Cognitive rehab & memory enhancement: evidence-based interventions (Part 5)

Social support and social engagement

I have been impressed by how seniors centers and senior living communities have incorporated more cognitive enhancement and stimulation activities into their programming in the past decade. Professionals no longer create activity programs simply by using the rule of the “Three Bs” (“Bingo, Bible and Birthdays”), as one executive suggested to me in the past was all that was necessary to do. Most communities today do a good job of providing stimulating environments for older adults. The areas that we most need to improve now are enhancing social engagement and decreasing loneliness.

Older adults who are the most socially engaged have a reduced likelihood of developing memory problems, whereas those who are the least integrated decline much more rapidly. ¹⁰ Loneliness is a risk factor for developing dementia. On the other hand, people who perceive their social support networks as being better than average are less likely to develop memory problems. 

A group-based class can take advantage of social connections to motivate people to participate in cognitive stimulation programs and other activities. Social interaction can be worked into cognitive stimulation programs by having participants share answers with a neighbor, learn information about each other, or work together on activities. As we age, our social support networks tend to become smaller through natural life events. Experiences such as retirement and losing the ability to drive can impact social groups, often making it difficult to maintain social relationships. Cognitive stimulation groups combat this phenomenon by providing opportunities to expand social ties and increase meaningful social interactions.

In group-based classes, older adults meet and socialize with others who are working toward a similar goal. Further, individuals with cognitive impairment can experience improvements in mood when they take part in a socially focused group activity.  These improvements can help buffer people from depression and other mood disorders, which may make cognitive functioning worse. For example, older adults without dementia who are experiencing depression often have problems with attention, concentration, and slower mental processing speeds, so anything that improves mood has the potential of improving cognition.

In our own published research at Western Oregon University, we reported that a three-month group-based cognitive enhancement program increased perceived social support and decreased self-reported loneliness in older adults relative to a control group. ²⁶ Many ideas about how to improve social engagement and decrease loneliness are also included in my book Train Your Brain: How to Maximize Memory Ability in Older Adulthood.  Increasing social engagement is important because older adults who are socially invested in a group may become more cognitively engaged in activities. 

Social engagement needs to be facilitated outside of memory classes as well. Many senior living communities provide nametags for residents, and anecdotal evidence suggests this has a positive effect on the social environment. Another effective strategy is to develop “new neighbor notes”—new residents are interviewed and a short biography written about them. This information and perhaps a photograph are given to those who live closest to the new resident.

Still another social engagement activity involves taking photographs of memory class participants and displaying the pictures on the wall in the activity room, with names hidden on pieces of paper underneath the photos and attached to the top of each with tape. Class participants and their peers can study the photos and names outside of class time. Finally, a resident directory using photographs can help individuals become familiar with, and therefore more likely to speak to, other people in their community.

As shown above, strategies that facilitate social engagement and support can have far-reaching effects on older adults’ quality of life, as people tend to become more engaged in social activities. 

A holistic approach

Maximizing memory ability and reducing the chance of dementia require a holistic approach. We must educate older adults about how they can improve their quality of life and memory ability by engaging in positive and healthy lifestyle behaviors. We must educate staff so they can inform these individuals about the benefits of exercising their minds and bodies; this knowledge can increase motivation to perform healthy behaviors. Finally, staff must have the resources, time and support to develop and promote high-quality activity programs. The combined effect of cognitive exercise, physical exercise, social engagement and proper nutrition can keep the older adults we work with not only physicallyhealthy, but also cognitively well.

Author, researcher and presenter Rob Winningham, PhD, has nearly 20 years of experience researching applied memory issues, and for the past 15 years has conducted research on older adults and ways to enhance their mental functioning and quality of life. Most recently, Winningham has been helping developers create video games and interactive activities specifically designed to enhance cognition. He is a full professor and chair of the Psychology Division at Western Oregon University, where he manages both the Psychology and Gerontology departments. Not only does Winningham train professionals to offer cognitive stimulation and therapy programs, he has also helped develop a certification program, which can be found at www.activityconnection.com. His book Train Your Brain: How to Maximize Memory Ability in Older Adulthood (Baywood Publishing, 2009) is available at www.amazon.com.

This article is provided courtesy of the International Council on Active Aging www.icaa.cc

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