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Can you count on anyone to listen to you when you need to talk? If so, your brain might be more resilient in the face of any future age- or disease-related changes, according to a study published Monday in the journal JAMA Network Open.
Among senior adults, prior studies have associated greater social network size with higher levels of cognitive function before death than would be expected, given the number of signs of Alzheimer's disease and related disorders in participants' brains at autopsies, the current study's authors wrote.
Cognitive function refers to a person's mental capacity for learning, thinking, reasoning, problem-solving, decision-making, remembering and paying attention.
Other studies have found adults with these signs don't always develop dementia later in life. Experts have named this mysterious ability to remain cognitively unscathed despite age- or disease-related changes in the brain as "cognitive resilience."
"There's many different forms of support, and it's not consistently recorded across different ways of assessing social support. And oftentimes, it's because it's all put into an aggregate score," said the lead study author Dr. Joel Salinas, the Lulu P. and David J. Levidow assistant professor of neurology at New York University's Grossman School of Medicine.
"When we look at how social support seems to promote better health in general, be it physical or mental health, I've always kind of wondered what is it specifically about social support?" he added. "It's important to know if there's a specific form of social support that can improve our health, because then that helps to inform more targeted interventions."
To answer this question, the authors analyzed data from 2,171 adults who were 45 or older, predominantly White and hadn't had dementia or a stroke. Participants reported how available five types of social support were in their lives based on five questions: Can you count on anyone to listen to you when you need to talk? Is there someone available to give you good advice about a problem? Is there someone available to you who shows you love and affection? Can you count on anyone to provide you with emotional support? Lastly, do you have as much contact as you would like with someone you feel close to, someone in whom you can trust and confide?
The authors measured depressive symptoms and educational attainment, too. Around nine months later, participants underwent brain MRIs and neuropsychological tests that measured cognitive abilities.
For every unit of decrease in brain volume, participants who were in their 40s or 50s and had low listener availability had a cognitive age that was four years older than adults with high listener availability, the authors found. In contrast, among adults with high listener availability, the same amount of brain volume decline was linked with only 0.25 years of cognitive aging. The authors didn't find these associations among adults 65 and older.
"The literature has suggested for decades now that socialization is an important protective and improvement factor for memory and cognition," said Dr. Glen R. Finney, a fellow of the American Academy of Neurology, who wasn't involved in the study.
The new study "makes it even more important to ensure that people have a strong network of support with people they can interact with who will listen to them," Finney, a professor of neurology at Geisinger Commonwealth School of Medicine in Pennsylvania, added via email. "If they don't, or there is a reduction in options for someone to 'lend an ear,' that may be a risk for their brain health."
Having a listener available might help strengthen parts of the brain that contribute to maintaining cognitive function and minimize any health- or age-related damage, Salinas said -- such as stress hormones or vascular diseases. "That may be more influenced at an earlier stage," Salinas said. "This may suggest that the earlier in our life that we look to improve listener availability, the greater the likelihood it will have an impact down the road."
Although the link between high listener availability and cognitive resilience was found among adults younger than 65, older adults haven't run out of time to bring that form of social support into their lives to aid brain health.
"If anything, it just means that you should probably act now rather than later, to try and get as much benefit as you can from it. The benefits of having a good listener in your life go way beyond just brain health," he said. But the study helps highlight the cognitive benefits, Salinas added, which can have a profound impact on adults' abilities to maintain independence, function well, interact with their loved ones and do things they love to do in their day-to-day lives for much longer than otherwise.
Why having a good listener could be more powerful than other forms of social support is a question that still needs figuring out, Salinas said -- as are the nuances regarding whether someone listens over the phone or in person, how often and how long the person listens, and whether just knowing someone is there for you is the key.
Seeing "this kind of work repeated in a wider, more diverse population to make sure that the results hold up and are generalizable to all people" is also important, Finney said.
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