may thus be an early indicator of an increased risk of dementia.

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