Journal Article 1 Mention
Recognition of social health: A conceptual framework in the context of dementia research
Myrra Vernooij‐Dassen2022
Eline VerspoorSuraj Samtani
Top 4% · 96th Percentile
41 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

People’s relationships, social opportunities, and support may help protect thinking abilities as they age. Understanding these factors could improve efforts to prevent or delay dementia.

Summary

1 Study Aim

The authors aimed to develop a conceptual framework for social health (wellbeing shaped by a person’s abilities and social surroundings) in dementia research. They hypothesized that social health helps people use cognitive reserve (the brain’s ability to maintain thinking despite damage), which may slow cognitive decline or preserve functioning. The study seeks to clarify how social conditions and personal abilities may influence thinking and dementia risk.

2 Study Design

The authors synthesized theories, concepts, and epidemiological evidence (research examining health patterns across populations). An international, multidisciplinary team developed the framework through repeated discussion and consensus within the Social Health And Reserve in the Dementia patient journey (SHARED) project. The team included 11 framework specialists and consortium members from six countries and several disciplines. They tested feasibility by applying the framework to a review of 314 studies, databases from five and 13 longitudinal cohort studies, and a Group Model Building study (a method for building models with experts). They also used it to organize measures and guide qualitative research. The researchers built and tested a shared organizing system rather than conducting a new clinical experiment.

3 Findings

The study defines social health as wellbeing that depends on both individual abilities and the social environment. Individual domains include fulfilling social obligations, managing life with some independence, and participating in social activities. Environmental domains include social network structure, social support and exchanges, and perceived relationship quality. The authors propose that social health stimulates cognitive reserve, potentially slowing impairment, but existing associations cannot establish causation. Applying the framework identified markers across SHARED studies and exposed gaps, especially in individual-level data. The authors recommend broader, validated measurement, culturally diverse research, and tailored preventive interventions addressing modifiable social risks and protective factors. People’s abilities and surroundings both matter, so future dementia research should measure social life more fully.

Abstract

Objective: The recognition of dementia as a multifactorial disorder encourages the exploration of new pathways to understand its origins. Social health might play a role in cognitive decline and dementia, but conceptual clarity is lacking and this hinders investigation of associations and mechanisms. The objective is to develop a conceptual framework for social health to advance conceptual clarity in future studies. Process: We use the following steps: underpinning for concept advancement, concept advancement by the development of a conceptual model, and exploration of its potential feasibility. An iterative consensus-based process was used within the international multidisciplinary SHARED project. Conceptual framework: Underpinning of the concept drew from a synthesis of theoretical, conceptual and epidemiological work, and resulted in a definition of social health as wellbeing that relies on capacities both of the individual and the social environment. Consequently, domains in the conceptual framework are on both the individual (e.g., social participation) and the social environmental levels (e.g., social network). We hypothesize that social health acts as a driver for use of cognitive reserve which can then slow cognitive impairment or maintain cognitive functioning. The feasibility of the conceptual framework is demonstrated in its practical use in identifying and structuring of social health markers within the SHARED project. Discussion: The conceptual framework provides guidance for future research and facilitates identification of modifiable risk and protective factors, which may in turn shape new avenues for preventive interventions. We highlight the paradigm of social health in dementia as a priority for dementia research.

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