It may take a lifetime but eventually many of us treasure how much wisdom our parents passed on to us. Years after my parents passing, I still appreciate what I can learn from their lives, especially after they entered their third act. I’m not just talking about “dos and don’ts,” which may have annoyed me at the time, but insights from the wisdom that comes from aging.
We know from the scientific literature and common sense how social connections typically decrease as people retire from day jobs, children become enmeshed in their own lives or even move away, grandchildren move on, and relatives, friends, neighbors die or simply are unavailable to sustain a treasured friendship. I remember watching my parents’ friends, who I’d known since youth, pass away, move away to be nearer their children, or lost interest in lifelong friends.
My parents lived into their 90s, so it’s not too surprising that my mother often said, “All my family, all my friends are gone.” She became the oldest person she knew and the oldest and only person alive from her birth family.
This, of course, is not news. But I’ll wager it’s not something most people think about or plan for. It is something I heard not just from my mother but also from participants in our decades long Adult Changes in Thought or ACT study, a long-running cohort study of aging.
SOCIAL CONNECTEDNES: A POTENTIALLY REVERSIBLE RISK FACTOR FOR DEMENTIA
According to the recently released Third Report of the Standing Lancet Commission on dementia, social isolation is a potentially reversible risk factor for dementia.
The Lancet is perhaps the most renowned international medical journal. It charters working commissions that work on important international health issues ranging from hepatitis, high blood pressure, global infection threats, to obesity, and including the early work relating health, energy and climate change.
I was invited to convene with international experts on aging and dementia to write The Lancet Commission Report on Dementia: Prevention, Intervention and Care. We published our extensive first report in 2017. Unlike other Lancet commission reports that are often “one and done,” the commission has now published three widely circulated reports, which reflect great increases in the population of older persons throughout the world coincident with the ongoing, vast expansion of scientific efforts and knowledge about dementia.
Summarizing what is currently known about prevention of dementia is a key feature of the Commission’s reports. One of the third report’s remarkable findings was naming the 14 potentially reversible risk factors which, if avoided or improved, had the potential to reduce lifetime risk of dementia by almost half. Infrequent social contact appeared in the second report and was supported with more detailed evidence in the third. Based on published research, the commission concluded that reducing social isolation or, conversely, maintaining frequent social contact had the potential to contribute 5% of the about 45% of total possible risk reduction from all 14 factors. I hope to write about some of the other 13 risk factors in future issues of 3rd ACT.
Maintaining social connectedness, being mindful and, if needed, proactive about the tendency for social connectedness to decline with age is what I wish to highlight now.
BE AWARE AND BE YOURSELF AS YOU AGE
My dear mother was an accomplished pianist and on and off again a church organist. Formerly, a lab technician, her second career was working in our school district’s library support center. In retirement she was quite happy playing her piano, reading and puttering about our family home and eventually a duplex apartment in a local senior community. She enjoyed being with younger people, and, as she saw her social circle contract, she redoubled efforts to foster new friendships, participate in study groups, seek out younger new friends, go to concerts, recitals, even attend the Portland Opera for as long as possible. She was not a natural social butterfly but even as her mobility declined due to severe osteoporosis and arthritis she reached out to others. She didn’t deny the impacts of disability but rather presented herself as she was. She didn’t bemoan or deny her challenge with short term memory as it declined but instead generally made light of or even joked about the recent events and even familiar names she didn’t remember. She stayed true to who she had been and had become and expressed the lifelong interest in others and events that she always had. I’m sure, as an experienced dementia research scientist that she avoided some of her late in life cognitive decline by staying socially connected.
As her son, I’m grateful for the example she provided. It’s not too surprising now that aging science recognizes the value of maintaining social connectedness as a potentially reversible way to reduce dementia risk and cognitive decline. But…
THANKS MOM!
Eric B. Larson, MD, MPH, is a Professor of Medicine at the University of Washington. He was Co-Principal Investigator of the SMARRT trial and formerly Vice President for Research and Healthcare Innovation at Group Health and Kaiser-Permanente Washington. With colleagues he co-founded the long running Adult Changes in Thought (ACT) study in 1986. He continues research through the UW Alzheimer’s Disease Research Center and other projects and has participated in The Lancet Commission on Dementia since its inception. With co-author Joan DeClaire he wrote the well-received book, Enlightened Aging: Building Resilience for a Long Active Life.
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