The effect of social engagement on incident dementia: the Honolulu-Asia Aging Study

UMMS Affiliation

Department of Medicine, Division of Geriatric Medicine; Department of Quantitative Health Sciences; Meyers Primary Care Institute

Publication Date


Document Type



Aged; Aging; Asian Americans; Confidence Intervals; Dementia; Family; Follow-Up Studies; Hawaii; Humans; Incidence; *Interpersonal Relations; Japan; Male; Middle Aged; Retrospective Studies; Risk Factors; *Social Behavior


Biostatistics | Epidemiology | Geriatrics | Health Services Research | Mental and Social Health


The authors examined whether low levels of social engagement in midlife and late life were associated with the risk of incident dementia in 2,513 Japanese-American men who have been followed since 1965 as part of the Honolulu Heart Program and the Honolulu-Asia Aging Study. In 1991, assessment of dementia began; incident dementia cases (n = 222) were diagnosed in 1994 and 1997. Social engagement was assessed in midlife (1968) and late life (1991). The relation between social engagement and dementia risk was examined using Cox proportional hazards models. No level of midlife social engagement was associated with the risk of dementia. In late life, compared with participants in the highest quartile of late-life social engagement, those in the lowest quartile had a significantly increased risk of dementia (hazard ratio = 2.34, 95% confidence interval: 1.18, 4.65). However, compared with those who were in the highest quartile of social engagement at both midlife and late life, only decreased social engagement from midlife to late life was associated with an increased risk of dementia (hazard ratio = 1.87, 95% confidence interval: 1.12, 3.13). Although low social engagement in late life is associated with risk of dementia, levels of late-life social engagement may already have been modified by the dementing process and may be associated with prodromal dementia.

DOI of Published Version



Am J Epidemiol. 2006 Mar 1;163(5):433-40. Epub 2006 Jan 12. Link to article on publisher's site

Journal/Book/Conference Title

American journal of epidemiology

PubMed ID


Related Resources

Link to Article in PubMed