Social Connection, Social Frailty and Dementia Risk

Can staying socially connected help protect your brain? In this episode, we unpack research linking “social frailty” — including reduced social contact and participation — with dementia risk. With help from Dr Hannah Fair, Lecturer at Wicking Dementia Research and Education Centre, we explore what the study found, how it was conducted, and why it’s considered strong evidence. The focus isn’t just on the results, but on how to recognise high‑quality research and what these findings mean in real life.

Based on the articles:

• Weaker social ties are linked to an increased dementia risk
• Chris Hemsworth's new show explores how socialising protects the brain | body+soul

Listener Reflection Questions

1. What features of this study made it feel more — or less — convincing compared to the research in previous episodes?
2. How is “social frailty” different from simply feeling lonely, and why might that distinction matter?
3. What signs will you now look for when deciding whether a study is strong or reliable?

Brought to you by the ISLAND Project and Wicking Dementia Research and Education Centre at the University of Tasmania. To continue the discussion and for more information visit https://island.mooc.utas.edu.au or email island@dementia.uas.edu.au

Transcript

Speaker 1: 00:00 

Neil Broomfield: 

Welcome back to Brain Matters, the podcast where we take a closer look at headlines and discuss what the research actually says. I'm Neil Broomfield recording on Palawa land. Today's episode is based on a couple of articles that take a slightly different approach to brain health, this time focusing on social connection. You might have seen headlines suggesting that staying socially engaged could help protect your brain as you age. Well, can staying socially connected help protect your brain? In this episode, we discuss a research study linking so-called social frailty, which includes reduced social contact and participation with dementia risk. Here we explore what the study found, how it was conducted, and why it's considered strong evidence. So, what's behind that idea, and how strong is the evidence? To help unpack it, I'm joined by Dr. Hannah Fair, who's a lecturer at the Wicking Dementia Centre and has a particular interest in social networks and dementia risk. Thanks for being here, Hannah.  

Hannah Fair: 

It's a pleasure to join you, Neil.  

Neil Broomfield: 

Before we take a look at the research in question, can you tell us a little more about socializing for dementia risk? 

Speaker 1: 01:10 

Hannah Fair:  

I sure can. Socializing for dementia risk is the part of dementia risk that I am most interested in and that I focus a lot of my research around. When we talk about dementia risk, as you heard from James in the last episode, there's a bit of non-modifiable dementia risk. So that's things like our genetics, our age, our biological sex, those sorts of things make up our non-modifiable dementia risk. On the other hand, about 45% of our cases of dementia are thought to be linked to these modifiable dementia risk factors. And so, what that means, is that if we could completely eliminate all of the identified modifiable risk factors, and at the moment that's a list of about 14 factors, we would expect to see 45% less people across society develop dementia. 

Speaker: 01:56 

Neil Broomfield:  

Do you want to go through those 14 factors, or shall we just keep this general for the moment? 

Speaker 1: 02:01 

Hannah Fair: 

I can't rattle off all 14 off the top of my head, but I'm sure you'll come back to many of them in following episodes. But I can tell you that overall, we've got early life education, and that's our only risk factor that starts to impact people from those sort of earliest years of life. And then through midlife, we have a cluster of cardiovascular-related risk factors, along with some of our exposure to toxins, things like smoking and alcohol consumption. And then as we enter later life, again, we have those toxin exposure-related risk factors, things like air pollution really come into play in later life, and socializing. And socializing, when someone has the Livingston paper, this group of researchers have mapped out how much dementia risk is attributable to each of these different modifiable lifestyle factors, socializing actually rises to the top as the risk factor that has the most percentage of dementia cases linked to it. And that sits at 5%. So, if there was no social isolation for any adult in later life, we would expect to see 5% less people develop dementia. Which is quite remarkable at the population level. But we've got to remember, and this is borrowing from our senior Australian of the year, Henry Brodaty, we've got to remember that 55% of people will still develop dementia, no matter what lifestyle they live. And so when we're talking about these modifiable risk factors, it's important not to think that that means someone who develops dementia is at fault for developing dementia, because for a lot of people, it was happening based on genetics and aging and other factors that we're not yet aware of or can't actually control. 

