Professor Carol Holland: the power of social engagement as we age

As we get older, life events such as bereavement and retirement can affect our social interactions. Research has shown that maintaining friendships and other relationships is good for our long term health and wellbeing. In this interview, we spoke to Professor Carol Holland, President of the British Society of Gerontology and Professor of Ageing at the University of Lancaster.

So, I know that you study links between social connection and cognition, could you first explain what we mean when we talk about cognition

Cognition is our thinking skills. Memory is an important part of it, and it's probably the thing that people notice as their cognition starts to become impaired in later life because they start forgetting people's names or where they left the keys, which we all do at any point in life, but it can become more regular as we get older. But our thinking skills also include what we call executive function, which is your ability to focus your attention on things and to shift your attention from one thing to another when you need to and to inhibit attention on things you don't need to attend to. And we all do this all the time without thinking about it. You know, if we actually thought about it, we could become very conscious of how cold our feet are or how comfortable we are on our seat or the noise of the traffic outside. But most of the time we screen all these things out effectively. Our inhibitory control allows us to shift attention between tasks and allows us to reprioritize without being overcome by thinking about the previous activity, we move on and get on with the next thing. Our cognition also includes our linguistic skills, our ability to have a conversation. This involves how you use your memory and language to share experiences or ideas with others. There are also other aspects of cognition such as visual attention and reaction times.

And what do we mean when we talk about social connection?

Social connection is generally how connected you are, how many people you know, how many friends you've got, whether you've got family that you see, that you feel close to, whether you've got friends that you feel close to, whether you've got an active social life and feel you have a good social network. We know that being socially connected and engaged is good for our brains, whereas social isolation, when someone has a limited social network and doesn’t have the opportunity to engage with others, is a risk factor for cognitive decline and loneliness. Loneliness is the emotional response to a perceived lack of companionship and whilst it may affect some people that are socially isolated, not everyone who is socially isolated experiences loneliness. Also, socially connected people can also be lonely. You can be lonely in a crowd, as they say. We see loneliness emerging especially in bereavement, for example, and this can happen despite being surrounded by friends and family members.

So what impact does social connection or lack of social connection have on our health and wellbeing as we age?

When you're new in a place; a new job, new group, new neighborhood, you are trying to find links and commonalities to the people you meet as part of building your connection with them. This is exercising your autobiographical memory and ability to be specific in storytelling – where you used to live and when and what your experiences were there. This ability to access autobiographical memory and tell stories with salient details rather than generalisations has been found to be important for social connections. So, our cognitive skills and social interaction are very much tied together. In social situations we are exercising our cognitive skills – memory, problem solving, linguistic skills, understanding someone else’s point of view and often building knowledge, as well as potentially receiving support and also hopefully finding enjoyment. There are also other benefits of social connections that we’ve seen, for instance, social cues around eating. As people get very old or with early Alzheimer's, often they lose their appetite and stop eating enough, but when they're eating in a social situation, they eat better.

These are clear benefits to social connect and so if someone is socially isolated they are not getting that mental workout which is protective for our brain health and other social cues. And, if someone becomes lonely, this can lead to depression. This can happen at any age but as you get older, you are a bit more vulnerable to loneliness and social isolation due to retirement, bereavements and poorer health which may limit your ability to get out and about. Depression has a negative impact on cognition and research has shown that depression can have direct impacts on brain connectivity and function.

So, would you say it's good for us, particularly as we age, to put ourselves in new situations with new people?

Absolutely. When we talk about cognitive stimulation, we talk about learning new stuff. New social situations are just the same, they work in the same way. They're intellectually stimulating but we also know for many people they can be a little bit daunting, especially if you're a shy person.

In terms of interventions to support social interactions, what’s out there and what works?

I think it's a mistake to think we have to evaluate every single intervention and look for evidence because actually we already have the evidence that social interaction helps. We have the evidence that physical activity helps. We have the evidence that learning something new helps. I think that what we need to think about is are we reaching everybody with these ideas? Who are we not reaching? We need to get better at making sure everyone is reached and has opportunities to engage with interventions that support healthy ageing.

So what are your top tips for ageing well?

I think it's around not thinking that if you've got a problem or a health issue, that's it, you’re not ageing well. Really by the time we're 60 or 65, most of us have some kind of physical ailment or a tablet that we take for something. Just because you have those issues doesn't mean you're not ageing well. You can still age well, eat healthily, maintain social connections, move and learn things. You can look after your health condition and it might take a little bit more of your time to think about your health. But I think it's that positive outlook that’s important; thinking positively about ageing rather than negatively. There is quite a lot of research on the impact of having a very negative view of ageing when you get to be older. So even if you're younger now, thinking about ageing positively helps both the older people around you but also helps your future self. The more people that can be positive about ageing also helps address ageism so it’s really important. And then staying socially engaged; feeling that you still need to have friends and understanding that actually social interaction is still really important, whatever stage of life you're at.

So, finally, why are you supporting Take Five to Age Well – what makes it a good idea?

Take Five highlights particular actions and helps people to focus on the things that count. And it gives people the choice – they can commit to one thing or five things – it all makes a difference. It shares health information; we talk about these things because we study it, but not everybody knows what things promote healthy ageing. And I think, there are moments as people age when we need help – often if you get that little bit of help, you can do much more towards staying engaged and enjoying life.

THANK YOU FOR READING

Thanks to The Centre for Ageing Better for the images in this article.