Identification and prediction of frailty among community-dwelling older Japanese adults based on Bayesian network analysis: a cross-sectional and longitudinal study.

BACKGROUND: Frailty is a multifactorial syndrome; through this study, we aimed to investigate the physiological, psychological, and social factors associated with frailty and frailty worsening in community-dwelling older adults. METHODS: We conducted a cross-sectional and longitudinal study using data from the "Community Empowerment and Well-Being and Healthy Long-term Care: Evidence from a Cohort Study (CEC)," which focuses on community dwellers aged 65 and above in Japan. The sample of the cross-sectional study was drawn from a CEC study conducted in 2014 with a total of 673 participants. After excluding those who were frail during the baseline assessment (2014) and at the 3-year follow-up (2017), the study included 373 participants. Frailty assessment was extracted from the Kihon Checklist, while social relationships were assessed using the Social Interaction Index (ISI). Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression and their predictive abilities were tested. Factors associated with frailty status and worsening were identified through the Maximum-min Hillclimb algorithm applied to Bayesian networks (BNs). RESULTS: At baseline, 14.1% (95 out of 673) participants were frail, and 24.1% (90 out of 373) participants experienced frailty worsening at the 3-years follow up. LASSO regression identified key variables for frailty. For frailty identification (cross-sectional), the LASSO model's AUC was 0.943 (95%CI 0.913-0.974), indicating good discrimination, with Hosmer-Lemeshow (H-L) test p = 0.395. For frailty worsening (longitudinal), the LASSO model's AUC was 0.722 (95%CI 0.656-0.788), indicating moderate discrimination, with H-L test p = 0.26. The BNs found that age, multimorbidity, function status, and social relationships were parent nodes directly related to frailty. It revealed an 85% probability of frailty in individuals aged 75 or older with physical dysfunction, polypharmacy, and low ISI scores; however, if their social relationships and polypharmacy status improve, the probability reduces to 50.0%. In the longitudinal-level frailty worsening model, a 75% probability of frailty worsening in individuals aged 75 or older with declined physical function and ISI scores was noted; however, if physical function and ISI improve, the probability decreases to 25.0%. CONCLUSION: Frailty and its progression are prevalent among community-dwelling older adults and are influenced by various factors, including age, physical function, and social relationships. BNs facilitate the identification of interrelationships among these variables, quantify the influence of key factors. However, further research is required to validate the proposed model.

The Relationship Between Three Sources of Social Support and Physical Activity Level in Middle-Aged and Older Adults.

This study examined how different sources of social support from family members (excluding partners), friends, and partners were associated with moderate and vigorous leisure-time physical activity (LTPA) among middle-aged and older adults. This study included married participants aged 45 or older (N = 2,155) from the Midlife in the United States secondary data set. Hierarchical linear regression was performed to investigate the relationship between the three sources of social support and moderate LTPA, and separately, with vigorous LTPA. Partner support (b = 0.19, p < .01), family support (b = -0.19, p < .01), and friend support (b = 0.26, p < .001) were all significantly associated with moderate LTPA. Only social support from friends was associated with vigorous LTPA (b = 0.24, p < .001). Our study emphasizes the significance of social support in influencing LTPA behaviors among middle-aged and older adults. Future programs promoting physical activity should incorporate social support from friends to have the greatest impact.

The influence of adolescents' self-perception of social relationships on personality functioning in the context of inclusive education.

Introduction: Adolescence is a special phase of life in which fundamentals of psychosocial functioning are formed. The present study investigates how adolescents' self-perception of social relationships in inclusive classes affect personality functioning. Furthermore, we examine whether the association between self-perceived social relationships and personality functioning is stronger for students with special educational needs in the domains of learning (SEN L) and social -emotional development (SED) than for students without SEN. Methods: At two measurement points questionnaire data was collected from 927 sixth- and seventh-graders from 20 primary and 20 comprehensive inclusive classes in Germany. Results: Results of longitudinal multilevel analyses show partially different results for sixth- and seventh-graders. Overall, students' perceived social relatedness predicted personality functioning. Students who perceived their social relationships more positively showed healthier personality functioning. Further, SEN SED represents a potential risk factor for personality functioning. But, we observed that differences in personality functioning between seventh-graders with SEN L or SED and those without SEN decreased over time. Furthermore, SEN does not appear to reinforce the association between low self-perception of social relationships and risky personality functioning. Discussion: The findings are discussed in the context of inclusive education and implications for future research as well as practice are given. Overall, our findings contribute to a better understanding of students' psychosocial development in inclusive learning environments.

