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Longevity Conferences 2023
January 19, 2023
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The four pillars of health: physical, emotional, cognitive, and social
Each aspect affects another – physical health impacts our emotional balance, emotional balance impacts our cognitive abilities, and social connectedness impacts our physical condition.
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Highlights:
- Nowadays, health is envisioned as a complex concept, including multiple sub-areas of physical, mental, emotional, and social well-being
- Physical health describes the condition of the body, from the absence of diseases to the level of fitness
- The primary strategy to support physical health is disease prevention through exercise, diet, sleep, and the absence of harmful habits
- Cognitive health includes our ability to think, learn, and remember and can be supported through mental engagement and stress management
- Social health lies in the ability to create and maintain meaningful social interactions
Introduction
Nowadays, developing ways to keep the population healthy becomes even more critical due to increased lifespan. According to the United Nations report, in the year 2050, the world population will include almost 22 percent of people over 60. Such an increase requires a rigorous approach to health. However, defining what health is, has never been easy. Is it merely an absence of diseases? According to a definition by the World Health Organization (WHO), health is “a state of complete physical, mental, and social well-being”. To be and feel truly healthy, one must maintain balance in multiple areas. This article will cover four main pillars on which health resides – physical fitness, emotional balance, cognitive abilities, and strong social networks.
Pillar I – physical health
Physical health is the first thing we consider when analyzing general health. It can be described as the body’s condition and takes into account multiple factors from the absence of disease to fitness level (mental, emotional, and social components excluded). Physical health is defined both by one’s genetic makeup and lifestyle factors, such as diet, exercise, and quality of sleep.
Among the major modern threats to physical health are considered non-communicable diseases (NCDs) – a type of disease that is not transmissible from one person to another. NCDs have become an immense burden in developing countries affecting 41 million people each year, causing around 71% of all deaths worldwide (1). Among the four most deadly NCDs are cardiovascular disease (CVD), followed by cancer, respiratory disorders, and diabetes. All these NCDs are strongly associated with a heightened risk of premature death (2).
Fortunately, many NCDs can be managed or avoided through modifying lifestyle factors, such as excessive alcohol consumption, poor diet, and lack of physical activity (3,4). All the modern aspects of maintaining physical health are pointed toward disease prevention.
Exercise is the primary preventive strategy applicable to everyone regardless of age that has shown multiple positive effects on more than 30 diseases, including CVD (5) and diabetes (6). The optimal exercise regimen is supposed to include a variety of exercises. The current WHO guidelines recommend combining moderate- (i.e., brisk walking) and vigorous-intensity (jogging, riding a bike) aerobic and muscle-strengthening (lifting weights, resistance training) activities while limiting sedentary periods as much as possible (5,7).
Other key players in physical health include diet and proper amount of sleep. The effects of diet on health and longevity are one of the most intensively studied, and more evidence and mechanisms emerge to support that claim (8). There are several diets with well-established benefits for health and longevity, such as the Mediterranean and Okinawan diets (9,10). Dietary patterns, such as intermittent fasting (11) and evasion of processed food rich in saturated fats and sweeteners (12), can also be employed as health-improving strategies.
Sleep is in no way the least important “influencer” of physical health. Adequate sleep length and quality impact our immediate well-being and determine multiple health risks and lifespan. (13).
Image 2
Pillar II – cognitive health
Cognitive health can be simply described as an ability to think, learn, and remember. It is one of the components of general brain health and has a crucial impact on the quality of living and ability to perform day-to-day tasks.
Cognitive health cannot be maintained without physical health and can be drastically impacted by many diseases (CVD, hypertension, and diabetes are examples). Cognitive abilities can be affected by age-related changes (14), stroke- or trauma-related injuries, substance abuse, dementia (especially Alzheimer’s disease), and mood disorders. As the brain is inseparably linked to all the other bodily systems, cognitive health, first and foremost, can be improved by the same key strategies as physical health – exercise (15), diet (16), and sleep (17).
