Renwick Kelly Ann, Sanmartin Claudia, Dasgupta Kaberi, Berrang-Ford Lea, Ross Nancy
Department of Interdisciplinary Studies, Appalachian State University, 301 Bodenheimer Drive, Boone, NC, 28608, USA.
Statistics Canada, R.H. Coats Building, Floor 24 A, 100 Tunney's Pasture, Driveway, Ottawa, ON, K1A 0T6, Canada.
Can J Public Health. 2020 Aug;111(4):594-605. doi: 10.17269/s41997-020-00310-9. Epub 2020 Mar 13.
Among older Canadians, we examined the influence of low social support, a weak sense of belonging, and living alone to understand their role on mortality risk in Canada.
We conducted a retrospective cohort study of older Canadians surveyed in 2001 from the Canadian Community Health Survey and followed up with death events through December 31, 2011 from the Canadian Vital Statistics Database. Analyses were stratified by age: 55-64 and 65 and older. Social support was assessed using measures developed for the Medical Outcomes Study. A sense of belonging, a binary measure, measured community integration. Living alone was a binary measure. Survival analysis was applied using a Cox proportional hazards model, adjusted for age, sex, income, smoking, and frailty.
Among respondents 55-64 (n = 6822), low affection (HR = 1.37; 95% CI 1.07, 1.75), low emotional/informational support (HR = 1.36; 95% CI 1.06, 1.74), and low positive social interactions (HR = 1.36; 95% CI 1.06, 1.75) were associated with mortality risk. Among respondents 65 and older (n = 8966), low affection (HR = 1.17; 95% CI 1.04, 1.31), low positive social interactions (HR = 1.20; 95% CI 1.07, 1.34), low emotional/informational support (HR = 1.19; 95% CI 1.06, 1.33), and a weak sense of belonging (HR = 1.13; 95% CI 1.05, 1.22) were associated with mortality risk.
Low social support and a weak sense of belonging are important risk factors among older Canadians and should be part of the dialogue in Canada about their roles in healthy aging.
在加拿大老年人中，我们研究了社会支持不足、归属感薄弱和独居的影响，以了解它们在加拿大死亡风险中所起的作用。
我们对2001年加拿大社区健康调查中调查的加拿大老年人进行了一项回顾性队列研究，并通过加拿大人口动态统计数据库追踪到2011年12月31日的死亡事件。分析按年龄分层：55 - 64岁和65岁及以上。社会支持使用为医疗结果研究开发的测量方法进行评估。归属感是一个二元测量指标，衡量社区融入情况。独居是一个二元测量指标。使用Cox比例风险模型进行生存分析，并对年龄、性别、收入、吸烟和虚弱状况进行了调整。
在55 - 64岁的受访者中（n = 6822），情感支持不足（风险比[HR] = 1.37；95%置信区间[CI] 1.07，1.75）、情感/信息支持不足（HR = 1.36；95% CI 1.06，1.74）以及积极社交互动不足（HR = 1.36；95% CI 1.06，1.75）与死亡风险相关。在65岁及以上的受访者中（n = 8966），情感支持不足（HR = 1.17；95% CI 1.04，1.31）、积极社交互动不足（HR = 1.20；95% CI 1.07，1.34）、情感/信息支持不足（HR = 1.19；95% CI 1.06，1.33）以及归属感薄弱（HR = 1.13；95% CI 1.05，1.22）与死亡风险相关。
社会支持不足和归属感薄弱是加拿大老年人中的重要风险因素，应该成为加拿大关于它们在健康老龄化中作用的讨论的一部分。