Older adults' subjective aging perceptions, mentalization, and social relationships: a micro-longitudinal study.

OBJECTIVES: Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link. METHOD: Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days. RESULTS: Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships. CONCLUSION: The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

Social support from the physiotherapist and the therapeutic relationship in physiotherapy: bridging theory to practice.

BACKGROUND/PURPOSE: Therapeutic relationship and social support are critical components in physiotherapy that shape patient outcomes. However, defining these constructs, discerning their similarities and differences, and measuring them pose challenges. This article aims to facilitate scientific and clinical advancement on social support and the therapeutic relationship in physiotherapy by (a) providing conceptual clarity, (b) discussing measurement tools, and (c) offering practical recommendations for the deliberate incorporation of these constructs in clinical practice. METHODS: This is a perspective paper drawing on examples from existing research. KEY RESULTS: Assessing the nature and strength of social support and promoting naturally occurring social support networks are practical ways for physiotherapists to foster social support in physiotherapy clinical practice. Physiotherapists can offer direct support, facilitate the development of an individual's social skills, and promote participation in group activities. To strengthen the therapeutic relationship, it is important to maintain good communication, foster connectedness with the patient, demonstrate professional skills, and adopt a reflective practice. Physiotherapists are encouraged to establish clear roles and responsibilities, prioritize individualized patient-centered care, and involve patients in shared decision-making, ensuring congruence in goals and expectations. Willingness to dedicate time and energy within and beyond direct patient-therapist interactions can foster connections. Moreover, using the body - which is the main point of contact with patients - and physical touch can help physiotherapists to connect with patients. Finally, physiotherapists must be prepared to address and mend any conflicts which can impact the relationship's trajectory. CONCLUSION: Social support and therapeutic relationships are complementary aspects of one's health care, and it is crucial to purposefully account for both in physiotherapy practice to optimize person-centered care and rehabilitation outcomes.

The Impairment of Social and Environmental Relationships in Patients With Heart Failure Correlated With Therapeutic Class.

Background and objectives Heart failure (HF) significantly influences the quality of life, both physically and emotionally, as well as social and environmental relationships. One major objective of HF treatment is to maintain or improve the quality of life. The aims of the study were to assess the impact of HF on social relationships and the relationship with the environment, according to therapeutic class and the presence of comorbidities, and to identify predictive factors for the impairment of these dimensions of the quality of life. Materials and methods This study was based on a cross-sectional survey; 252 patients with HF who have referred themselves to the medical rehabilitation department of the "Avram Iancu" Clinical Hospital, Oradea, between February 2023 and February 2024 were included. The patients were divided into two groups (Group HF-S/V, patients undergoing treatment with sacubitril/valsartan; Group HF-CT, patients receiving conventional therapy). All patients were asked to complete two assessment tools: the Charlson Comorbidity Index (CCI) questionnaire and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Results The mean values obtained per the domain of social relationships were significantly better for Group HF-CT (65.762 ± 12.519 versus 61.266 ± 12.428, p = 0.024). The mean values obtained on the domain of social relations and in relation to the environment were significantly better for Group HF-CT (65.762 ± 12.519 versus 61.266 ± 12.428, p = 0.024; 61.333 ± 13.461 versus 51.719 ± 16.769, p < 0.001). Both dimensions of the quality of life correlate with age and CCI (F = 7.793, p < 0.001, for social relationships; F = 16.821, p < 0.001, for relationship with the environment). Conclusions Social relationships and the relationship with the environment are affected in HF patients and correlate with age and comorbidity index, regardless of the type of therapy.

