Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 8200, Denmark.
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Sci Rep. 2018 Mar 16;8(1):4731. doi: 10.1038/s41598-018-22963-w.
Social isolation is associated with increased mortality. Meta-analytic results, however, indicate heterogeneity in effect sizes. We aimed to provide new evidence to the association between social isolation and mortality by conducting a population-based cohort study. We reconstructed the Berkman and Syme's social network index (SNI), which combines four components of social networks (partnership, interaction with family/friends, religious activities, and membership in organizations/clubs) into an index, ranging from 0/1 (most socially isolated) to 4 (least socially isolated). We estimated cumulative mortality and adjusted mortality rate ratios (MRR) associated with SNI. We adjusted for potential important confounders, including psychiatric and somatic status, lifestyle, and socioeconomic status. Cumulative 7-year mortality in men was 11% for SNI 0/1 and 5.4% for SNI 4 and in women 9.6% for SNI 0/1 and 3.9% for SNI 4. Adjusted MRRs comparing SNI 0/1 with SNI 4 were 1.7 (95% CI: 1.1-2.6) among men and 1.6 (95% CI: 0.83-2.9) among women. Having no partner was associated with an adjusted MRR of 1.5 (95% CI: 1.2-2.1) for men and 1.7 (95% CI: 1.2-2.4) for women. In conclusion, social isolation was associated with 60-70% increased mortality. Having no partner was associated with highest MRR.
社会隔离与死亡率增加有关。然而,荟萃分析结果表明,效应大小存在异质性。我们旨在通过进行一项基于人群的队列研究,为社会隔离与死亡率之间的关联提供新的证据。我们重建了 Berkman 和 Syme 的社会网络指数(SNI),该指数将社会网络的四个组成部分(伙伴关系、与家人/朋友的互动、宗教活动和组织/俱乐部的成员身份)组合成一个指数,范围从 0/1(最孤立)到 4(最不孤立)。我们估计了与 SNI 相关的累积死亡率和调整后的死亡率比(MRR)。我们调整了潜在的重要混杂因素,包括精神和躯体状况、生活方式和社会经济地位。男性 SNI 0/1 的 7 年累积死亡率为 11%,SNI 4 的死亡率为 5.4%,女性 SNI 0/1 的死亡率为 9.6%,SNI 4 的死亡率为 3.9%。与 SNI 0/1 相比,SNI 4 的调整后 MRR 为男性 1.7(95%CI:1.1-2.6)和女性 1.6(95%CI:0.83-2.9)。男性没有伴侣的调整后 MRR 为 1.5(95%CI:1.2-2.1),女性为 1.7(95%CI:1.2-2.4)。总之,社会隔离与 60-70%的死亡率增加有关。没有伴侣与最高的 MRR 相关。