Speaker: 03:33 

Neil Broomfield: 

Nothing to blame yourself for. 

Speaker 1: 03:35 

Hannah Fair: 

Yes, nothing to blame yourself for. 

Speaker: 03:37 

Neil Broomfield: 

Right. Hannah, I'm intrigued. Why do you think then it is, that socializing or not socializing has an effect on your risk of developing dementia? 

Speaker 1: 03:47 

Hannah Fair: 

Yeah, that's a great question, Neil. And there's a few theories as to why this might be the case. Probably the most prominent theory is that when you socialize, that uses your brain. And there's that use it or lose it theory, where if you're using your brain more through all different forms of cognitive activity, and socializing is considered one of those, that's really good for your brain and helps preserve your brain into older life and reduces your risk of developing dementia. The other theory is that socializing is really good for reducing our stress, and having lower stress is really good for reducing our dementia risk. It makes us more resilient to a whole lot of different biological and psychosocial stresses. So for many of us, socializing is a great stress reducer, and that's good for our dementia risk. There's a third theory which has way less attention, but is a theory that I think is quite interesting, and that is, that it's not so much how much we socialize, but who we socialize with, that might matter. Because the way our friends behave, impacts the way we behave. So, if we're socializing with people who encourage us to behave in ways that reduce our dementia risk, well, that's going to be really good for not developing dementia, isn't it? 

Speaker: 04:51 

Neil Broomfield: 

 I suppose it is, but one doesn't pick one's friends from those sorts of criteria, does one? 

Speaker 1: 04:57 

Hannah Fair: 

No, one does not. And so that's why it's a really interesting theory. And these are all in the theoretical space. None of these have been proven. And that final one is the one with less support. But it does stand to reason that if we socialize a lot with people who behave healthier, we are probably more likely to behave healthier ourselves. 

Speaker: 05:14 

Neil Broomfield: 

Gosh, Hannah, you've got a lot more work to do, haven't you?  

Hannah Fair: I do.  

Neil Broomfield: 

Well, thank you very much for clarifying all of that. Now, both of the articles we're looking at today are based on a study exploring something called social frailty. That's probably not a term that many people hear every day. Would you mind starting by explaining what it actually means? 

Speaker 1: 05:35 

Hannah Fair: 

I would love to. So social frailty, well, when we think about socializing, we normally think about what we enjoy doing. We might think about the number of people we see, the kinds of experiences we go out and do with our friends. We might think about how lonely we feel. And so those are all different ways of measuring social engagement. And what social frailty tries to do is bring all of those different ways we think about socializing together into one measure. In the dementia risk space, we see a lot of studies looking at one form of social isolation. Maybe they're counting the number of family members you engage with. Maybe they're measuring how many people you have in your life who you could discuss important matters with. Maybe they're measuring loneliness. But it's less common to see someone who brings all of those different social factors together into one measure. And that's what social frailty tries to capture. But there is one other element of social frailty that I think is important to mention too. When we define social frailty, the researchers behind this particular paper that we're looking at actually give us a definition, which is really helpful. They say that social frailty is characterized by vulnerability to losing resources that are important to fulfill basic social needs. So, on top of our set of social isolation and loneliness measures, they also include education level as one of their predictors of social frailty and a lack of financial resources, so a lack of comfortableness with your financial situation, which are two things that we might not generally think of as part of our social world. But when we think about our social world more broadly, it encompasses something called our socioeconomic status, which is our level of advantage and disadvantage across a range of indicators. And again, I have a definition here for you. According to the Australian Bureau of Statistics, socioeconomic status can be defined as people's access to material and social resources and their ability to participate in society. When you think about that, it does link into our socializing and how well we participate, how much we see people, how lonely we feel. And this is often measured by using a combination of income, education, employment, occupation and housing characteristics. These also come into our social frailty measures. 