Other interventions that have shown positive associations with cognitive health are stress management and mental stimulation. Studies have shown that exposure to chronic stress impairs learning, attention, and memory processes (18). Developing a robust stress-coping mechanism allows to develop resilience and preserve cognitive abilities (19). Multiple approaches allow for developing one’s resilience – from psychotherapeutic interventions to mindfulness meditation practices.
Mental stimulation is another way to support cognitive well-being effectively. It may include a plethora of activities, such as puzzles, new games, learning new languages, or solving mathematical problems. Any kind of new knowledge, which makes the brain active, helps to increase neuroplasticity and build a protective cognitive reserve (20).
Pillar III – emotional health
Emotional health, like cognitive health, can be considered a part of the mental health concept. Emotional health refers to being able to recognize and adequately respond to emotions (both pleasant and unpleasant). Stable responses to emotions are inextricably linked to successful living and aging and can serve as protection from harmful psychological conditions (21). However, various factors (22) related to stress, trauma, or aging can negatively impact our ability to deal with emotional states, leading to emotional instability.
There are a variety of strategies able to enhance emotional health, which can be classified into several categories, including engagement and taking control, attainment and pursuit of goals, creation of positive opportunities, adding personal meaning, and developing self-acceptance (23). Though it might be possible to develop and maintain emotional health through self-regulation techniques, a guided path might be easier to follow, especially if a person struggles with any condition connected to the previous two pillars. Psychotherapy (24), mindfulness-based techniques (25), and even involvement in spirituality (26) have shown a positive impact on emotional health and well-being.
Image 3
Pillar IV – Social health
Modern society made us simultaneously the most connected and the most isolated than ever before. Despite being involved in multiple social networks, many people today are heavily impacted by the loneliness and loss of meaningful social connections. However, humans evolutionary crave to belong and feel connected (27), and perceived social isolation has multiple detrimental effects. Lack of social interactions has been linked to various physiological and psychological conditions, such as depression (28) or cardiometabolic disorders (29). Moreover, mortality tends to be 2 to 3 times higher among people feeling isolated (30).
A range of approaches can be utilized to address social health, though it can be challenging for older people or people suffering from severe health conditions. Possible ways to improve social health and feeling of connectedness include maintaining existing personal contacts, participating in group learning activities (studying, volunteering, discussion clubs, exercises, etc.), or becoming involved in community work (31). Contact with animals has also been shown beneficial in alleviating loneliness (32). Similar to emotional health, addressing social health can be done more effectively under guidance. Interventions that can help include mindfulness-based stress reduction (33) and techniques supporting friendship development (goal- and boundary-setting, analysis of one’s social network) (34) and self-management (i.e., behavioral confirmation) (35).
Conclusions
Inevitably, every pillar of health depends on and influences others. Each aspect affects another – physical health impacts our emotional balance, emotional balance impacts our cognitive abilities, and social connectedness impacts our physical condition. We frequently perceive different areas of our health as separate entities, but none can exist without the others. In this sense, physical health is the entry point, defining all the other aspects in many ways. To make lives healthy and long (and, most importantly, happy), we must maintain a balance between all four aspects and employ all the available strategies – from diet and exercise to making new friends.
References
1. WHO: Noncommunicable diseases [Internet]. [cited 2022 Jun 6]. Available from: https://www.who.int/health-topics/noncommunicable-diseases
2. WHO: Noncomunnicable diseases and Mortality [Internet]. [cited 2022 Jun 6]. Available from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/ncd-mortality
3. Benziger CP, Roth GA, Moran AE. The Global Burden of Disease Study and the Preventable Burden of NCD. Glob Heart. 2016 Dec;11(4):393–7.
4. Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, et al. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Front Public Health. 2020 Nov 26;8:574111.
