Can Social Engagement Prevent Cognitive Decline in Old Age?

• Cognition disorders
• Aged
• Social support
• Social isolation
• Dementia

Is being alone in old age common? Death of a spouse or friends and preoccupation with life among one's children seem likely tolead to a shrinking of a person's primary social network. These events have health consequences; for example, greater mortality rates among bereaved spouses have often been reported (1). We may not recognize the adaptive abilities of older persons. In old age, the nature of social contact and interaction changes in old age: It may expand to include non family members, may be more formalized because of involvement of organizations, and may be freer and more fluid because of fewer obligations. van Tilburg (2) reported that social networks in older persons remained stable over time. However, frequency of contact decreased and instrumental and emotional support increased. Such changes are consistent with increases in functional disability that could prevent an elderly person from traveling (even within his or her town) but permit material and emotional support in the face of illness or other distress. Our need for social contact and involvement is built into our biology. Social withdrawal—as a consequence of disease or of decimation of a person's network of friends, family, and social circles—may be a pathologic state and not a common one.

In this issue, Bassuk and colleagues (3) report modest associations between social ties and cognitive decline that persisted after adjustment for such covariates as ill health, activities of daily living, socioeconomic status, …