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社会网络多样性对老年人死亡率、认知和身体功能的影响:芝加哥健康与老龄化项目(CHAP)的纵向分析。

Effects of social network diversity on mortality, cognition and physical function in the elderly: a longitudinal analysis of the Chicago Health and Aging Project (CHAP).

机构信息

Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.

Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Epidemiol Community Health. 2018 Nov;72(11):990-996. doi: 10.1136/jech-2017-210236. Epub 2018 Jul 3.

DOI:10.1136/jech-2017-210236
PMID:29970598
Abstract

BACKGROUND

Having a larger social network has been shown to have beneficial effects on health and survival in adults, but few studies have evaluated the role of network diversity, in addition to network size. We explore whether social network diversity is associated with mortality, cognition and physical function among older black and white adults.

METHODS

Data are obtained from the Chicago Health and Aging Project, a longitudinal, population-based study of adults aged 65 years and older at baseline. Using Cox proportional hazards regression, we estimate the hazard of mortality by network diversity (n=6497). The association between network diversity and cognition (n=6560) and physical function (n=6561) is determined using generalised estimating equations. Models were adjusted for age, gender, race, socioeconomic status, marital status and health-related variables.

RESULTS

In fully adjusted models, elderly with more diverse social networks had a lower risk of mortality (HR=0.93, p<0.01) compared with elderly with less diverse networks. Increased diversity in social networks was also associated with higher global cognitive function (coefficient=0.11, p<0.001) and higher physical function (coefficient=0.53, p<0.001).

CONCLUSIONS

Social networks are particularly important for older adults as they face the greatest threats to health and depend on network relationships, more than younger individuals, to meet their needs. Increasing diversity, and not just increasing size, of social networks may be essential for improving health and survival among older adults.

摘要

背景

拥有更大的社交网络已被证明对成年人的健康和生存有有益影响,但很少有研究评估网络多样性(除了网络规模之外)的作用。我们探讨社交网络多样性是否与老年黑人和白人成年人的死亡率、认知和身体功能有关。

方法

数据来自芝加哥健康和老龄化项目,这是一项针对基线时年龄在 65 岁及以上的成年人的纵向、基于人群的研究。我们使用 Cox 比例风险回归估计网络多样性(n=6497)与死亡率之间的风险比。使用广义估计方程确定网络多样性与认知(n=6560)和身体功能(n=6561)之间的关联。模型调整了年龄、性别、种族、社会经济地位、婚姻状况和与健康相关的变量。

结果

在完全调整的模型中,与网络多样性较低的老年人相比,具有更多样化社交网络的老年人死亡率较低(HR=0.93,p<0.01)。社交网络多样性的增加也与更高的总体认知功能(系数=0.11,p<0.001)和更高的身体功能(系数=0.53,p<0.001)相关。

结论

社交网络对老年人尤为重要,因为他们面临着最大的健康威胁,并且比年轻人更依赖网络关系来满足他们的需求。增加社交网络的多样性,而不仅仅是增加规模,可能是改善老年人健康和生存的关键。

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