Conceptual advancement: social health as a facilitator in the use of cognitive reserve

Dementia is a syndrome where the origins are not fully understood, and we have no cure. New thinking through exploration of paradigms beyond biological approaches has scope to improve knowledge about this complex condition. We aim to explore the role of social health in cognitive decline and the onset of dementia. We performed a scoping and a systematic review of the literature, hypothesizing that social health acts as a driver for stimulating the use of cognitive reserve. The review yielded theoretical pathways and evidence for the association between neurobiological and social health markers. However, lack of conceptual clarity on social health hinders its articulation and associated inclusion of social health markers in epidemiological studies. We therefore apply concept advancement of social health. We developed a conceptual framework, and we present a first testing of our overarching hypothesis. This framework proved to effectively guide the identification of social health markers in our epidemiological data bases. This promotes the identification of modifiable risk factors, which may in turn shape new avenues for preventive interventions. ### Competing Interest Statement None declared by the authors, except for Perminder Sachdev and Henry Brodaty. Conflict of interest: PS is on the Expert Advisory Committee of Biogen Australia. Conflict of interest: HB has been an advisory board member or consultant to Nutricia Australia, Biogen, Roche Pharmaceuticals and Synapse2Neuron. ### Funding Statement the paper is part of the SHARED project funded by JPND 733051082 ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Review of published data I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors