Even though “Elaine Hamlin” (a pseudonym) had been retired from teaching for a number of years, she still maintained an active social and community life. She belonged to a book club, volunteered at the League of Women Voters and was a frequent dinner guest at the homes of her former colleagues.
Suddenly, right before she turned 78, her life changed dramatically. Hamlin stopped attending her regular reading group, missed volunteer meetings, and even declined to meet friends for dinner. Always a careful dresser, she now seldom bothered to change her clothes.
She became a recluse, and often couldn’t remember what day of the week it was. One night when she was on the phone with her daughter, she said her mother was in the kitchen cooking her dinner. Her mother had been dead for 15 years.
At this point, the family knew there was a serious problem — most likely Alzheimer’s. However, Hamlin had been reluctant to undergo a neurological examination. The final straw came when she was arrested for driving the wrong way down a one-way street in the middle of the night.
After trying home care, which did nothing to mitigate her loneliness, Hamlin moved into an assisted living facility. There she quickly made friends, played cards, joined a singing group, and even found a boyfriend. She began to care about her appearance again. Her family was astonished and wondered what had happened to cause such a dramatic reversal in her behavior, her mood, even her cognitive abilities. Was this a common occurrence, or was Hamlin’s experience a unique case?
Recent research in the field of brain health has shown that Elaine Hamlin’s turnaround may be partially due to the effects of social networking. Scientists and health professionals now believe that the more socially active people are, the less likely they will experience signs of dementia, including the devastating cognitive impairments associated with Alzheimer’s pathology. In fact, maintaining a large social fabric may even act as a neuroprotective.
David Bennett, M.D., a neurologist and the director of the Rush University Alzheimer’s Disease Center in Chicago, was the first to examine the relationship between social networks and Alzheimer’s. His 2006 study followed 89 elderly people known to have Alzheimer’s. Participants underwent cognitive performance tests each year to determine their participation in social networks. For example, they were asked how involved they were with children, spouses, and friends, as well as any groups or organizations.
At death, when the patients’ brains were autopsied and evaluated, Bennett and his group discovered that the level of social networks did not affect the pathology of the brain — patients’ brains were equally riddled with diseased plagues and tangles, hallmarks of the presence of Alzheimer’s. However, it appeared that the more socializing they did, the higher functioning they were. The data even suggested that having an active social life provided a protective reserve as the pathology of the disease continued to progress. Furthermore, as the size and the differing spheres of social interaction grew — friends, family, church, volunteer service, hobbies involving others such as bridge, quilting, singing, golf, or bowling — the cognitive impairment associated with the disease decreased.
A similar study in 2007 by Dr. Valerie Crooks, a researcher at Kaiser Permanente Southern California, followed 2,200 women ages 78 to 82 and found that those with large social networks reduced their risk of getting dementia by 26 percent. Those with daily contact had a lower risk of dementia, but the contact did not have to be in person — it could be through email or phone conversations. What mattered was staying socially and mentally connected to other people. While the findings did not reveal exactly how social support impacts the disease, they did show that the more we interact, the more our brains are challenged to stay active.
The area of the brain specifically affected by social interaction is our semantic memory, where long-term memory, ideas, concepts, language, and facts are stored. These are the things we learn from engagement with other people and the world. Semantic memory (as opposed to episodic memory or autobiographical memory, which may only take one exposure to imprint) is acquired by repetitive exposure and needs to be constantly updated. Whenever we have a basic exchange with another human being, we have to engage and think of a response. This process stimulates our brains.
Social connections have long been thought to reduce the risk of age-related decline. Dr. Denise Park, a psychologist and director of the University of Texas Center for Vital Longevity, has sought to understand how brains function as individuals age, and whether stimulation can maintain health. Park theorizes that social interaction, like mental exercises and learning, limits the amount of time that aging brains remain unfocused, in what she calls a daydream state. Park believes that the older we get, the more difficult it is to switch between this daydream state and the focused attention that is required to perform everyday tasks. Therefore, the more an aging brain stays stimulated and connected to others, the easier it is for that person to maintain a productive, independent life.
In 2007, National Geographic reporter Dan Buettner traveled the globe to identify the Blue Zones: Five hot spots where higher percentages of people enjoy healthy long lives (over 100 years of age) — Sardinia, Italy; Loma Linda, California; Nicoya Peninsula, Costa Rica; Icaria, Greece; and Okinawa, Japan. These communities have lower rates of diseases and are virtually free of dementia. All five share certain factors — a Mediterranean climate, a diet rich in legumes, constant moderate physical activity, family connection, and the key component of a social life that creates a strong sense of community.
So what does all this mean? While we can’t all live in Ikaria, Greece, we can actively engage in our own communities. William Thies, chief medical and scientific officer of the Alzheimer’s Association, predicts that science will eventually reveal that social interaction stimulates the brain to make new connections and that this perhaps helps the brain compensate for age-related decline. To reap the best benefits, he suggests learning a new skill or regular exercise, such as going for a daily walk or taking a dance class, in the company of friends.
As yet there is no cure for Alzheimer’s dementia. But as human beings we are social creatures whose interpersonal relations not only foster emotional, mental, and physical well-being, they provide a cognitive safety net, imperative to a healthy old age.
Hamlin’s family agrees. Even as Elaine’s disease progressed, she was a happier person, someone who was eager to participate in life.