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Psychosocial Risk Factors

By Laura Fratiglioni, Karolinska Institute, Stockholm, Sweden.

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A psychosocial factor may be defined as a measurement that potentially relates psychological phenomenon to the social environment and to physical changes. The psychosocial component of dementia and cognitive disturbances is a rapidly developing field, but the research evidence is still scarce. Psychosocial factors that have been related to dementia and AD are: personality, life events, work-life stress, leisure activity, social network and socio-economical status. Objectives. 1. To systematically review the literature of the last few years on this topic; and 2. To report new findings from our longitudinal population-based study, the Kungsholmen Project. Methods. 1. Searching strategies have included MEDLINE, MEDLINEplus, citations of available literature, available abstract books of workshops and conference proceedings; 2. In a dementia-free cohort of 776 subjects, mental, physical and social components detected in common leisure activities was related to the development of dementia 6.4 years later. The three components were evaluated using a 4-grade score by the researchers and by a group of elderly. Results. Most of the available data concerns social network and physical and non-physical activity. Fifteen observational longitudinal studies on cognition and 14 on dementia could be detected following our research criteria. Most of the observations (75%) reported an association of one lifestyle with dementia. From the Kungsholmen Project the multi-adjusted relative risks of dementia for subjects with higher mental, physical and social component score were 0.71 (0.49-1.03), 0.61 (0.42-0.87), and 0.68 (0.47-0.99), respectively. Few data are available at the moment on the other factors. Conclusions. The findings support the hypothesis that an active and social integrated life may be beneficial in brain aging by reducing cognitive decline and dementia risk. Several mechanisms may underline the reported associations from vascular to functional reserve.

Citation: NeuroBiology of Aging, Volume 25, Number S2 , July 2004, Page 5

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