Department of Medicine, College of Medicine, Howard University, Washington, DC, USA.
BMC Geriatr. 2009 Jul 28;9:33. doi: 10.1186/1471-2318-9-33.
Prior research suggests an interaction between social networks and Alzheimer's disease pathology and cognitive function, all predictors of survival in the elderly. We test the hypotheses that both social integration and cognitive function are independently associated with subsequent mortality and there is an interaction between social integration and cognitive function as related to mortality in a national cohort of older persons.
Data were analyzed from a longitudinal follow-up study of 5,908 American men and women aged 60 years and over examined in 1988-1994 followed an average 8.5 yr. Measurements at baseline included self-reported social integration, socio-demographics, health, body mass index, C-reactive protein and a short index of cognitive function (SICF).
Death during follow-up occurred in 2,431. In bivariate analyses indicators of greater social integration were associated with higher cognitive function. Among persons with SICF score of 17, 22% died compared to 54% of those with SICF score of 0-11 (p < 0.0001). After adjusting for confounding by baseline socio-demographics and health status, the hazards ratio (HR) (95% confidence limits) for low SICF score was 1.43 (1.13-1.80, p < 0.001). After controlling for health behaviors, blood pressure and body mass, C-reactive protein and social integration, the HR was 1.36 (1.06-1.76, p = 0.02). Further low compared to high social integration was also independently associated with increased risk of mortality: HR 1.24 (1.02-1.52, p = 0.02).
In a cohort of older Americans, analyses demonstrated a higher risk of death independent of confounders among those with low cognitive function and low social integration with no significant interaction between them.
先前的研究表明，社交网络与阿尔茨海默病病理和认知功能之间存在相互作用，而这两者都是老年人存活的预测因素。我们检验了以下假设：社交融合度和认知功能均与随后的死亡率独立相关，并且在一个老年人的全国队列中，社交融合度和认知功能之间存在交互作用，与死亡率有关。
对 5908 名年龄在 60 岁及以上的美国男女进行了纵向随访研究的数据进行了分析，这些人于 1988-1994 年接受检查，平均随访 8.5 年。基线测量包括自我报告的社交融合度、社会人口统计学、健康、体重指数、C 反应蛋白和简短认知功能指数（SICF）。
随访期间有 2431 人死亡。在双变量分析中，社交融合度较高的指标与认知功能较高相关。在 SICF 评分为 17 的人群中，有 22%的人死亡，而 SICF 评分为 0-11 的人群中，有 54%的人死亡（p<0.0001）。在调整基线社会人口统计学和健康状况的混杂因素后，SICF 评分低的危险比（HR）（95%置信区间）为 1.43（1.13-1.80，p<0.001）。在控制健康行为、血压和体重、C 反应蛋白和社交融合度后，HR 为 1.36（1.06-1.76，p=0.02）。进一步分析表明，与高社交融合度相比，低社交融合度也与死亡率增加独立相关：HR 为 1.24（1.02-1.52，p=0.02）。
在一个美国老年人队列中，分析表明，认知功能较低和社交融合度较低的人死亡风险较高，且两者之间没有显著的交互作用，这一结果独立于混杂因素。
