The long-held belief that social isolation is one of the key risk factors, and also an early symptom of Alzheimer's disease, has been challenged by the latest scientific findings. Paradoxically, it seems that increased social activity, not withdrawal, may be one of the first, very subtle indicators that changes associated with this neurodegenerative disease are occurring in the brain. One extensive study, which analyzed data from several hundred thousand individuals, points to a complex relationship between our genes, social behavior, and the risk of Alzheimer's, opening a completely new chapter in understanding this disease.

A revolutionary discovery changes the perception of the disease

Scientists delved into the genetic data and social habits of a huge sample of nearly half a million Britons, with an average age of 56. The results surprised the researchers themselves. It turned out that individuals with a heightened genetic risk for developing Alzheimer's disease, in the life stage when symptoms had not yet clinically manifested, reported less feeling of isolation. Moreover, they participated in a wider spectrum of social activities and described their family relationships as happier compared to individuals with a lower genetic risk.

What is further intriguing is that no significant differences were found between these two groups when it came to feelings of loneliness, the quality of friendships, or perceived emotional support. It seems that in the earliest, so-called prodromal stages, the disease does not encourage people to socially withdraw. On the contrary, their social lives may even become richer and more fulfilling, which is in complete contrast to previous clinical experiences with patients in later stages of the disease.

Possible explanations for the unexpected phenomenon

The key question arises: why would an increased risk of a disease that destroys cognitive functions lead to a more intense social life? The scientific community offers two possible explanations that are not mutually exclusive. The first hypothesis suggests that individuals, on some subconscious level, feel early and subtle changes in their own functioning and compensatorily increase interaction with others as a kind of instinctive coping mechanism. Increased socialization could be the brain's attempt to resist the upcoming changes.

The second, equally compelling theory, focuses on the environment. It is possible that family and close friends notice tiny, barely perceptible changes in the person's behavior, speech, or orientation – changes that the person themself is not aware of. In response, they increase their support, invite the person to gatherings more often, and give them more attention, resulting in an objectively richer social life. In this scenario, the expanded social circle is not the initiative of the individual at risk, but a reaction of their immediate environment to the first, almost invisible signals of the disease.

Cognitive reserve and the role of social connections

For years, the importance of creating a so-called cognitive reserve has been emphasized as a key defense mechanism against dementia. Cognitive reserve represents the brain's ability to resist damage and maintain normal functioning despite aging or pathological processes like those in Alzheimer's disease. It is believed that this reserve is built through education, mentally challenging activities, and, of course, through rich social interactions. Social connection stimulates the brain, creates new synapses, and strengthens existing neural networks, thereby delaying the onset of clinical symptoms of dementia.

The new findings do not negate the protective role of social connection. However, they indicate that the relationship between social life and Alzheimer's disease is bidirectional and significantly more complex than previously thought. While an active social life undoubtedly helps build brain resilience, the disease itself in its earliest stage can, it seems, paradoxically trigger behaviors that lead to greater social engagement.

Genes are not the only culprit: Factors we can influence

Although genetics plays a certain role, it is important to emphasize that it is not decisive. It is estimated that approximately one-third of all cases of Alzheimer's disease can be attributed to so-called modifiable risk factors. These are aspects of our lifestyle and health that we can directly influence and thus significantly reduce our risk or at least delay the onset of the disease. These factors include:

• Physical inactivity: Regular exercise promotes circulation in the brain, reduces inflammatory processes, and encourages the growth of new nerve cells.


• Uncontrolled diabetes: High blood sugar levels damage blood vessels, including those in the brain, and can contribute to the accumulation of harmful proteins.


• High blood pressure: Hypertension in middle age significantly increases the risk of dementia in later years because it damages the delicate network of capillaries in the brain.


• Poor sleep quality: During deep sleep, the brain cleanses itself of toxins, including beta-amyloid, the protein that forms the plaques characteristic of Alzheimer's disease. Chronic sleep deprivation disrupts this key process.


• Depression: Although the link is not fully understood, chronic depression is associated with inflammatory conditions and changes in brain structure that can increase susceptibility to dementia.


• Smoking: Smoking damages blood vessels and introduces numerous toxins into the body, increasing oxidative stress that harms brain cells.


• Certain medications: Long-term use of some drugs, such as certain types of anxiolytics and anticholinergics, is associated with an increased risk.

Recognizing the earliest signs: More than forgetfulness

Focusing on changes in social life is useful, but it is also important to know other early signs of Alzheimer's disease that are often overlooked or attributed to normal aging. Classic forgetfulness, especially concerning recent events, remains a key symptom. But there are also more subtle indicators:

• Difficulty in planning and problem-solving: Problems with following recipes, managing household finances, or completing tasks that require multiple steps.


• Problems with performing familiar tasks: A person may have difficulty going to a familiar place, remembering the rules of a favorite game, or using household appliances.


• Confusion with time and place: Losing track of dates, seasons, and the passage of time. Sometimes a person may forget where they are or how they got there.


• New problems with words in speech or writing: Difficulty following or joining a conversation, stopping in the middle of a sentence, or struggling to find the right word (e.g., "that thing for writing" instead of "pen").


• Misplacing things: Frequently losing items and being unable to retrace steps to find them, sometimes accusing others of stealing.


• Changes in mood and personality: People may become confused, suspicious, depressed, fearful, or anxious. They can get easily upset, both at home and outside of a familiar environment.

Understanding that Alzheimer's disease can begin with an unexpected expansion of one's social circle, and not just with withdrawal, provides a new, more complex picture of this disease. This emphasizes the importance of paying attention to all changes in the behavior and habits of our loved ones, even those that seem positive at first glance.

Source: University of California