Schrempft Stephanie, Jackowska Marta, Hamer Mark, Steptoe Andrew
Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
Department of Psychology, University of Roehampton, London, SW15 5PJ, UK.
BMC Public Health. 2019 Jan 16;19(1):74. doi: 10.1186/s12889-019-6424-y.
The impact of social isolation and loneliness on health risk may be mediated by a combination of direct biological processes and lifestyle factors. This study tested the hypothesis that social isolation and loneliness are associated with less objective physical activity and more sedentary behavior in older adults.
Wrist-mounted accelerometers were worn over 7 days by 267 community-based men (n = 136) and women (n = 131) aged 50-81 years (mean 66.01), taking part in the English Longitudinal Study of Ageing (ELSA; wave 6, 2012-13). Associations between social isolation or loneliness and objective activity were analyzed using linear regressions, with total activity counts and time spent in sedentary behavior and light and moderate/vigorous activity as the outcome variables. Social isolation and loneliness were assessed with standard questionnaires, and poor health, mobility limitations and depressive symptoms were included as covariates.
Total 24 h activity counts were lower in isolated compared with non-isolated respondents independently of gender, age, socioeconomic status, marital status, smoking, alcohol consumption, self-rated health, limiting longstanding illness, mobility limitations, depressive symptoms, and loneliness (β = - 0.130, p = 0.028). Time spent in sedentary behavior over the day and evening was greater in isolated participants (β = 0.143, p = 0.013), while light (β = - 0.143, p = 0.015) and moderate/vigorous (β = - 0.112, p = 0.051) physical activity were less frequent. Physical activity was greater on weekdays than weekend days, but associations with social isolation were similar. Loneliness was not associated with physical activity or sedentary behavior in multivariable analysis.
These findings suggest that greater social isolation in older men and women is related to reduced everyday objective physical activity and greater sedentary time. Differences in physical activity may contribute to the increased risk of ill-health and poor wellbeing associated with isolation.
社会隔离和孤独对健康风险的影响可能是由直接的生物学过程和生活方式因素共同介导的。本研究检验了以下假设：社会隔离和孤独与老年人较少的客观身体活动以及更多的久坐行为相关。
267名年龄在50 - 81岁（平均66.01岁）的社区男性（n = 136）和女性（n = 131）参与了英国老龄化纵向研究（ELSA；2012 - 2013年第6轮），他们佩戴腕式加速度计7天。使用线性回归分析社会隔离或孤独与客观活动之间的关联，将总活动计数以及久坐行为、轻度和中度/剧烈活动所花费的时间作为结果变量。通过标准问卷评估社会隔离和孤独情况，并将健康状况不佳、行动不便和抑郁症状作为协变量纳入分析。
与非隔离受访者相比，隔离受访者的24小时总活动计数更低，且不受性别、年龄、社会经济地位、婚姻状况、吸烟、饮酒、自我评定健康状况、长期疾病限制、行动不便、抑郁症状和孤独感的影响（β = -0.130，p = 0.028）。隔离参与者在白天和晚上久坐行为所花费的时间更多（β = 0.143，p = 0.013），而轻度（β = -0.143，p = 0.015）和中度/剧烈（β = -0.112，p = 0.051）身体活动的频率更低。工作日的身体活动比周末更多，但与社会隔离的关联相似。在多变量分析中，孤独感与身体活动或久坐行为无关。
这些发现表明，老年男性和女性中更大程度的社会隔离与日常客观身体活动减少和久坐时间增加有关。身体活动的差异可能导致与隔离相关的健康不良和幸福感降低风险增加。
