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Cognitive Health Through Social Engagement: Why Conversation is Good for the Brain

With a special focus on Stroke and Parkinson's Disease

Conversation is the most fundamental brain exercise we engage in every day. The benefits of social engagement can’t be overstated, from its positive impact on mental health to the physical health benefits on a cellular level! Science suggests we could actually lower our risk of dementia with an active social life.

social engagement contributes to a healthy brain
social engagement is good for the brain

Why maintaining cognitive health is crucial

We all want to preserve existing healthy brain cells. Recommendations for preserving brain health include ongoing cognitive stimulation. A 2020 report by the Lancet Commission added up the modifiable risk factors that can lead to dementia and calculates that 40% of one's risk can be reduced with lifestyle choices.

People with a communication impairment are at higher risk of cognitive decline for various reasons. Modifiable risk factors identified in the Lancet report include physical inactivity, depression, and social isolation, all of which are often complications associated with the condition that caused the communication impairment, such as a stroke or Parkinson's disease. In fact dementia has been found at a higher rate in stroke survivors. After a stroke, the risk of developing dementia is 3-5 times higher than in individuals who haven't experienced a stroke. For people with Parkinson's reports show that 20 years after a Parkinson's diagnosis, the incidence of dementia is as high as 80%.

Something as simple and rewarding as Social Engagement and Conversation are considered exercises in Cognitive Stimulation that preserve Cognitive Wellness.

Complications in Stroke Recovery

Post-Stroke Depression (PSD) affects approximately one-third of stroke survivors and can significantly diminish motivation and positive outlook. It can also hamper the benefits of rehabilitation, leading to a decreased drive to complete essential therapies like physical and speech therapy.

The American Heart Association (AHA) highlights PSD as a significant factor affecting the quality-of-life post-stroke. It can lead to decreased participation, engagement, and overall lower quality of life scores. Studies have found that stroke survivors report higher levels of social isolation compared to their peers who haven't experienced a stroke.

Complications in Parkinson's disease

One of the non-motor symptoms of Parkinson’s is apathy, causing decreased interest and motivation. One study found the prevalence of clinically significant apathy in Parkinson's disease to be at 23%. Depression has been reported as high as 35-50% and anxiety at 30-40%. Combatting apathy, depression and anxiety to stay engaged in physical therapy or voice therapy, or to stay on an exercise maintenance program to preserve balance, gait, voice or cognition can be a challenge. These barriers may contribute to social withdrawal which can have negative consequences for cognitive health.

The Impact of Depression on the Brain

Depression and the consequences of social withdrawal have cascading effects on mental health. Social isolation has been found to be a predictor of lower cognitive functioning and accelerates cognitive decline. Maintaining a healthy social life is associated with cognitive wellness.

How social connection positively impacts brain health

Social connection provides a sense of belonging, support, and validation, contributing to mental well-being. Additionally, engaging in altruistic activities and experiencing humor further boosts mood and reduces feelings of depression, anxiety, and stress—all good for the brain.

Recent studies have also highlighted the impact of social engagement on immune function and Alzheimer's disease pathology, emphasizing its role in maintaining cognitive health. Studies have found loneliness to be associated with biological markers of Alzheimer’s disease pathology. A rather arcane study of BDNF (brain derived neurotrophic factor) compared mice that lived in isolation versus mice paired or co-housed with another mouse . The mice that lived alone had significantly less recovery than co-habitating mice. The brain tissue of these mice were measured on day 49 after a stroke and it was found that the mice who had social support had better outcomes. Other studies have found people with strong social relationships had a 50% likelihood of survival than individuals with weaker ties. The power of community and social support cannot be overestimated.

Conversation is the Key

What is the most important thing we do in social situations?  We talk, of course. Conversation is the most important executive function we perform. Here’s a sample of some of the complex actions the brain performs in conversation

  • Recognize and follow social rules

  • Recall and use grammatical rules

  • Word finding

  • Coordinate complex sequences of sounds in rapid succession to form sounds-words-sentences

  • Use strategy to break into a conversation (or exit one)

  • Listen to another person’s story while simultaneously recalling on your own memories of a similar topic

  • Planning and organizing your ideas to contribute to the conversation

  • Strategize to be persuasive, or to use humor to reduce tension  

Prioritizing social engagement is key to maintaining cognitive wellness. It is also easier said than done if someone is dealing with depression or anxiety in addition to their diagnosis of stroke or Parkinson’s disease, etc.

Depression and social engagement can be bi-directional. This means that if we are battling depression or anxiety, we are less likely to be socially active. If less socially active, we are likely to experience depression or anxiety. It’s a difficult cycle to break. But on a positive note, if we can take a step toward becoming more socially engaged, we feel better. When we feel better, we are more likely to engage more. Gradually, with effort and small steps we can overcome the negative effects of social isolation and depression.

Find Your Group

There are resources such as support groups, book clubs, and community programs that help people recovering from stroke to re-engage, or help people with Parkinson’s maintain communication skills. And for those experiencing aphasia, there are initiatives like the Aphasia Conversation Group started by Amplify Speech Therapy. There are online groups for people who don’t have a local program or find it difficult to leave the home. Such groups can provide invaluable social support and encouragement for people with aphasia who are at even greater risk of social isolation and withdrawal. But they also offer conversation and cognitive wellness!

If you or someone you know is interested in joining our conversation group or exploring other resources for social engagement, please don't hesitate to reach out. Together, we can combat social isolation, build vibrant, supportive communities and keep our brains stimulated.

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