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社会隔离与孤独作为临床有意义的衡量指标之间的差异:来自爱尔兰和英国老龄化纵向研究(TILDA 和 ELSA)的发现。

The discrepancy between social isolation and loneliness as a clinically meaningful metric: findings from the Irish and English longitudinal studies of ageing (TILDA and ELSA).

机构信息

Institute of Neuroscience, Trinity College, Dublin 2, Ireland.

Centre for Public Health, Queen's University Belfast, BT12 6BJ, UK.

出版信息

Int J Geriatr Psychiatry. 2017 Jun;32(6):664-674. doi: 10.1002/gps.4509. Epub 2016 Jun 1.

Abstract

OBJECTIVE

Scant evidence is available on the discordance between loneliness and social isolation among older adults. We aimed to investigate this discordance and any health implications that it may have.

METHOD

Using nationally representative datasets from ageing cohorts in Ireland (TILDA) and England (ELSA), we created a metric of discordance between loneliness and social isolation, to which we refer as Social Asymmetry. This metric was the categorised difference between standardised scores on a scale of loneliness and a scale of social isolation, giving categories of: Concordantly Lonely and Isolated, Discordant: Robust to Loneliness, or Discordant: Susceptible to Loneliness. We used regression and multilevel modelling to identify potential relationships between Social Asymmetry and cognitive outcomes.

RESULTS

Social Asymmetry predicted cognitive outcomes cross-sectionally and at a two-year follow-up, such that Discordant: Robust to Loneliness individuals were superior performers, but we failed to find evidence for Social Asymmetry as a predictor of cognitive trajectory over time.

CONCLUSIONS

We present a new metric and preliminary evidence of a relationship with clinical outcomes. Further research validating this metric in different populations, and evaluating its relationship with other outcomes, is warranted. Copyright © 2016 John Wiley & Sons, Ltd.

摘要

目的

关于老年人孤独感和社会隔离之间的不一致性,相关证据很少。本研究旨在调查这种不一致性及其可能产生的健康影响。

方法

利用爱尔兰(TILDA)和英国(ELSA)老龄化队列的全国代表性数据集,我们创建了一种孤独感和社会隔离之间不一致性的度量标准,我们称之为社会不对称。该度量标准是孤独感和社会隔离量表的标准化分数之间的分类差异,分为以下几类:一致孤独和隔离、不一致:对孤独有抵抗力、不一致:易受孤独影响。我们使用回归和多层次模型来确定社会不对称与认知结果之间的潜在关系。

结果

社会不对称性预测了认知结果的横断面和两年后的随访结果,即不一致:对孤独有抵抗力的个体表现更优,但我们未能发现社会不对称性是认知轨迹随时间变化的预测因素的证据。

结论

我们提出了一种新的度量标准和与临床结果的初步关系的证据。需要进一步的研究来验证该指标在不同人群中的有效性,并评估其与其他结果的关系。

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