Richard Kyte
A recent study by a team of international researchers reports that social engagement in middle age and later may reduce the risk of dementia by 30 to 50%. The study, published last month in the journal Nature Aging, is a meta-analysis that compiles evidence from multiple studies conducted around the world over the past couple of decades.
Researchers have not yet established a causal link between the rising rates of dementia and behavioral changes in older adults, but it makes sense to think that such links will be discovered. We know that all forms of dementia involve a loss of neural connections, and we also know that neural pathways are both formed and enhanced when having new experiences or learning new skills. This happens most readily and predictably within social contexts.
Furthermore, there is a marked correlation between the rising rates of dementia throughout the world with the loss of social infrastructure. People of all ages have fewer friends, fewer acquaintances and fewer interactions with strangers than those of the same age several decades ago.
If a new drug had just been discovered that promised to cut one’s odds of getting dementia by up to half, people would be clamoring for it. But we aren’t talking about a new drug here. We aren’t talking about something that has to be thoroughly tested in clinical trials and approved by the FDA. We are talking about spending more time in the company of other people, something that has a multitude of well-established physical and emotional benefits.
It is time to start thinking about social engagement as a public health matter. And this means taking a close look at why people today interact with one another so much less than previous generations did.
I see three reasons for this decline: loss of opportunity, loss of practical knowledge and loss of desire.
One reason social interaction has declined so much in the last few decades is because we have designed our cities and towns to be increasingly efficient, which has usually meant eliminating chance encounters which take up valuable time. We need to look at revising zoning laws to encourage placing small businesses in neighborhoods. We should build more socially connected housing and invest more in public transportation.
Another reason social interaction has declined is that we have lost much of the collected wisdom of previous generations about how to engage with others. Many people simply do not know how to make friends anymore. Firms that provide financial advice might consider supplementing their services with social advisers, specialists who can help clients invest wisely in the kinds of activities and relationships that pay dividends in later life, so that when a crisis comes, they have a reservoir of friendship upon which to draw. A person who is retire to might be counseled to seek out a part-time job that allows them to spend a few hours every day in the company of others.
The final reason for the reduction in social interaction might be the most significant and also the hardest to overcome. We have become a society that increasingly sees other people as obstacles to getting what we want out of life. Marriage rates and family size are declining. Membership in organizations of all kinds, from churches to service clubs, is going down. Use of the word “intruder” has doubled over the past 20 years.
What is needed is a complete reappraisal of what is important in life. It might mean thinking about one’s primary identity not in terms of profession, politics, gender or race, but in terms of community membership. This would also mean thinking about “community” not as an abstract collection of people with similar interests, backgrounds or goals, but as the group of people among whom I live, who depend on me and upon whom I depend. It would mean thinking about the people around me not as burdens to endure or obstacles getting in the way of my personal goals but as blessings.
A few days ago, I was having coffee with an old acquaintance I hadn’t seen for a long time. I knew his wife had been diagnosed with Alzheimer’s and that he had been caring for her for several years. He said he had been feeling overwhelmed, questioning why life had burdened him with such hardship. He was sitting in church on a Sunday morning, listening to a sermon, when it occurred to him that he is now fulfilling a promise he had made over 50 years ago. Suddenly he felt filled with light, and what had been a burden became a blessing.
Increasing our social engagement means committing ourselves to meaningful relationships, and that requires a willingness to give up a portion of our personal autonomy for a long-term, greater good. Whatever the relationship is — whether spouse, parent, friend, family member or neighbor — what is required is a willingness to sacrifice. Blessings and burdens go hand in hand. You just can’t have one without the other.
Structuring our lives upon the quality of the relationships that keep us connected is not just important for preventing dementia later in life, it is important for the quality of our lives in general.