5. Pedersen BK. Which type of exercise keeps you young? Curr Opin Clin Nutr Metab Care. 2019 Mar;22(2):167–73.
6. Johansen MY, MacDonald CS, Hansen KB, Karstoft K, Christensen R, Pedersen M, et al. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA. 2017 Aug 15;318(7):637.
7. WHO: Physical activity [Internet]. 2022 [cited 2022 Jun 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity
8. Mente A, Yusuf S. Evolving evidence about diet and health. Lancet Public Health. 2018 Sep;3(9):e408–9.
9. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health: Mediterranean Diet and Disease Prevention. BioFactors. 2013 Jul;39(4):335–42.
10. Willcox DC, Scapagnini G, Willcox BJ. Healthy aging diets other than the Mediterranean: A focus on the Okinawan diet. Mech Ageing Dev. 2014 Mar;136–137:148–62.
11. Vasim I, Majeed CN, DeBoer MD. Intermittent Fasting and Metabolic Health. Nutrients. 2022 Jan 31;14(3):631.
12. Dunford EK, Popkin B, Ng SW. Junk Food Intake Among Adults in the United States. J Nutr. 2022 Feb 8;152(2):492–500.
13. Mazzotti DR, Guindalini C, Moraes WA dos S, Andersen ML, Cendoroglo MS, Ramos LR, et al. Human longevity is associated with regular sleep patterns, maintenance of slow wave sleep, and favorable lipid profile. Front Aging Neurosci [Internet]. 2014 Jun 24 [cited 2022 Jun 9];6. Available from: http://journal.frontiersin.org/article/10.3389/fnagi.2014.00134/abstract
14. Scahill RI, Frost C, Jenkins R, Whitwell JL, Rossor MN, Fox NC. A Longitudinal Study of Brain Volume Changes in Normal Aging Using Serial Registered Magnetic Resonance Imaging. Arch Neurol. 2003 Jul 1;60(7):989.
15. Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci. 2008 Jan;9(1):58–65.
16. Yannakoulia M, Kontogianni M, Scarmeas N. Cognitive health and Mediterranean Diet: Just diet or lifestyle pattern? Ageing Res Rev. 2015 Mar;20:74–8.
17. Ferrie JE, Shipley MJ, Akbaraly TN, Marmot MG, Kivimäki M, Singh-Manoux A. Change in Sleep Duration and Cognitive Function: Findings from the Whitehall II Study. Sleep. 2011 May;34(5):565–73.
18. Lupien SJ, Fiocco A, Wan N, Maheu F, Lord C, Schramek T, et al. Stress hormones and human memory function across the lifespan. Psychoneuroendocrinology. 2005 Apr;30(3):225–42.
19. Yang JS, Jeon YJ, Lee GB, Kim HC, Jung SJ. The association between psychological resilience and cognitive function in longitudinal data: Results from the community follow-up survey. J Affect Disord. 2021 Jul;290:109–16.
20. Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast. 2017;2017:1–22.
21. Depp C, Vahia IV, Jeste D. Successful Aging: Focus on Cognitive and Emotional Health. Annu Rev Clin Psychol. 2010 Mar 1;6(1):527–50.
22. Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009 Jun;10(6):434–45.
23. Robertson SM, Stanley MA, Cully JA, Naik AD. Positive Emotional Health and Diabetes Care: Concepts, Measurement, and Clinical Implications. Psychosomatics. 2012 Jan;53(1):1–12.
24. Beauregard M. Mind does really matter: Evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. Prog Neurobiol. 2007 Mar;81(4):218–36.
25. Guendelman S, Medeiros S, Rampes H. Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies. Front Psychol [Internet]. 2017 Mar 6 [cited 2022 Jun 10];8. Available from: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.00220/full
26. Larson DB, Larson SS. Spirituality’s Potential Relevance to Physical and Emotional Health: A Brief Review of Quantitative Research. J Psychol Theol. 2003 Mar;31(1):37–51.
27. Leavell MA, Leiferman JA, Gascon M, Braddick F, Gonzalez JC, Litt JS. Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review. Curr Environ Health Rep. 2019 Dec;6(4):297–308.
28. Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM. The association between social relationships and depression: A systematic review. J Affect Disord. 2015 Apr;175:53–65.
29. Larrabee Sonderlund A, Thilsing T, Sondergaard J. Should social disconnectedness be included in primary-care screening for cardiometabolic disease? A systematic review of the relationship between everyday stress, social connectedness, and allostatic load. Latham-Mintus K, editor. PLOS ONE. 2019 Dec 19;14(12):e0226717.
30. Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. Brayne C, editor. PLoS Med. 2010 Jul 27;7(7):e1000316.
31. O’Rourke HM, Collins L, Sidani S. Interventions to address social connectedness and loneliness for older adults: a scoping review. BMC Geriatr. 2018 Dec;18(1):214.
32. Banks MR, Banks WA. The Effects of Animal-Assisted Therapy on Loneliness in an Elderly Population in Long-Term Care Facilities. J Gerontol A Biol Sci Med Sci. 2002 Jul 1;57(7):M428–32.
33. Creswell JD, Irwin MR, Burklund LJ, Lieberman MD, Arevalo JMG, Ma J, et al. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain Behav Immun. 2012 Oct;26(7):1095–101.
34. Martina CMS, Stevens NL. Breaking the cycle of loneliness? Psychological effects of a friendship enrichment program for older women. Aging Ment Health. 2006 Sep 1;10(5):467–75.
35. Kremers IP, Steverink N, Albersnagel FA, Slaets JPJ. Improved self-management ability and well-being in older women after a short group intervention. Aging Ment Health. 2006 Sep 1;10(5):476–84.
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Highlights:
- Nowadays, health is envisioned as a complex concept, including multiple sub-areas of physical, mental, emotional, and social well-being
- Physical health describes the condition of the body, from the absence of diseases to the level of fitness
- The primary strategy to support physical health is disease prevention through exercise, diet, sleep, and the absence of harmful habits
- Cognitive health includes our ability to think, learn, and remember and can be supported through mental engagement and stress management
- Social health lies in the ability to create and maintain meaningful social interactions
Introduction
Nowadays, developing ways to keep the population healthy becomes even more critical due to increased lifespan. According to the United Nations report, in the year 2050, the world population will include almost 22 percent of people over 60. Such an increase requires a rigorous approach to health. However, defining what health is, has never been easy. Is it merely an absence of diseases? According to a definition by the World Health Organization (WHO), health is “a state of complete physical, mental, and social well-being”. To be and feel truly healthy, one must maintain balance in multiple areas. This article will cover four main pillars on which health resides – physical fitness, emotional balance, cognitive abilities, and strong social networks.
Pillar I – physical health
Physical health is the first thing we consider when analyzing general health. It can be described as the body’s condition and takes into account multiple factors from the absence of disease to fitness level (mental, emotional, and social components excluded). Physical health is defined both by one’s genetic makeup and lifestyle factors, such as diet, exercise, and quality of sleep.
Among the major modern threats to physical health are considered non-communicable diseases (NCDs) – a type of disease that is not transmissible from one person to another. NCDs have become an immense burden in developing countries affecting 41 million people each year, causing around 71% of all deaths worldwide (1). Among the four most deadly NCDs are cardiovascular disease (CVD), followed by cancer, respiratory disorders, and diabetes. All these NCDs are strongly associated with a heightened risk of premature death (2).
Fortunately, many NCDs can be managed or avoided through modifying lifestyle factors, such as excessive alcohol consumption, poor diet, and lack of physical activity (3,4). All the modern aspects of maintaining physical health are pointed toward disease prevention.
Exercise is the primary preventive strategy applicable to everyone regardless of age that has shown multiple positive effects on more than 30 diseases, including CVD (5) and diabetes (6). The optimal exercise regimen is supposed to include a variety of exercises. The current WHO guidelines recommend combining moderate- (i.e., brisk walking) and vigorous-intensity (jogging, riding a bike) aerobic and muscle-strengthening (lifting weights, resistance training) activities while limiting sedentary periods as much as possible (5,7).
