Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Cattedra di Geriatria, Università degli Studi di Napoli Federico II, Via S. Pansini, 5, 80131 Napoli, Italy.
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):323-8. doi: 10.1016/j.archger.2010.01.011. Epub 2010 Feb 12.
Several studies have demonstrated a global increase in morbidity and mortality in elderly subjects with low social support or high comorbidity. However, the relationship between social support and comorbidity on long-term mortality in elderly people is not yet known. Thus, the present study was performed to evaluate the relationship between social support and comorbidity on 12-year mortality of elderly people. A random sample of 1288 subjects aged 65-95 years interviewed in 1992 was studied. Comorbidity by Charlson Comorbidity Index (CCI) score and Social Support by a scale in which total score ranges from 0 to 17, assigning to lowest social support the highest score, were evaluated. At 12-year follow-up, mortality progressively increase with low social support and comorbidity increasing (from 41.5% to 66.7% and from 41.2% to 68.3%, respectively; p<0.001). Moreover, low social support progressively increases with comorbidity increasing (and 12.4±2.5 to 14.3±2.6; p<0.001). Accordingly, multivariate analysis shows an increased mortality risk of 23% for each increase of tertile of social support scale (Hazard ratio=HR=1.23; 95% CI=1.01-1.51; p=0.045). Moreover, when the analysis was performed considering different degrees of comorbidity we found that social support level was predictive of mortality only in subjects with the highest comorbidity (HR=1.39; 95% CI=1.082-1.78; p=0.01). Thus, low social support is predictive of long-term mortality in the elderly. Moreover, the effect of social support on mortality increases in subjects with the highest comorbidity.
多项研究表明，社会支持水平低或合并症高的老年患者发病率和死亡率呈全球性上升。然而，社会支持与老年人长期死亡率之间的关系尚不清楚。因此，本研究旨在评估社会支持与合并症对老年人 12 年死亡率的关系。对 1992 年接受采访的 1288 名 65-95 岁的随机样本进行了研究。通过 Charlson 合并症指数（CCI）评分评估合并症，通过总分范围为 0-17 的量表评估社会支持，得分最低的社会支持分数最高。在 12 年的随访中，死亡率随着社会支持水平和合并症的增加而逐渐升高（分别从 41.5%升至 66.7%和从 41.2%升至 68.3%；p<0.001）。此外，随着合并症的增加，社会支持水平也逐渐升高（从 12.4±2.5 升至 14.3±2.6；p<0.001）。因此，多变量分析显示，社会支持量表每增加一个三分位，死亡率风险增加 23%（危险比[HR]=1.23；95%置信区间[CI]=1.01-1.51；p=0.045）。此外，当我们根据不同程度的合并症进行分析时，我们发现只有在合并症最严重的患者中，社会支持水平才是死亡率的预测因素（HR=1.39；95% CI=1.082-1.78；p=0.01）。因此，低社会支持水平是老年人长期死亡率的预测因素。此外，社会支持对死亡率的影响在合并症最严重的患者中增加。
