Social isolation, loneliness, and all-cause mortality: A cohort study of 35,254 Chinese older adults

被引:43
作者
Yu, Bin [1 ,2 ,3 ]
Steptoe, Andrew [4 ]
Chen, Yongjie [5 ]
机构
[1] Tianjin Univ, Inst Appl Psychol, Tianjin, Peoples R China
[2] Tianjin Univ, Acad Med Engn & Translat Med, Tianjin, Peoples R China
[3] Tianjin Med Univ, Sch Basic Med Sci, Dept Psychiat & Psychol, Tianjin, Peoples R China
[4] UCL, Dept Behav Sci & Hlth, London, England
[5] Tianjin Med Univ, Sch Publ Hlth, Dept Epidemiol & Stat, 22 Qixiangtai Rd, Tianjin 300070, Peoples R China
关键词
all-cause mortality; loneliness; older adults; social isolation; RISK-FACTORS; HEALTH; MEN;
D O I
10.1111/jgs.17708
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background Few studies of social isolation, loneliness and associations with all-cause mortality in older adults have been conducted in non-Western countries. The aim of this study was to conduct such an analysis in a nationally representative sample of Chinese older adults. Methods This study used eight waves of data from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018 and focused on participants aged >= 60 years. A total of 21,570 people died (61.2%) over a median follow-up of 4.8 years. Social isolation, loneliness, demographic, health and lifestyle factors were measured at baseline. The primary outcome was all-cause mortality. Cox proportional hazard regression models were used to examine the associations of isolation and loneliness with all-cause mortality. Results This study included 35,254 participants with mean age of 86.63 +/- 11.39 years. Social isolation was significantly associated with an increased mortality (adjusted HR 1.22; 95% CI 1.18-1.25; p < 0.01). The association of loneliness with mortality was nonsignificant after adjustment for health indicators and low psychological well-being (HR 1.01; 95% CI 0.98-1.04; p = 0.69). However, when stratified by age, there was a significant association of loneliness with mortality among participants aged <80 years (HR 1.15; 95% CI 1.05-1.26; p < 0.01). Conclusions Social isolation was associated with an increased all-cause mortality among the older Chinese adults. However, loneliness was associated with an increased mortality only among younger participants. Public health interventions aimed at increasing social connectedness may potentially reduce excess mortality among older adults.
引用
收藏
页码:1717 / 1725
页数:9
相关论文
共 26 条
[1]   Loneliness, Social Networks, and Health: A Cross-Sectional Study in Three Countries [J].
Alejandra Rico-Uribe, Laura ;
Felix Caballero, Francisco ;
Olaya, Beatriz ;
Tobiasz-Adamczyk, Beata ;
Koskinen, Seppo ;
Leonardi, Matilde ;
Maria Haro, Josep ;
Chatterji, Somnath ;
Luis Ayuso-Mateos, Jose ;
Miret, Marta .
PLOS ONE, 2016, 11 (01)
[2]   How are missing data in covariates handled in observational time-to-event studies in oncology? A systematic review [J].
Carroll, Orlagh U. ;
Morris, Tim P. ;
Keogh, Ruth H. .
BMC MEDICAL RESEARCH METHODOLOGY, 2020, 20 (01)
[3]   Household context and subjective well-being among the oldest old in China [J].
Chen, Feinian ;
Short, Susan E. .
JOURNAL OF FAMILY ISSUES, 2008, 29 (10) :1379-1403
[4]  
Cyhlarova E., 2020, Recruiting participants for adult social care studies: Challenges and mitigating strategies
[5]   Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report [J].
Donovan, Nancy J. ;
Blazer, Dan .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 2020, 28 (12) :1233-1244
[6]   Older adult loneliness: myths and realities [J].
Dykstra, Pearl A. .
EUROPEAN JOURNAL OF AGEING, 2009, 6 (02) :91-100
[7]   Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women [J].
Hakulinen, Christian ;
Pulkki-Raback, Laura ;
Virtanen, Marianna ;
Jokela, Markus ;
Kivimaki, Mika ;
Elovainio, Marko .
HEART, 2018, 104 (18) :1536-1542
[8]   Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review [J].
Holt-Lunstad, Julianne ;
Smith, Timothy B. ;
Baker, Mark ;
Harris, Tyler ;
Stephenson, David .
PERSPECTIVES ON PSYCHOLOGICAL SCIENCE, 2015, 10 (02) :227-237
[9]   Social Relationships and Mortality Risk: A Meta-analytic Review [J].
Holt-Lunstad, Julianne ;
Smith, Timothy B. ;
Layton, J. Bradley .
PLOS MEDICINE, 2010, 7 (07)
[10]   Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL) [J].
Holwerda, T. J. ;
Beekman, A. T. F. ;
Deeg, D. J. H. ;
Stek, M. L. ;
van Tilburg, T. G. ;
Visser, P. J. ;
Schmand, B. ;
Jonker, C. ;
Schoevers, R. A. .
PSYCHOLOGICAL MEDICINE, 2012, 42 (04) :843-853