Other key players in physical health include diet and proper amount of sleep. The effects of diet on health and longevity are one of the most intensively studied, and more evidence and mechanisms emerge to support that claim (8). There are several diets with well-established benefits for health and longevity, such as the Mediterranean and Okinawan diets (9,10). Dietary patterns, such as intermittent fasting (11) and evasion of processed food rich in saturated fats and sweeteners (12), can also be employed as health-improving strategies.
Sleep is in no way the least important “influencer” of physical health. Adequate sleep length and quality impact our immediate well-being and determine multiple health risks and lifespan. (13).
Image 2
Pillar II – cognitive health
Cognitive health can be simply described as an ability to think, learn, and remember. It is one of the components of general brain health and has a crucial impact on the quality of living and ability to perform day-to-day tasks.
Cognitive health cannot be maintained without physical health and can be drastically impacted by many diseases (CVD, hypertension, and diabetes are examples). Cognitive abilities can be affected by age-related changes (14), stroke- or trauma-related injuries, substance abuse, dementia (especially Alzheimer’s disease), and mood disorders. As the brain is inseparably linked to all the other bodily systems, cognitive health, first and foremost, can be improved by the same key strategies as physical health – exercise (15), diet (16), and sleep (17).
Other interventions that have shown positive associations with cognitive health are stress management and mental stimulation. Studies have shown that exposure to chronic stress impairs learning, attention, and memory processes (18). Developing a robust stress-coping mechanism allows to develop resilience and preserve cognitive abilities (19). Multiple approaches allow for developing one’s resilience – from psychotherapeutic interventions to mindfulness meditation practices.
Mental stimulation is another way to support cognitive well-being effectively. It may include a plethora of activities, such as puzzles, new games, learning new languages, or solving mathematical problems. Any kind of new knowledge, which makes the brain active, helps to increase neuroplasticity and build a protective cognitive reserve (20).
Pillar III – emotional health
Emotional health, like cognitive health, can be considered a part of the mental health concept. Emotional health refers to being able to recognize and adequately respond to emotions (both pleasant and unpleasant). Stable responses to emotions are inextricably linked to successful living and aging and can serve as protection from harmful psychological conditions (21). However, various factors (22) related to stress, trauma, or aging can negatively impact our ability to deal with emotional states, leading to emotional instability.
There are a variety of strategies able to enhance emotional health, which can be classified into several categories, including engagement and taking control, attainment and pursuit of goals, creation of positive opportunities, adding personal meaning, and developing self-acceptance (23). Though it might be possible to develop and maintain emotional health through self-regulation techniques, a guided path might be easier to follow, especially if a person struggles with any condition connected to the previous two pillars. Psychotherapy (24), mindfulness-based techniques (25), and even involvement in spirituality (26) have shown a positive impact on emotional health and well-being.
Image 3
Pillar IV – Social health
Modern society made us simultaneously the most connected and the most isolated than ever before. Despite being involved in multiple social networks, many people today are heavily impacted by the loneliness and loss of meaningful social connections. However, humans evolutionary crave to belong and feel connected (27), and perceived social isolation has multiple detrimental effects. Lack of social interactions has been linked to various physiological and psychological conditions, such as depression (28) or cardiometabolic disorders (29). Moreover, mortality tends to be 2 to 3 times higher among people feeling isolated (30).
A range of approaches can be utilized to address social health, though it can be challenging for older people or people suffering from severe health conditions. Possible ways to improve social health and feeling of connectedness include maintaining existing personal contacts, participating in group learning activities (studying, volunteering, discussion clubs, exercises, etc.), or becoming involved in community work (31). Contact with animals has also been shown beneficial in alleviating loneliness (32). Similar to emotional health, addressing social health can be done more effectively under guidance. Interventions that can help include mindfulness-based stress reduction (33) and techniques supporting friendship development (goal- and boundary-setting, analysis of one’s social network) (34) and self-management (i.e., behavioral confirmation) (35).