Revisiting adolescence as a sensitive period for sociocultural processing.

CHENG, T.W., K.L. Mills and J.H. Pfeifer. Revisiting adolescence as a sensitive period for sociocultural processing. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2024. Waves of research and public discourse have characterized adolescence as periods of developmental risk and opportunity. Underlying this discussion is the recognition that adolescence is a period of major biological and social transition when experience may have an outsized effect on development. This article updates and expands upon prior work suggesting that adolescence may be a sensitive period for sociocultural processing specifically. By integrating evidence from developmental psychology and neuroscience, we identify how trajectories of social and neurobiological development may relate to adolescents' ability to adapt to and learn from their social environments. However, we also highlight gaps in the literature, including challenges in attributing developmental change to adolescent experiences. We discuss the importance of better understanding variability in biology (e.g., pubertal development) and cultural environments, as well as distinguishing between sensitive periods and periods of heightened sensitivity. Finally, we look toward future directions and translational implications of this research.

Exploring the role of motherhood in healthcare engagement for women living with HIV in the USA.

Mothers living with HIV are faced with managing their own complex healthcare and wellness needs while caring for their children. Understanding the lived experiences of mothers living with HIV, including grandmothers and mothers with older children - who are less explicitly represented in existing literature, may guide the development of interventions that best support them and their families. This study sought to explore the role of motherhood and related social/structural factors on engagement with HIV care, treatment-seeking behaviour, and overall HIV management among mothers living with HIV in the USA to inform such efforts. Semi-structured interviews were conducted between June and December 2015 with 52 mothers living with HIV, recruited from the Women's Interagency HIV Study (WIHS) sites in four US cities. Five broad themes were identified from the interviews: children as a motivation for optimal HIV management; children as providing logistical support for HIV care and treatment; the importance of social support for mothers; stressors tied to responsibilities of motherhood; and stigma about being a mother living with HIV. Findings underscore the importance of considering the demands of motherhood when developing more effective strategies to support mothers in managing HIV and promoting the overall health and well-being of their families.

The relationship of social contacts with prisoners' mental health: a systematic review.

OBJECTIVES: Prisoners' common mental disorders (CMDs) and their social contacts are a complex and significant concern. We have systematically investigated the relationship between social contacts (i.e. perceived, and objective social support, and loneliness) and prisoners' mental health. STUDY DESIGN: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). METHODS: A protocol was developed and registered in PROSPERO (CRD42023372942). A search strategy was applied across four databases (namely MEDLINE [via OVID SP], APA PsycINFO, Scopus, and Web of Science). The quality assessment entailed the critical appraisal skills program (CASP) Checklist for cohort studies. The data were presented through a narrative synthesis. RESULTS: After screening, 32 studies that fulfilled the inclusion criteria were included in this review. Most were cross-sectional (k = 27), while five had a longitudinal design. The total number of study participants was 10,613. The majority of the studies reported negative correlations between perceived and objective social support and symptoms of common mental disorders (CMDs), specifically, depression, anxiety, and post-traumatic stress disorder (PTSD). The included studies appeared to indicate a correlation between loneliness and PTSD symptoms. CONCLUSIONS: The lack of social support was linked to the development or exacerbation of CMDs in prisoners. Initiatives, such as reducing visitation barriers and providing access to technology for remote communication, can assist prisoners in strengthening their support systems and enhancing their opportunities for reintegration into society.

Childhood adversity and suicidal ideation in older Korean adults: unraveling the mediating mechanisms of mental health, physical health, and social relationships.