Speaker: 07:50 

Neil Broomfield: 

Your clarity of explanation there is so helpful. It really throws up the difference between loneliness and social isolation, I think, doesn't it? 

Speaker 1: 07:58 

Hannah Fair: 

Yeah. Some people don't socialize much at all, and we might view them as having a small social network, we might measure them as fairly socially isolated, but they don't feel lonely. Those are two distinct, but we think, related parts of socializing for dementia risk. And frailty is a beautiful measure because it captures both of those together.  

Neil Broomfield: 

Right. 

Speaker: 08:17 

I guess that then in simple terms, it's about things like how often we see other people, whether we feel supported, and whether we're able to take part in social activities. 

Speaker 1: 08:27 

Hannah Fair: 

Yes, and that taking part in social activities includes that broader set of socioeconomic circumstances. 

Speaker: 08:33 

Neil Broomfield: 

So now let's look at what did the study do. The articles are based on a single study that followed around 850 older adults over more than a decade, investigating whether social frailty predicted who went on to develop dementia. From your perspective, Hannah, what stands out about how this study was designed? 

Speaker 1: 08:56 

Hannah Fair: 

Yeah, the thing that stands out most about this study design, is that they have longitudinal data, so they followed people for between two and 12 years, and they have measures of cognition both at baseline, when people enrolled in the study, and at least one follow-up time point to include someone in this little analysis. And that's really nice because often when we're studying dementia risk factors, we're looking at changes in a behaviour relating to dementia risk, rather than actual changes in the number of people who go on to develop dementia. And this study is really nice, in that they have studied that change in developing dementia. They also looked at quite an older group of adults, so people between the age of 70 and 90, which means that a fair few of those people, based on their age alone, did go on to develop dementia in the course of this study. They had 260 of their 850 participants who developed dementia, and that gives us a large enough sample to actually start to understand what was different about that group who got dementia, versus the group who didn't. And that's really nice and not something we always see in research. Sometimes we have such a small group of people who develop dementia that it's really hard to make any claims about what might predict that. 

Speaker: 10:07 

Neil Broomfield:  

You're using the word nice here in the sense of it being precise, are you, really, rather than pleasant? 

Speaker 1: 10:14 

Hannah Fair:  

Yeah, I am using it in the sense of being  precise, being able to make a genuine research claim. 

Speaker: 10:18 

Neil Broomfield: 

 Indeed so. Good. Thank you. 

Speaker 1: 10:20 

Hannah Fair: 

The other thing that I really like about this study, is that it uses some really thorough statistical methods. It does a few things that I think are really powerful. It has a sensitivity analysis, which is examining whether the decisions that the research team has made, that are in some ways a little bit arbitrary, they're seeing if they change that decision, do they still find the same result? And that's a really nice way of validating, again, nice in the terms of precise, that's a really nice way of just showing that the finding that they are putting forward is not because of the somewhat arbitrary decisions they've made, like what number on a frailty scale means that someone is socially frail. They're doing a sensitivity analysis and seeing if they change the number that they set as the cut point for social frailty, do they still find the same things? And by and large they did. And that's a really nice thing that the study does to make sure that what they're presenting isn't an artifact of their methods, but is actually a real finding. 

Speaker: 11:16 

Neil Broomfield: 

So there are a multiple number of measures that you take into account when you're assessing this. 

Speaker 1: 11:22 

Hannah Fair:  

There's a lot of different ways of assessing social frailty. And this particular research team, we've already covered a little bit of this, but this particular research team is looking at, let me count one, two, three, four, five, six, seven, eight, nine, ten, eleven potential different measures of social frailty. 

Speaker: 11:42 

Neil Broomfield: 

That's a pretty broad number, isn't it? 

Hannah Fair: 

Yes, it is. 

