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孤独感、独居生活和全因死亡率:在 19 年的随访中,情感孤独感和社会孤独感在老年人中的作用。

Loneliness, Living Alone, and All-Cause Mortality: The Role of Emotional and Social Loneliness in the Elderly During 19 Years of Follow-Up.

机构信息

From the School of Psychology (O'Súilleabháin), National University of Ireland Galway; Department of Psychology (O'Súilleabháin, Gallagher), Health Research Institute, University of Limerick, Ireland; and Department of Behavioural Science and Health (Steptoe), University College London, United Kingdom.

出版信息

Psychosom Med. 2019 Jul/Aug;81(6):521-526. doi: 10.1097/PSY.0000000000000710.

Abstract

OBJECTIVE

The aims of the study were to examine the predictive value of social and emotional loneliness for all-cause mortality in the oldest-old who do and do not live alone and to test whether these varied by functional status and personality.

METHODS

Participants were 413 older adults from the Berlin Aging Study (M [SD] = 84.53 [8.61] years of age) who either lived alone (n = 253) or did not live alone (n = 160). Significance values for hazard ratios are reported having adjusted for age, sex, education, income, marital status, depressive illness, and both social and emotional loneliness.

RESULTS

Although social loneliness was not associated with mortality in those living alone, emotional loneliness was; with each 1 SD increase in emotional loneliness, there was an 18.6% increased risk of all-cause mortality in the fully adjusted model (HR = 1.186, p = .029). No associations emerged for social or emotional loneliness among those not living alone. Examinations of potential moderators revealed that with each 1 SD increase in functional status, the risk associated with emotional loneliness for all-cause mortality increased by 17.9% (hazard ratiointeraction = 1.179, p = .005) in those living alone. No interaction between personality traits with loneliness emerged.

CONCLUSIONS

Emotional loneliness is associated with an increased risk of all-cause mortality in older adults who live alone. Functional status was identified as one potential pathway accounting for the adverse consequences of loneliness. Emotional loneliness that can arise out of the loss or absence of a close emotional attachment figure seems to be the toxic component of loneliness.

摘要

目的

本研究旨在探讨社交和情感孤独对独居和非独居的最年长老年人全因死亡率的预测价值,并检验这些因素是否因功能状态和人格而异。

方法

参与者为来自柏林老龄化研究的 413 名老年人(M [SD] = 84.53 [8.61]岁),他们要么独居(n = 253),要么非独居(n = 160)。风险比的显著性值报告在调整了年龄、性别、教育、收入、婚姻状况、抑郁和社交及情感孤独后得出。

结果

虽然社交孤独与独居者的死亡率无关,但情感孤独与死亡率有关;在完全调整的模型中,情感孤独每增加 1 个标准差,全因死亡率的风险增加 18.6%(HR = 1.186,p =.029)。对于非独居者,社交或情感孤独均无关联。对潜在调节因素的检查表明,随着功能状态每增加 1 个标准差,情感孤独对全因死亡率的风险增加 17.9%(风险比交互作用 = 1.179,p =.005)。在独居者中,人格特质与孤独之间没有交互作用。

结论

情感孤独与独居老年人全因死亡率的增加有关。功能状态被确定为解释孤独不良后果的一个潜在途径。情感孤独可能是由亲密情感依恋对象的缺失或丧失引起的,它似乎是孤独的有毒成分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787f/6615929/6bbd1476ba7a/psm-81-521-g003.jpg

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