We thank Dr. Holwerda for the insightful comments on our study.1 The association of social isolation and loneliness with dementia is inconsistent in literature.2-4 One possibility for this discrepancy is that the associations may be affected by risk factors that were not consistently considered in previous studies. Another explanation is that the study population and duration of follow-up is different. In this study, we found social isolation was an independent risk factor for dementia. However, the association between loneliness and dementia was not significant after full adjustment, which was decreased by 75% when controlling for depressive symptoms.
