Электронный научный журнал

In the context of global population aging, the prevention of cognitive impairment in older adults, including the oldest-old, is becoming increasingly important. Along with traditional risk factors, growing attention is being paid to the role of social connections; however, the evidence on their association with cognitive decline is inconsistent, and Russian-language publications remain limited, which necessitates further comprehensive study of the social determinants of cognitive health and an assessment of the potential for incorporating them into geriatric prevention programs. The aim of this review was to examine current evidence on the role of social connections in shaping cognitive status in older adults, to identify the underlying mechanisms, and to evaluate the prospects of incorporating the assessment of social connections into geriatric prevention of cognitive impairment. The literature analysis confirms an association between social connections and cognitive functioning in old and very old age: a deficit of social connections is associated with a 26–58% increase in dementia risk, as well as with decline in memory, verbal fluency, and overall cognitive functioning. The proposed mechanisms include chronic activation of the hypothalamic–pituitary–adrenal axis, systemic inflammation, insufficient cognitive stimulation, depletion of cognitive reserve, and behavioral factors. A reverse effect is also possible: cognitive decline narrows one's social network, thereby aggravating cognitive deficit. These findings justify the systematic assessment of social connections within comprehensive geriatric assessment, early detection of impairments in social connections, and the development of social support programs combined with the correction of somatic risk factors. Social connections represent a significant component of cognitive health preservation in old and very old age: their impairment increases the risk of cognitive disorders and requires timely detection and correction. Given the inconsistency of the available evidence and the insufficient study of this problem in Russian practice, it is advisable to incorporate standardized screening for impaired social connections into comprehensive geriatric assessment as a basis for the prevention of cognitive impairment and the preservation of quality of life in older adults.