Speaker 1: 11:46 

That list includes engagement in activities, going out, volunteering, being a part of interest groups, your social network size, whether or not you're lonely, whether how frequently you have access to social support, your perception of your self-worth, whether you live alone or whether you live with others, how often you see other people face to face, how satisfied you feel with your relationships, whether or not you're employed, because employment gives people access to a whole range of social settings. I wouldn't be sitting here with you today, Neil, if I was not employed in my job. That's another way of accessing social resources. Whether people are satisfied with the neighbourhood they live in. That's starting to get at socioeconomic status kind of indicators. Along with that, we have people's financial situation, how satisfied they are with their finances, and people's educational attainments.  

Speaker: 12:40 

Neil Broomfield: 

You've covered an awful lot of ground here, Hannah. Would you mind if I try and encapsulate this, so that we can just try and find out where we are? At a high level, then, the study found that people who were more socially frail had a higher risk of developing dementia over time.  

Hannah Fair: 

 Absolutely.  

Neil Broomfield: 

Some specific factors included things like less frequent social contact, lower satisfaction with relationships, and less engagement in social activities. Do you think that captures it pretty well? 

Speaker 1: 13:10 

Hannah Fair: 

Yeah, those are definitely some of the findings of this paper. Though I would draw your attention back to the financial situation one. When they started to pick apart which of these variables mattered most, they actually found that it was that financial situation, that mattered a lot more than any of our other measures of loneliness or social isolation, in this particular frailty measure. 

Speaker: 13:32 

Neil Broomfield: 

That's a very interesting measure, because how much wealth, if you like, that you have and what's important to you varies hugely from person to person. Some people are quite happy with very little. Other people are always trying to get more. Is there a differentiation you can find in that, or is that going really off the track of what we're trying to do here? 

Speaker 1: 13:58 

Hannah Fair: 

Look, it is going beyond the scope of this study. But I would also say that there's a lot of other research that is showing that people with objectively less wealth are at higher risk of dementia. People with a lower socioeconomic status are across the board, across the world, at lowest risk, at highest risk, sorry, of developing dementia. 

Speaker: 14:19 

Neil Broomfield:  

Yeah, that kind of makes sense, doesn't it? 

Speaker 1: 14:20 

Hannah Fair: 

The other thing I'd like to say about what makes this a particularly good study is that they do a really good job of adjusting for what we call confounders. Are you familiar with confounders, Neil? 

Speaker: 14:30 

Neil Broomfield: 

 I'm not. 

Speaker 1: 14:31 

Hannah Fair: 

A confounder is something that might be causing us to see a relationship between two variables that we might be looking at a relationship that isn't as real as we think it is because something else actually is what's explaining the relationship, and that's called a confounder. What we can see is that if researchers study a particular variable, we'll use social frailty as our example, but social frailty maps closely with another variable that predicts dementia, but we're not adjusting for that variable. We could be saying that social frailty predicts dementia when actually it's just that everyone who is socially frail is much older, or they're physically frail, or they're exposed to a whole lot of other dementia risk factors. We could incorrectly make a claim that social frailty causes dementia when actually it's that social frailty lines up with all these other things that cause dementia. One of the things that's done really well in this study, is they've adjusted for all those potential confounders. They have three different analyses that adjust for a different set of potential confounders. The first analysis they present, adjusts for age and gender, because we know those are unmodifiable risk factors for dementia that contribute a lot to those incidents of dementia. Then they have an analysis that adjusts for physical frailty and for psychosocial frailty, so your psychological factors that you can also be frail on, you can also be at risk of decline in those areas. They adjust for those. Then they have a final analysis that adjusts for almost all of that set of 14 risk factors, that we were talking about earlier, to see if the social frailty matters over and above all of the other risk factors that someone has for dementia. They found that on some of their measures of social frailty, it survives all of those different adjustments. So there is something there that's unique to social frailty, and not just that people who are socially frail are also at risk in a whole lot of other risk domains. That's something that is very impressive about this study is the number of different confounders they have measured and adjusted for, to be able to make their claim that social frailty predicts the development of dementia. 

