Review 1 Mention
What Do We Know about Social and Non-Social Factors Influencing the Pathway from Cognitive Health to Dementia? A Systematic Review of Reviews
Marta Lenart‐Bugla2022
Mateusz ŁucMarcin Pawłowski
Top 18% · 82nd Percentile
34 citations · Psychiatry and Mental health
Open AccessSocial Health And Reserve in the Dementia patient journey (SHARED)SHARED - Soziale Gesundheit und kognitive Reserven im Verlauf demenzieller BeeinträchtigungenSocial Health and Reserve in the Dementia Patient Journey

TLDR

Memory and thinking are shaped by many parts of life, including physical health, daily habits, mood, education, and relationships. Staying active, eating well, and maintaining supportive connections may help, but the evidence about social relationships is still mixed.

Summary

1 Study Aim

The authors aimed to map factors linked with cognitive health (how well a person thinks and remembers), cognitive decline, and dementia. They especially examined social factors and sought gaps for prevention research. The study also aimed to support an integrated framework combining physical, psychological, and social health. The study examined which parts of life may influence thinking and memory as people age.

2 Study Design

This systematic review of reviews (a structured summary of existing evidence summaries) covered systematic reviews and meta-analyses (studies combining results statistically) published from 2009 to 2021. Two reviewers independently searched Medline, PsycINFO, CINAHL Complete, Cochrane, and Epistemonikos. They screened records, resolved disagreements through discussion, and followed PRISMA 2020 (standard reporting guidance). They included 314 reviews involving adults aged 18 and older. The team grouped reported factors into seven categories and assessed review quality with AMSTAR (a checklist for judging review methods). The researchers combined findings from many earlier studies rather than testing participants directly.

3 Findings

The study identified 624 cognitive-related factors. Risk factors represented 61.2%, while protective factors represented 20%. Somatic comorbidities (coexisting physical illnesses), especially diabetes and cardiovascular disease, and genetic predispositions dominated. Lifestyle protections included the Mediterranean diet, physical activity, and cognitively stimulating activities (mentally challenging activities). Social factors represented 9.6%. Greater support, frequent contact, social participation, and larger networks sometimes related to lower dementia risk, but results were inconsistent. Overall, 81.3% of reports showed significant associations, while 14.3% were unclear. The authors recommend more longitudinal research across the life course, especially on social health, cognitive reserve (the ability to cope with brain changes), lifestyle, and positive psychological factors. Many health habits and relationships may matter, but stronger long-term research is needed before firm advice can be given.

Abstract

The heterogeneous and multi-factorial nature of dementia requires the consideration of all health aspects when predicting the risk of its development and planning strategies for its prevention. This systematic review of reviews provides a comprehensive synthesis of those factors associated with cognition in the context of dementia, identifying the role of social aspects and evidencing knowledge gaps in this area of research. Systematic reviews and meta-analyses from 2009-2021 were searched for within Medline, PsycINFO, CINAHL Complete, Cochrane, and Epistemonikos. Reviewers independently screened, reviewed, and assessed the records, following the PRISMA-2020 guidelines. From 314 included studies, 624 cognitive-related factors were identified, most of them risk factors (61.2%), mainly belonging to the group of 'somatic comorbidities' (cardiovascular disease and diabetes) and 'genetic predispositions'. The protective factors (20%) were mainly related to lifestyle, pointing to the Mediterranean diet, regular physical activity, and cognitively stimulating activities. Social factors constituted 9.6% of all identified factors. Research on biological and medical factors dominates the reviewed literature. Greater social support and frequent contact may confer some protection against cognitive decline and dementia by delaying its onset or reducing the overall risk; however, overall, our findings are inconsistent. Further research is needed in the fields of lifestyle, psychology, social health, and the protective factors against cognitive decline and dementia.

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