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Loneliness, social isolation, and effects on cognitive decline in patients with dementia: A retrospective cohort study using natural language processing
James A C Myers, Tom Stafford, Ivan G. Koychev, Robert Perneczky, Oliver Bandmann, Nemanja Vaci. Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring, 2025-07-01
Topic: Risk, prevention and care in population studies
Abstract INTRODUCTION The study aimed to compare cognitive trajectories between patients with reports of social isolation and loneliness and those without. METHODS Reports of social isolation, loneliness, and Montreal Cognitive Assessment (MoCA) scores were extracted from dementia patients' medical records using natural language processing models and analyed using mixed‐effects models. RESULTS Lonely patients ( n = 382), compared to controls ( n = 3912), showed an average MoCA score that was 0.83 points lower at diagnosis ( P = 0.008) and throughout the disease. Socially isolated patients ( n = 523) experienced a 0.21 MoCA point per year faster rate of cognitive decline in the 6 months before diagnosis ( P = 0.029), but were comparable to controls before this period. This led to average MoCA scores that were 0.69 MoCA points lower at diagnosis ( P = 0.011). DISCUSSION Lower cognitive levels in lonely and socially isolated patients suggest that these factors may contribute to dementia progression. Highlights Developed Natural Language Processing model to detect social isolation and loneliness in electronic health records. Patients with loneliness reports have lower Montreal Cognitive Assessment (MoCA) scores than other patients. Social isolation was related to the faster decline in MoCA scores before diagnosis. Social isolation and loneliness are promising targets for slowing cognitive decline.
Key findings
- RESULTS Lonely patients ( n = 382), compared to controls ( n = 3912), showed an average MoCA score that was 0.83 points lower at diagnosis ( P = 0.008) and throughout the disease.
- DISCUSSION Lower cognitive levels in lonely and socially isolated patients suggest that these factors may contribute to dementia progression.
Why it matters
This retrospective cohort study using natural language processing found that lonely patients had lower MoCA scores at diagnosis, and socially isolated patients had a faster rate of cognitive decline before diagnosis. The authors suggest social isolation and loneliness are promising targets for slowing cognitive decline, but the study is observational and does not test an intervention.
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Study details
- Participants382
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring) |
| Journal's citation record | 1 / 4 | Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring: journal h-index 86 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 382 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Nemanja Vaci: h-index 19 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40726520) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/dad2.70149
- PubMed: 40726520
- Original source →
- Free full text: Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Myers, J. A. C., Stafford, T., Koychev, I. G., Perneczky, R., Bandmann, O., & Vaci, N. (2025). Loneliness, social isolation, and effects on cognitive decline in patients with dementia: A retrospective cohort study using natural language processing. Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring. https://doi.org/10.1002/dad2.70149
Vancouver
Myers JAC, Stafford T, Koychev IG, Perneczky R, Bandmann O, Vaci N. Loneliness, social isolation, and effects on cognitive decline in patients with dementia: A retrospective cohort study using natural language processing. Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring. 2025. doi:10.1002/dad2.70149. PMID: 40726520.
BibTeX
@article{myers2025-40726520,
author = {Myers, James A C and Stafford, Tom and Koychev, Ivan G. and Perneczky, Robert and Bandmann, Oliver and Vaci, Nemanja},
title = {{Loneliness, social isolation, and effects on cognitive decline in patients with dementia: A retrospective cohort study using natural language processing}},
journal = {Alzheimer s \& Dementia Diagnosis Assessment \& Disease Monitoring},
year = {2025},
doi = {10.1002/dad2.70149},
pmid = {40726520},
url = {https://doi.org/10.1002/dad2.70149}
}
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