BACKGROUND: Suicide rates in older adults are much higher than those in younger age groups. Given the rapid increase in the proportion of older adults in Korea and the high suicide rate of this age group, it is worth investigating the mechanism of suicidal ideation for older adults. Generally, adverse childhood experiences are positively associated with suicidal ideation; however, it is not fully understood what mediating relationships are linked to the association between these experiences and current suicidal ideation. METHODS: The data from 685 older Korean adults were analyzed utilizing logistic regression, path analyses, and structural equation modeling. Based on our theoretical background and the empirical findings of previous research, we examined three separate models with mental health, physical health, and social relationship mediators. After that, we tested a combined model including all mediators. We also tested another combined model with mediation via mental health moderated by physical health and social relationships. RESULTS: The univariate logistic regression results indicated that childhood adversity was positively associated with suicidal ideation in older adults. However, multivariate logistic regression results demonstrated that the direct effect of childhood adversity became nonsignificant after accounting all variables. Three path models presented significant mediation by depression and social support in the association between childhood adversity and suicidal ideation. However, combined structural equation models demonstrated that only mediation by a latent variable of mental health problems was statistically significant. Social relationships moderated the path from mental health problems to suicidal ideation. CONCLUSIONS: Despite several limitations, this study has clinical implications for the development of effective strategies to mitigate suicidal ideation. In particular, effectively screening the exposure to adverse childhood experiences, early identification and treatment of depressive symptoms can play a crucial role in weakening the association between childhood adversity and suicidal ideation in older adults.

Impact of the COVID-19 pandemic on psychosocial health in rheumatic patients: A longitudinal study.

AIM: To describe the impact of the COVID-19 on the psychosocial health of patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and systemic lupus erythematosus (SLE). DESIGN: Longitudinal observational study of a series of patients with rheumatic disease. METHODS: The main outcome measure was impairment of the ability to participate in social activities, as measured using the PROMIS-APS instrument Short Form-8a. We evaluated social activities in various settings and performed a multivariate analysis to study the association between worsening of social participation during the COVID-19 pandemic and implicated factors. RESULTS: One hundred and twenty-five patients had completed the prospective follow-up: 40 with AR (32%), 42 with SpA (33.6%), and 43 with SLE (34.4%). Overall, poorer mean PROMIS scores were recorded after the COVID-19 pandemic for: satisfaction with social roles (p=0.029), depression (p=0.039), and ability to participate in social activities (p=0.024). The factors associated with ability to participate in social activities after the COVID-19 pandemic were older age (ß=-0.215; p=0.012), diagnosis of SLE (ß=-0.203; p=0.015), depression (ß=-0.295; p=0.003) and satisfaction with social roles (ß=0.211; p=0.037). CONCLUSION: The ability to participate in social activities after the COVID-19 pandemic is affected in patients with rheumatic disease, especially in SLE.

Cancer Patients' Social Relationships During 3 Years After Diagnosis-Generic and Cancer-Specific Social Networks.

BACKGROUND: Social relationships are important health resources and may be investigated as social networks. We measured cancer patients' social subnetworks divided into generic social networks (people known to the patients) and disease-specific social networks (the persons talked to about the cancer) during 3 years after diagnosis. METHOD: Newly diagnosed patients with localized breast cancer (n = 222), lymphoma (n = 102), and prostate cancer (n = 141) completed a questionnaire on their social subnetworks at 2-5 months after diagnosis and 9, 18, and 36 months thereafter. Generic and cancer-specific numbers of persons of spouse/partner; other family; close relatives, in detail; and friends were recorded as well as cancer-specific numbers of persons in acquaintances; others with cancer; work community; healthcare professionals; and religious, hobby, and civic participation. The data was analyzed with regression models. RESULTS: At study entry, most patients had a spouse/partner, all had close relatives (the younger, more often parents; and the older, more often adult children with families) and most also friends. The cancer was typically discussed with them, and often with acquaintances and other patients (74-86%). Only minor usually decreasing time trends were seen. However, the numbers of distant relatives and friends were found to strongly increase by the 9-month evaluation (P < 0.001). CONCLUSION: Cancer patients have multiple social relationships and usually talk to them about their cancer soon after diagnosis. Most temporal changes are due to the natural course of life cycle. The cancer widened the patients' social networks by including other patients and healthcare professionals and by an increased number of relatives and friends.

How do social and parasocial relationships on TikTok impact the well-being of university students? The roles of algorithm awareness and compulsive use.