Conclusions
Inevitably, every pillar of health depends on and influences others. Each aspect affects another – physical health impacts our emotional balance, emotional balance impacts our cognitive abilities, and social connectedness impacts our physical condition. We frequently perceive different areas of our health as separate entities, but none can exist without the others. In this sense, physical health is the entry point, defining all the other aspects in many ways. To make lives healthy and long (and, most importantly, happy), we must maintain a balance between all four aspects and employ all the available strategies – from diet and exercise to making new friends.
References
1. WHO: Noncommunicable diseases [Internet]. [cited 2022 Jun 6]. Available from: https://www.who.int/health-topics/noncommunicable-diseases
2. WHO: Noncomunnicable diseases and Mortality [Internet]. [cited 2022 Jun 6]. Available from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/ncd-mortality
3. Benziger CP, Roth GA, Moran AE. The Global Burden of Disease Study and the Preventable Burden of NCD. Glob Heart. 2016 Dec;11(4):393–7.
4. Budreviciute A, Damiati S, Sabir DK, Onder K, Schuller-Goetzburg P, Plakys G, et al. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Front Public Health. 2020 Nov 26;8:574111.
5. Pedersen BK. Which type of exercise keeps you young? Curr Opin Clin Nutr Metab Care. 2019 Mar;22(2):167–73.
6. Johansen MY, MacDonald CS, Hansen KB, Karstoft K, Christensen R, Pedersen M, et al. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA. 2017 Aug 15;318(7):637.
7. WHO: Physical activity [Internet]. 2022 [cited 2022 Jun 6]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity
8. Mente A, Yusuf S. Evolving evidence about diet and health. Lancet Public Health. 2018 Sep;3(9):e408–9.
9. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health: Mediterranean Diet and Disease Prevention. BioFactors. 2013 Jul;39(4):335–42.
10. Willcox DC, Scapagnini G, Willcox BJ. Healthy aging diets other than the Mediterranean: A focus on the Okinawan diet. Mech Ageing Dev. 2014 Mar;136–137:148–62.
11. Vasim I, Majeed CN, DeBoer MD. Intermittent Fasting and Metabolic Health. Nutrients. 2022 Jan 31;14(3):631.
12. Dunford EK, Popkin B, Ng SW. Junk Food Intake Among Adults in the United States. J Nutr. 2022 Feb 8;152(2):492–500.
13. Mazzotti DR, Guindalini C, Moraes WA dos S, Andersen ML, Cendoroglo MS, Ramos LR, et al. Human longevity is associated with regular sleep patterns, maintenance of slow wave sleep, and favorable lipid profile. Front Aging Neurosci [Internet]. 2014 Jun 24 [cited 2022 Jun 9];6. Available from: http://journal.frontiersin.org/article/10.3389/fnagi.2014.00134/abstract
14. Scahill RI, Frost C, Jenkins R, Whitwell JL, Rossor MN, Fox NC. A Longitudinal Study of Brain Volume Changes in Normal Aging Using Serial Registered Magnetic Resonance Imaging. Arch Neurol. 2003 Jul 1;60(7):989.
15. Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci. 2008 Jan;9(1):58–65.
16. Yannakoulia M, Kontogianni M, Scarmeas N. Cognitive health and Mediterranean Diet: Just diet or lifestyle pattern? Ageing Res Rev. 2015 Mar;20:74–8.
17. Ferrie JE, Shipley MJ, Akbaraly TN, Marmot MG, Kivimäki M, Singh-Manoux A. Change in Sleep Duration and Cognitive Function: Findings from the Whitehall II Study. Sleep. 2011 May;34(5):565–73.
18. Lupien SJ, Fiocco A, Wan N, Maheu F, Lord C, Schramek T, et al. Stress hormones and human memory function across the lifespan. Psychoneuroendocrinology. 2005 Apr;30(3):225–42.
