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老年人住院期间社会隔离的风险因素。

Social isolation risk factors in older hospitalized individuals.

机构信息

Unit of Geriatrics, INRCA (Italian National Institute on Aging), Contrada Mossa, 63023 Fermo, Italy.

出版信息

Arch Gerontol Geriatr. 2012 Nov-Dec;55(3):580-5. doi: 10.1016/j.archger.2012.01.011. Epub 2012 Feb 19.

Abstract

BACKGROUND

Elderly people are particularly vulnerable to the effects of social reduction, so there is an urgent need to identify the risks associated with social isolation. The aim of this paper was to analyze associations between psychological, socio-demographic, functional aspects on the risk of social isolation, mortality and re-hospitalization in older persons.

METHODS

This is a longitudinal study on 580 hospitalized elderly sample aged ≥70yrs recruited from 2005 to 2007 in the Geriatrics Operative Unit of INRCA in Fermo, Italy. The comprehensive geriatric assessment (CGA) was used. Outcome measures included 36-month mortality and re-hospitalization.

RESULTS

In all patients, approximately 20% (n=112) of the subjects were socially isolated. Women perceived their social support significantly worse than men (77.7 vs. 22.3%; p<0.001). A multiple logistic regression analysis (goodness of fit χ(2)=102.86, p<0.001) with risk of social isolation as the dependent variable, showed that women were at a greater risk than men for social isolation (OR=1.99, 95% CI=1.13-3.50). Furthermore, patients with a higher number of family components (OR=0.72, 95% CI=0.59-0.88) and good parameters of quality of life (PCS-12: OR=0.94, 95% CI=0.91-0.98; MCS-12: OR=0.94, 95% CI=0.92-0.97) were less likely to be socially isolated. Cox regression models adjusted for gender, quality of life and number of family components, showed that the social isolation did not predict mortality (HR=1.44, 95% CI=0.84-2.46, p=0.19), but was associated with higher re-hospitalization rates (HR=1.28, 95% CI=1.02-1.59, p=0.03).

CONCLUSIONS

Our findings highlight several aspects related to the risk of social isolation and re-hospitalization in a specific group of older persons.

摘要

背景

老年人特别容易受到社交减少的影响,因此迫切需要确定与社会隔离相关的风险。本文旨在分析心理、社会人口学和功能方面与老年人社会隔离、死亡和再住院风险之间的关联。

方法

这是一项对 2005 年至 2007 年期间意大利费尔莫 INRCA 老年病学手术病房 580 名≥70 岁住院老年人样本进行的纵向研究。使用综合老年评估(CGA)。主要观察指标包括 36 个月死亡率和再住院率。

结果

在所有患者中,约有 20%(n=112)的患者社会隔离。女性感知的社会支持明显差于男性(77.7 比 22.3%;p<0.001)。采用多因素逻辑回归分析(拟合优度χ(2)=102.86,p<0.001),以社会隔离为因变量,结果显示,女性比男性更容易发生社会隔离(OR=1.99,95%CI=1.13-3.50)。此外,家庭构成人数较多(OR=0.72,95%CI=0.59-0.88)和生活质量较好的患者(PCS-12:OR=0.94,95%CI=0.91-0.98;MCS-12:OR=0.94,95%CI=0.92-0.97)不太可能被社会隔离。调整性别、生活质量和家庭构成人数的 Cox 回归模型显示,社会隔离不能预测死亡率(HR=1.44,95%CI=0.84-2.46,p=0.19),但与再住院率较高相关(HR=1.28,95%CI=1.02-1.59,p=0.03)。

结论

我们的研究结果强调了与特定老年人群体社会隔离和再住院风险相关的几个方面。

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