Social networks for older adults with and without Alzheimer’s disease in Wakiso District; A comparative cross- sectional study

Abstract

Background: Alzheimer's disease (AD) is the commonest cause of dementia with one case diagnosed every 4 seconds translating to about 10 million new cases per year globally. The majority of these cases live in Low and Middle Income Countries like Uganda. Small social networks have been associated with dementia in a number of studies. However, there is a huge knowledge gap about social networks for older adults in our setting. Objective: To compare social networks for older adults with and without Alzheimer's disease in Wakiso District, central Uganda. Methodology: This was a community cross-sectional study carried out in 23 villages of Wakiso District. Older adults aged ≥60 years were enrolled and assessed for cognitive impairment using the Mini Mental State Exam, a cut off of <24. A psychiatrist diagnosis of Alzheimer’s disease was confirmed based on the Diagnostic and Statistical Manual-5. Social network characteristics were determined with the Lubben Social Network Scale (LSNS-R), total score of 60 with a cut off <24, for poor social networks. We compared AD and non-AD groups using bivariate and multivariable analysis with statistical significance set at p<0.05. Results: A total of 208 participants were enrolled. There were 64 participants diagnosed with AD compared to 144 participants without AD. The mean (SD) age in the AD and non-AD groups was 78.8 (9.8) and 72.8 (8.2) respectively; AOR; 4.39 (1.42-13.56) p<0.01. Half of the participants 32 (50.0%) in AD group were >80 years, versus a quarter 38 (26.4%) in the non-AD group. Poor social networks were worse in the AD group at 25(39.1%) compared to 40 (27.8%) in non-AD group, though this was not statistically significant. Participants with AD were contacted less by their relatives before making decisions; AOR; 6.22(1.12-4.14) p=0.049. Conclusion: The social networks were poorer among older adults in the AD group, though there was no statistical difference with the social networks in the non AD group in this study. Older adults with AD were less frequently contacted by relatives for decision making. We recommend community activities for older persons to improve social interaction and supporting shared decision making for older adults with AD and their caregivers.