19. Yang JS, Jeon YJ, Lee GB, Kim HC, Jung SJ. The association between psychological resilience and cognitive function in longitudinal data: Results from the community follow-up survey. J Affect Disord. 2021 Jul;290:109–16.
20. Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast. 2017;2017:1–22.
21. Depp C, Vahia IV, Jeste D. Successful Aging: Focus on Cognitive and Emotional Health. Annu Rev Clin Psychol. 2010 Mar 1;6(1):527–50.
22. Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009 Jun;10(6):434–45.
23. Robertson SM, Stanley MA, Cully JA, Naik AD. Positive Emotional Health and Diabetes Care: Concepts, Measurement, and Clinical Implications. Psychosomatics. 2012 Jan;53(1):1–12.
24. Beauregard M. Mind does really matter: Evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. Prog Neurobiol. 2007 Mar;81(4):218–36.
25. Guendelman S, Medeiros S, Rampes H. Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies. Front Psychol [Internet]. 2017 Mar 6 [cited 2022 Jun 10];8. Available from: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.00220/full
26. Larson DB, Larson SS. Spirituality’s Potential Relevance to Physical and Emotional Health: A Brief Review of Quantitative Research. J Psychol Theol. 2003 Mar;31(1):37–51.
27. Leavell MA, Leiferman JA, Gascon M, Braddick F, Gonzalez JC, Litt JS. Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review. Curr Environ Health Rep. 2019 Dec;6(4):297–308.
28. Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM. The association between social relationships and depression: A systematic review. J Affect Disord. 2015 Apr;175:53–65.
29. Larrabee Sonderlund A, Thilsing T, Sondergaard J. Should social disconnectedness be included in primary-care screening for cardiometabolic disease? A systematic review of the relationship between everyday stress, social connectedness, and allostatic load. Latham-Mintus K, editor. PLOS ONE. 2019 Dec 19;14(12):e0226717.
30. Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. Brayne C, editor. PLoS Med. 2010 Jul 27;7(7):e1000316.
31. O’Rourke HM, Collins L, Sidani S. Interventions to address social connectedness and loneliness for older adults: a scoping review. BMC Geriatr. 2018 Dec;18(1):214.
32. Banks MR, Banks WA. The Effects of Animal-Assisted Therapy on Loneliness in an Elderly Population in Long-Term Care Facilities. J Gerontol A Biol Sci Med Sci. 2002 Jul 1;57(7):M428–32.
33. Creswell JD, Irwin MR, Burklund LJ, Lieberman MD, Arevalo JMG, Ma J, et al. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial. Brain Behav Immun. 2012 Oct;26(7):1095–101.
34. Martina CMS, Stevens NL. Breaking the cycle of loneliness? Psychological effects of a friendship enrichment program for older women. Aging Ment Health. 2006 Sep 1;10(5):467–75.
35. Kremers IP, Steverink N, Albersnagel FA, Slaets JPJ. Improved self-management ability and well-being in older women after a short group intervention. Aging Ment Health. 2006 Sep 1;10(5):476–84.
Article reviewed by
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Dr. Ana Baroni MD. Ph.D.
Scientific & Medical Advisor
Quality Garant
Ana has over 20 years of consultancy experience in longevity, regenerative and precision medicine. She has a multifaceted understanding of genomics, molecular biology, clinical biochemistry, nutrition, aging markers, hormones and physical training. This background allows her to bridge the gap between longevity basic sciences and evidence-based real interventions, putting them into the clinic, to enhance the healthy aging of people. She is co-founder of Origen.life, and Longevityzone. Board member at Breath of Health, BioOx and American Board of Clinical Nutrition. She is Director of International Medical Education of the American College of Integrative Medicine, Professor in IL3 Master of Longevity at Barcelona University and Professor of Nutrigenomics in Nutrition Grade in UNIR University.
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