Speaker: 16:35 

Neil Broomfield:  

Right. So let's try and backtrack a bit and see if we can summarize what we've just been talking about. I think we were talking, were we not, about longitudinal design that's following people over time? We were talking about careful diagnosis of dementia and not self-reporting. 

Speaker 1: 16:52 

Hannah Fair: Yep. 

Speaker: 16:53 

Neil Broomfield:  

We were talking about adjustment for other factors such as physical and mental health. 

Speaker 1: 16:58 

Hannah Fair: Yes. 

Speaker: 16:59 

Neil Broomfield: And testing multiple ways of measuring social frailty. And so for listeners, this is a good example of what we l might look for when we're judging research quality. Is that right? 

Speaker 1: 17:11 

Hannah Fair: Yes. 

Speaker: 17:13 

Neil Broomfield:  

Well, like many other studies, this is still observational. That is, we're talking about association, not proof of cause? 

Hannah Fair : Yeah 

Neil Broomfield: 

But interestingly, the researchers did try to explore whether this relationship might be causal and found some evidence pointing in that direction. Can you explain what that means in practice? 

Speaker 1: 17:35 

Hannah Fair: 

Yeah, the researchers have looked at social frailty at one point in time and then they've looked at the development of dementia in the future. Rather than measuring them together and saying, “we see socially frail people have dementia,” they've actually gone, “you were socially frail a number of years before you develop dementia”. So that gives us some evidence that people who are socially frail might go on to develop dementia, not just they happen to have those two things at the same time. Often that's taken as good evidence that something is a causal relationship. The difficulty with dementia is that people start to have the changes in cognition that go on to lead to dementia, and particularly those changes in neurobiology, 10 to 20 years before they actually get to a point where they get diagnosed with dementia. And so the changes in social frailty that the researchers are seeing before the development of dementia could be that those social frailty changes are actually contributing to the onset of dementia, or it could be that those changes are a result of the changes in their brain that are leading to dementia. So maybe there's some changes already starting in their cognition, that aren't yet at a clinically detectable level, that are changing the way that they socialize. And it's those changes in their brain that are causing the increased dementia rate, not actually the lack of socializing. That's common in this kind of research. We know that people who live with dementia socialize less, they are more socially frail than people who don't live with dementia. It's always this chicken and the egg argument of which came first, was the brain declining and that caused a reduced socializing, or were people socializing less and that caused further decline in the brain? 

Speaker: 19:13 

Neil Broomfield: 

Now I don't want to muddy the waters of this discussion, but I think it might be interesting to reflect that another part of the research, that's going on in the Wicking Centre, does concentrate on trying to detect whether you're showing signs even 20 years before you develop dementia.  

Hannah Fair:  

Yes.  

Neil Broomfield: 

But that doesn't confuse any of this, does it? 

Speaker 1: 19:37 

Hannah Fair:  

No. We know already, there's a lot of research showing that those changes, that go on to lead to dementia, do start years and years before the dementia. And that does complicate all of our risk factor studies because, particularly things that people choose to do or not do, such as socializing, if your brain is already changing, which we know it is, that will change the way you engage in the world around you. The earlier we can tell that someone's brain is changing, the more we might be able to do to slow that decline and to help adjust things for people too. Socializing is really important, even if you are living with dementia, but you might need some extra help to socialize well as your brain starts to decline. If we already knew that someone's brain was, perhaps, not as healthy as it once was, we might be able to help them socialize in a way that works better for them. Maybe they didn't socially withdraw before they developed dementia, hopefully, even once they're living with dementia. We could support people to stay socially engaged. They are related, predicting dementia earlier and this sort of progression, and how we see risk factors change before people develop dementia, could help us intervene better to help people be less exposed to these risk factors. 

Speaker: 20:48 

Neil Broomfield: 

Which leads us rather neatly on to where the headlines often move. They move quickly to advice, don't they?  

Hannah Fair: 

They do. 