Social media now has emerged as one of the most widely used communication channels. The objective of this work is to verify the factors that influence the compulsive use of TikTok, as well as the mediating role of algorithm awareness, and to identify the predictors of well-being related to the use of TikTok. In the present work, the relevance of the study of PSRs and FoMO that affect the compulsive use of TikTok in young people is discussed. A total of 379 young university students (56.7 % girls) between 15 and 25 years old (M = 19.80; S.D. = 1.49) were surveyed using self-reports. Data treatment followed serial mediation through structural equation modeling. The results showed that exist significant relationships between these variables. Likewise, they reinforce the understanding of the diversity of the mechanisms of social and parasocial motivations on compulsive use and well-being. The results highlight the need to strengthen the training and education of young people in the appropriate and regulated use of TikTok in the university setting.

Association between disability and cognitive function in older Chinese people: a moderated mediation of social relationships and depressive symptoms.

Objective: Many previous studies have found that disability leads to cognitive impairment, and in order to better understand the underlying mechanisms between disability and cognitive impairment, the present study aimed to investigate the moderating role of social relationships, including their role as mediators between disability and cognitive impairment in depressive symptoms. Study design: This is a cross-sectional study. Methods: A total of 5,699 Chinese older adults from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) were included in this study, and PROCESS macro was used to perform simple mediator and moderator mediator analyses, which were used to analyze the relationship between depressive symptoms and social relationships between disability and cognitive impairment. Results: The results of this study showed significant correlations between disability, cognitive impairment, depressive symptoms, and social relationships, and that depressive symptoms mediated the relationship between disability and cognitive functioning [B = -0.232; 95% CI: (-0.304, -0.164)], and that social relationships mediated disability and cognitive functioning through pathway a (Disability-Depressive Symptoms) [B = 0.190; 95% CI: (0.020, 0.036)], path b (depressive symptoms-cognitive impairment) [B = 0.029; 95% CI: (0.015, 0.042)], and path c' (incapacitation-cognitive impairment) [B = 0.492; 95% CI: (0.298, 0.685)] to modulate the effect of incapacitation on cognitive impairment. In addition, social activities and social networks moderated the mediation model directly or indirectly, whereas social support moderated only the direct effect. Conclusion: This study explains the intrinsic link between incapacitation and cognitive impairment in Chinese older adults, and that social relationships and depressive symptoms can directly or indirectly modulate the effects between them. This provides a basis for healthcare professionals to be able to better develop interventions that can be used to improve the level of cognitive functioning and mental health of older adults.

Social Statuses, Quality of Social Relationships, and Self-Esteem Among Older Adults in Canada: Resource Multiplication or Substitution?

This research examines how older adults' self-esteem is shaped by core social statuses and ongoing social relationships. Based on a national survey of Canadian older adults (N = 4010), analyses show that men have greater self-esteem than women, as do people with higher quality of social relationships and a high degree of educational attainment. Neither gender nor quality of social relationships intersect with education to shape self-esteem, but quality of social relationships is more strongly associated with self-esteem for women. Consequently, strong gender differences are observed at low levels of relationship quality, but these gender differences are negated at high levels of relationship quality. This research shows that social statuses and relationships cohere to shape self-esteem in later-life, but gender differences are not evident in the context of high-quality social relationships. Conversely, educational attainment appears to be a key determinant of high self-esteem, irrespective of gender or quality of social relationships.

Demographic determinants of happiness in Andalusia: insights from the 2022 social survey data.

The Social Survey of Andalusia is an instrument for monitoring the Andalusian reality developed by the regional government of Andalusia, whose dataset is open access to the citizens. The 2022 edition included questions related to happiness, social relations as well as socio-demographic factors. Based on this dataset, the present study aimed to analyse the relationship between socio-demographic factors and people's experiences of happiness. It also set out to explore which factors might be indispensable for experiencing moments of happiness as measured in the survey. A sample of 4,968 cases was gotten, conducting a descriptive analysis, a logit regression in complex samples, and a Necessary Conditions Analysis. The results found two very different social profiles in terms of the experience of happiness, determined by age, sex, educational level and economic status. However, neither factor proved to be a necessary condition for happiness. Both conclusions should be taken into consideration in any socio-community intervention.

