Middle-aged adults in the early stages of Alzheimer’s disease may actually become more sociable — not more withdrawn — according to a new large-scale study that challenges long-held assumptions about the condition.

Researchers analysed data from nearly 500,000 people in the UK aged 40 and above and discovered that those with a higher genetic risk for Alzheimer’s were more likely to report active social lives, strong family relationships, and lower levels of isolation.

“We found this quite unexpected,” said Dr. Scott Zimmerman, senior research fellow at Boston University and lead author of the study, speaking to BBC Science Focus. “We had anticipated signs of social withdrawal due to mood changes or difficulties managing social plans, but instead, we saw the opposite trend.”

Published in the American Journal of Epidemiology, the study suggests that individuals experiencing subtle early symptoms of Alzheimer’s — like slight changes in memory and thinking — might seek closer bonds with family and friends, potentially to access more daily support.

While Alzheimer’s and other forms of dementia have often been linked to loneliness and social isolation, it remains unclear whether being socially isolated contributes to developing dementia or if it’s a consequence of early disease progression.

However, the new findings suggest that people at higher risk of Alzheimer’s might actually increase their social engagement years before any formal diagnosis.

“Their social networks may even expand,” explained co-senior author Dr. Ashwin Kotwal of the University of California, San Francisco (UCSF). He clarified that the study doesn’t contradict past research connecting dementia and social disconnection, but rather deepens the understanding of that relationship.

“This indicates that the link between social isolation and dementia, as seen in other studies, isn’t simply the result of early symptoms causing withdrawal,” added co-author Dr. Ruijia Chen of Boston University. “It strengthens the argument that maintaining social connections could genuinely help preserve brain health.”

Alongside genetic predisposition, numerous lifestyle factors — such as physical activity, smoking, blood pressure, glucose levels, sleep, mental health, and medication use — also influence the risk of developing dementia. Researchers estimate these modifiable elements could account for about 30% of Alzheimer’s cases, and loneliness may be one of them.

“In an age where social interaction is declining, we hope families, communities, and policymakers prioritize opportunities for meaningful social engagement throughout life,” said co-author Dr. Jacqueline Torres, associate professor at UCSF.