Zhang Xuanping, Norris Susan L, Gregg Edward W, Beckles Gloria
The Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr. Zhang, Dr. Gregg, Dr. Beckles)
The Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (Dr. Norris)
Diabetes Educ. 2007 Mar-Apr;33(2):273-81. doi: 10.1177/0145721707299265.
The purpose of this study was to examine the relationship between social support and mortality among older persons with diabetes and the pathways by which social support affects diabetes survival.
Using data from the Longitudinal Study of Aging cohort 2 baseline (1994) and follow-up (1997-1998 and 1999-2000 surveys), the authors identified 1431 persons aged >or=70 years with diabetes, among whom 387 deaths occurred. Social support was measured by an index with regard to participants' connection with relatives, friends, neighbors, social events, church, and senior centers. Regression analysis was used to find the pathway, and survival analysis was used to find the relationship between social support and mortality.
Compared to people with a low level of social support, the risk of death is 41% lower among people with medium levels of support (hazards ratio = 0.59, 0.39-0.91) and 55% lower among those with the highest levels of support (hazards ratio = 0.45, 0.21-0.98). Eight of the 11 regression models demonstrated that the effect of social support on mortality was mediated by both physical and mental health status.
Social support is strongly associated with mortality. Based on findings from this study, social support should be considered an important target for intervention to reduce mortality risk among older adults with diabetes.
本研究旨在探讨糖尿病老年人社会支持与死亡率之间的关系,以及社会支持影响糖尿病患者生存的途径。
利用老年纵向研究队列2基线(1994年)和随访(1997 - 1998年及1999 - 2000年调查)的数据,作者确定了1431名年龄≥70岁的糖尿病患者,其中387人死亡。社会支持通过一个关于参与者与亲属、朋友、邻居、社交活动、教会和老年中心联系的指数来衡量。采用回归分析来寻找途径,采用生存分析来寻找社会支持与死亡率之间的关系。
与社会支持水平低的人相比,社会支持水平中等的人死亡风险降低41%(风险比 = 0.59,0.39 - 0.91),社会支持水平高的人死亡风险降低55%(风险比 = 0.45,0.21 - 0.98)。11个回归模型中有8个表明,社会支持对死亡率的影响是通过身心健康状况介导的。
社会支持与死亡率密切相关。基于本研究结果,社会支持应被视为降低老年糖尿病患者死亡风险干预的重要目标。