Neil Broomfield: 

Things like socialize more to prevent dementia or try reminiscence therapy. From your perspective, how should we think about applying these findings in real life? 

Speaker 1: 21:08 

Hannah Fair: 

In the socializing for dementia risk reduction space specifically, we have very little evidence that any particular intervention will change your socializing for dementia risk. We're just at the point of linking things and trying to work out which parts of socializing are linked to dementia risk, and that's where this frailty paper comes in, particularly their finding around financial situations. There's different parts of socializing that seem to be linked to dementia risk in different ways, and we're not very good, yet, at being able to see what people could change in their life to change that dementia risk. Another area of dementia risk, where we're a lot better at this, is something like hearing loss. We have strong evidence that people who experience hearing loss are at higher risk of dementia. We also have really strong evidence that people who experience hearing loss but wear hearing aids are at much reduced risk of dementia. What we don't have in the socializing space yet, is evidence that people who are, say, socially frail and then they change some things so that they are less socially frail, do they go back to being at baseline dementia risk, or is there something else happening here? That would also help with that causation argument. If we knew that someone was socially frail and they fixed that social frailty, then they didn't develop dementia at any higher rates than people who were never socially frail, that would be really good evidence that it's a causal relationship. 

Speaker: 22:31 

Neil Broomfield: 

Hannah, we've reached the point now I think, where we've really explored what's behind all this research and how it's progressed. Would you be able to summarize in a few words where you think this has taken us so far and where you expect it to be leading? 

Speaker 1: 22:50 

Hannah Fair: 

Yeah, so far I think what we've talked about is that social isolation, in all of its many forms and with all of its many contributing factors, puts people at higher risk of dementia. We don't yet have particularly good evidence around what people might be able to do to reduce that risk, other than, perhaps, encouraging people to stay socially active where they can, because we know when we look at groups of people, those who are more socially active are at lower dementia risk.  

At the start of this episode you also used the phrase strong evidence. In the research space we often reserve that phrase for when we're really sure we can make a particular claim in a general sense. We might say overall we have strong evidence that social isolation is a dementia risk factor. That's coming from studies that compile evidence from lots of different studies. That paper I was talking about at the start, the Livingston paper, that's what that paper does. However, a single study, often we wouldn't refer to that as being strong evidence for a particular claim. We could refer to it as a really good thorough study, which is what I think we're looking at here. But for us to have really strong evidence that social frailty predicts dementia, we'd want to be seeing that finding come up a lot in a lot of different research studies, looking at different populations in different contexts and seeing that social frailty consistently predicts dementia. Which does bring me to a couple of the limitations that this paper is really honest about in their own discussion. The main one of those is about the population that they're studying. Their 850 people are all older people from highly advantaged parts of Eastern Sydney, from just two suburbs in eastern Sydney, that are two of the most affluent suburbs in the country of Australia. 

Speaker: 24:32 

Neil Broomfield: 

Although, given on a mathematical level, this is quite a large study? 

Speaker 1: 24:36 

Hannah Fair: 

It is, but they're only studying a particular kind of person and that's a really advantaged, highly educated Caucasian person. We've got both binary genders there covered quite clearly but we can't say whether this would be true in lower socioeconomic neighbourhoods or amongst migrant populations or amongst populations with low education levels, because we simply didn't have enough of those kinds of people in this sample and that's a really nice link to our island project we're running here in Tasmania as well. We have a sample that is a bit more diverse than this sample in Sydney and so projects, like the Island project, give us the opportunity to study some of these socializing and some of these dementia risk factors in a different population to what we're seeing out of some of these big, big studies in other parts of Australia that have a less representative population. 

Speaker: 25:27 

Neil Broomfield:  

Although I guess we shouldn't belittle our own study, which is big too, isn't it? 

Speaker 1: 25:32 

Hannah Fair:  

Oh yeah, the Island Project is bigger than this study. 

Speaker: 25:34 

Neil Broomfield: 

Indeed. 

