REPORTING FROM ACTRIMS
Americas Committee for Treatment and Research in Multiple Sclerosis
West Palm Beach, Florida
SATURDAY, FEBRUARY 29
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Harvard Neurologist Suggests Social Isolation is "The New Smoking" In Terms of Detrimental Health Effects
Amar Dhand, MD, DPhil, Associate Professor of Neurology at Brigham and Women's Hospital, Harvard University in Boston, MA, told the ACTRIMS audience about his unique experiments on the effects of social connections among people with MS.WEST PALM BEACH, FL — Social isolation is a "silent epidemic" in this country, with effects comparable to smoking three packs of cigarettes per day, asserted Amar Dhand, MD, DPhil, of Harvard University. "That's equivalent to hypertension, yet we hardly screen for it in the clinic," he told the audience at the 2020 ACTRIMS Forum on Friday, February 28. Dr. Dhand's talk was unique within the "networking" theme of this year's ACTRIMS meeting, because it focused on social networks among individuals with multiple sclerosis (MS) rather than on cellular or immunological networks.
Dr. Dhand, Associate Professor of Neurology at Brigham and Women's Hospital and head of Harvard's Dhand Laboratory (www.dhandlab.com), offered plenty of data to back up his theories on social networks. His work focuses on how human networks affect health outcomes, using a "social connectome" to map patients' social relationships. "We don't do a very formal social isolation assessment with our patients, even though it's such a potent determinant of health," Dr. Dhand said. "There are multiple mechanisms involved, biological as well as behavioral. Indirectly, social isolation is related to smoking, inactivity, sedentary behaviors, and poor sleep. Biologically, there has been some beautiful work in animal models as well as humans that shows CNS structural changes," he told the ACTRIMS audience. For example, deleterious brain changes from social isolation can be viewed on MRI, as shown in a 2019 New England Journal of Medicine study of people before and after they engaged in a 14-month Antarctic expedition.
Although his early studies focused on social networks in patients with stroke, Dr. Dhand has turned some of his attention to MS. Social networks among individuals start with household/family members and extend outward to close friends, coworkers, and acquaintances. The influence of these interactions on health has been mapped and quantified by his research team. "We developed a scalable approach to measure and quantify social connectivity via an online tool for patients using a secure, HIPAA-compliant system," he said The tool is described in a 2018 paper in Nature Communications.
It's not always those people closest to the patient who have the greatest impact, Dr. Dhand said. When it comes to seeking health care in an emergency such as a stroke or acute cardiac syndrome, research shows that people who were at home were likely to delay medical care longer, while those who were with a more distant acquaintance or coworker got care more promptly. The difference, he says, is that with loved ones the discussion gets into a circular pattern (e.g., they argue about it), while strangers or friends are more likely to say, "I don't what's going on, but you're going to the hospital."
For people with MS, higher degrees of social support have been shown to be beneficial in terms adapting to long-term and progressive MS, stress, and positive behaviors such as healthy diet and exercise.
By Katherine Wandersee, for the Consortium of Multiple Sclerosis Centers (CMSC)