Vignesh Subramanian ’24
Alzheimer’s disease and related disorders (ADRD) are neurodegenerative dementias that cause progressive loss of memory, critical thinking skills, and behavioral capabilities that typically worsen with age. However, certain older adults with significant degrees of ADRD-associated pathologies are not as vulnerable to the age- or disease-related physical changes in the brain that precede the development of dementia. These adults are classified as “cognitively resilient” and remain relatively unimpaired, typically not demonstrating symptoms beyond mild cognitive impairment. Cognitive resilience is believed to be enhanced by educational attainment, assistance by loved ones, and physical and mental activity-based lifestyles that ameliorate physio-psychological stress. To better understand the relationship between the presence of such social supports and the early prognosis of ADRD, a study led by Dr. Salinas of New York University explored changes in brain volume in relation to the global cognitive performances of adults with varying support domains.
Researchers used patients from the Framingham Study to enroll and assess three generations of participants, divided between ‘original’ and ‘offspring’ cohorts, for cognitive function testing and brain structure imaging purposes. The 2,171 subjects, all of whom had completed Berkman-Syme Social Network Index (SNI)-based assessments inquiring about their networks and contact with caregivers, were then subjected to neuropsychological test batteries that evaluated their memory, recall, organization and reproduction abilities. Participants simultaneously underwent brain-dedicated MRI scans to determine cerebral volumes. Adjusting for sample characteristics and risk factors, researchers then performed stratified analyses to determine the correlation between social support and cognitive resilience for these adults and compared them to the results of existing cross-sectional studies.
Researchers found that while the distribution of social support scores was understandably skewed due to subjectivity, differences in social support domains were closely associated with changes in cerebral volume. For participants over 65 years of age with lower mean total cerebral volumes and global cognitive function scores, the presence of social support did provide the neurocognitive benefit that other studies had predicted. Researchers also found that unlike other social support domains, high listener availability – which gives patients reliable opportunities to work through emotional issues or intellectual disabilities tied to ADRD – was directly associated with greater cognitive resilience. This significantly modified the association between brain volume and cognitive function, particularly in the younger cohort. Future research may determine whether more aggressive psychosocial interventions might delay the clinical onset of ADRD or reduce its likelihood of developing.
 J. Salinas, et al., Association of social support with brain volume and cognition. JAMA Network Open 4, 1-13 (2021). doi: 10.1001/jamanetworkopen.2021.21122
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