Speaker 1: 25:35 

Hannah Fair: 

I have, in a little subset of the island study that I'm doing, some research around socializing for dementia risk reduction in over a thousand participants, which is actually bigger than what we're reading about here. 

Speaker: 25:46 

Nil Broomfield: 

That's wonderful isn't it. Okay, so why don't we ,before we wrap up, just have a quick brain matters check-in. If listeners want to decide whether a study is good or not, based on this example, what are one or two signs they can look for? 

Speaker 1: 26:05 

Hannah Fair: 

I would encourage people to think about, well first off, are they reading the actual study or are they reading a news report that talks about a study? News reports are quite prone to taking the biggest finding from a particular study and making that the biggest deal they possibly can, because that's what gets people to read a news article. Going back to the original study is a great starting point, verifying that the news claim is there and seeing what other questions the study has addressed and perhaps not found as compelling evidence for. In this particular study one of the news articles that we were drawing on, which is going to be in our podcast description, pulls out this 50% number, that people who are socially frail are 50% more likely to develop dementia. That is a number from the paper, but it is only one of many different numbers that come out of this paper, so it's only part of the story. And as you might expect in a media article, that's the biggest number. And going back to James Vicker's episode, remembering that 50% means you're increasing your baseline risk by 50%, it doesn't mean that you're objectively likely to develop dementia, it just means whatever risk level you were sitting at, you're now at a higher risk level by about 50% of whatever that original risk was. For many of us that still means we're actually at quite low dementia risk. Anyway the media article will pull out the biggest headline finding which is in the paper, but when you digest a paper as a whole, there's a lot more nuance to that and a lot more negative findings generally than what make it into the media reports. So that's one thing, going back to the original research and making sure that the claim is there and seeing what else has been studied and perhaps not presenting as compelling a case. Then as we've talked about, you would want to look for long follow-up, objective outcome measures wherever possible, adjusting for confounders is really important and taking into account the population that was studied. If we're studying something in a really specific population, we can't generalize that to be true of the broader population. And a good research paper will be really honest about that. So when you read this paper, it gets to the end and it talks about the fact that you know we've got this really specific population and we have done a really good study. We can definitely say that what we're saying is true in that population, but it's hard to generalize that to the broader public. These are some of the markers of a good piece of research. 

Speaker: 28:24 

Neil Broomfield: 

Hannah this has been really in-depth interesting for me and I'm sure for our listeners. One thing, I think, would probably be a common factor, with certainly me and most other people, is that they'll never actually get around to reading the paper itself. And so we have to rely on experts like you to let us know really what's behind it. And for that I thank you for a  really wonderful expose of what's been going on. 

Speaker 1: 28:53 

Hannah Fair: 

Oh thank you Neil it's a pleasure to talk about this and me ,myself and a lot of other researchers, get frustrated when we see things written in headlines that really aren't quite aligned with the underlying research and definitely don't carry across all the caveats and weird nuances and so it's lovely to have the opportunity to dig into some of that with you and with our listeners. 

Speaker: 29:13 

Neil Broomfield: 

we're so glad we had you on the show today. Thank you. 

Speaker 1: 29:16 

Hannah Fair: 

Thank you. 

Speaker: 29:17 

Neil Bloomfield: 

And there we have it, for you dear listeners, this study adds to growing evidence that social connection plays an important role in brain health. But like most things, it's one piece of a much bigger picture. And importantly, social frailty isn't just about how many people you see, it's about feeling connected, supported and able to take part in meaningful activities over time. So as a bit of a takeaway, you might like to reflect on your own situation. What helps you stay socially connected and other the small ways you could maintain, or build those connections, as you get older? That could be anything from catching up regularly with friends or family, joining a group or activity, or finding ways to stay involved in your community, perhaps by volunteering, for example. Whatever feels realistic and meaningful for you. We'd love to hear your thoughts on this. You can join the discussion or share your reflections via the link in the show notes or on the Island project website. This has been Brain Matters. Thank you for listening and see you again soon for another episode.