Exploring the associations between structural and functional aspects of social relationships and cognition in very old age.

OBJECTIVES: Few studies have examined the associations between social relationships and cognition in very old adults (80+ years). Moreover, limited research has considered structural and functional aspects of social relationships together when exploring their associations with cognition. Therefore, the present study aimed to investigate the associations between structural and functional social aspects and cognition in very old age. METHOD: The sample comprised 518 two-wave participants of the NRW80+ Study, who showed no indication of dementia and an average age of 85 years at baseline (range: 80-97 years). They were assessed twice over an approximate 2-year interval. Multilevel linear growth curve analysis was employed to model cognitive development over very old age and to examine the associations between structural and functional aspects of social relationships and cognitive development. It was controlled for demographic and health characteristics. RESULTS: A larger social network size (ß = 0.05, 95% CI [0.02, 0.08], p = 0.002) and frequent compared with occasional, seldom, and no contact with others (ß = 0.16, 95% CI [0.03, 0.28], p = 0.013) were associated with higher global cognition in the fully-controlled model. Model comparisons further revealed that structural aspects better predicted global cognition in very old age compared to functional aspects (χ2(2) = 16.17, p < 0.001). CONCLUSION: The findings underline the positive association between structural aspects of social relationships and global cognition in very old age. They also highlight the need for interventions promoting a socially active lifestyle to prevent cognitive decline in this vulnerable age group.

An integrated intervention on well-being: A qualitative study on relationships and emotions.

BACKGROUND: Oncological treatments lead to physical and emotional difficulties with notable consequences in everyday life. Thus, integrated interventions that can promote quality of life are needed. Since current studies suggest that integrated programs of both physical exercises and psychological sessions can promote positive emotions, this pilot study aims to explore the impact of a one-week intervention that combines sailing activities and psychological support. METHODS: Twenty-nine breast cancer survivors took part in this study. Before and after the intervention, participants were invited to answer three open questions to evaluate their perceptions of personal evaluations about their relationships and emotions. A Qualitative Thematic Analysis was used to evaluate participants' answers and to compare the sub-themes that emerged in the two times. RESULTS: Findings highlighted three main themes: a) caregivers and emotional closeness - family members are generally a crucial point of reference for participants. Friends, colleagues, and healthcare professionals were also cited as relevant figures during the cancer journey and after the psychological intervention; b) emotions towards others - positive and negative emotions towards these figures emerged, and some women felt alone, and c) emotions towards oneself - exploring emotions related to themselves highlighted positive and negative feelings and the desire for change to promote love and care towards themselves. Interestingly, the number of negative emotions towards themselves decreased after the intervention. CONCLUSIONS: The integrated intervention could promote the reflection on personal relationships and emotions.

Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark.

Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.

Social relationships, amyloid burden, and dementia: The ARIC-PET study.

INTRODUCTION: This study aimed to assess whether social relationships in mid-life reduce the risk of dementia related to amyloid burden. METHODS: Participants in the Atherosclerosis Risk in Communities (ARIC) study were assessed for social support and isolation (visit 2; 1990-1992). A composite measure, "social relationships," was generated. Brain amyloid was evaluated with florbetapir positron emission tomography (PET); (visit 5; 2012-2014). Incident dementia cases were identified following visit 5 through 2019 using ongoing surveillance. Relative contributions of mid-life social relationships and elevated brain amyloid to incident dementia were evaluated with Cox regression models. RESULTS: Among 310 participants without dementia, strong mid-life social relationships were associated independently with lower dementia risk. Elevated late-life brain amyloid was associated with greater dementia risk. DISCUSSION: Although mid-life social relationships did not moderate the relationship between amyloid burden and dementia, these findings affirm the importance of strong social relationships as a potentially protective factor against dementia.