Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain.
Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain.
Psychoneuroendocrinology. 2021 Jan;123:104918. doi: 10.1016/j.psyneuen.2020.104918. Epub 2020 Oct 18.
This study aimed to examine how loneliness contributes to metabolic dysregulation among older adults with depression and determine the relative contribution of loneliness to the development of chronic diseases in late adulthood. Harmonised data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project were used. Concretely, the sample comprised 6195 participants (53.95% women; M = 61.30 years, SD = 7.11) from three European cohorts. Three groups were considered: control group (CG); depressive symptom episode group (DEP); and a group with depression and loneliness (DEP + LONE). A metabolic score was estimated using anthropometric and blood indicators, by means of multi-indicator multi-causes (MIMIC) modelling and after controlling for sociodemographic and health-related covariates. Group-comparison was based on measurement-invariance procedures. Multimorbidity development was predicted at follow-up considering the study group and relevant covariates. All the analyses were sex-specific. As a result, measurement invariance revealed the influence of group (ΔCFI = -0.017 for male participants and ΔCFI = -0.009 for female ones) on metabolic scores in both sexes. Metabolic scores were significantly lower (i.e., they had more metabolic risk) in DEP + LONE women in comparison to women from the other groups. DEP men showed the lowest metabolic scores but those from the DEP + LONE group showed meaningfully lower scores than CG men (d = 1.35). In terms of multimorbidity prediction, DEP + LONE group membership significantly predicted the outcome in both sexes; DEP group membership significantly predicted multimorbidity at follow-up in women. In summary, these results highlight the relevant contribution of loneliness in depression-related metabolic dysregulation in the short- (concurrent metabolic risk) and long-term (chronic condition development). Moreover, sex-specific mechanisms seem to be involved in metabolic alterations of depressed people showing loneliness feelings. This study calls for action to reduce the impact of loneliness in old age and to promote healthy ageing.
本研究旨在探讨孤独感如何导致老年抑郁症患者代谢失调，并确定孤独感对晚年慢性疾病发展的相对贡献。使用了来自欧洲三个队列的 Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) 项目的协调数据。具体来说，样本包括 6195 名参与者（53.95%为女性；M = 61.30 岁，SD = 7.11 岁）。考虑了三个组：对照组（CG）；抑郁症状发作组（DEP）；以及伴有抑郁和孤独感的组（DEP+LONE）。使用多指标多原因（MIMIC）模型，通过人体测量和血液指标估计代谢评分，并在控制社会人口统计学和健康相关协变量后进行。基于测量不变性程序进行组间比较。考虑研究组和相关协变量，预测随访时的多种疾病发展。所有分析均为性别特异性。结果表明，在两性中，组别的影响（男性参与者的 ΔCFI = -0.017，女性参与者的 ΔCFI = -0.009）导致了代谢评分的测量不变性。与其他组别的女性相比，DEP+LONE 女性的代谢评分显著较低（即存在更多代谢风险）。DEP 男性的代谢评分最低，但与 CG 男性相比，DEP+LONE 组的得分明显更低（d = 1.35）。在多种疾病预测方面，DEP+LONE 组的成员身份在两性中均显著预测了结果；DEP 组的成员身份在女性中显著预测了随访时的多种疾病。总之，这些结果强调了孤独感在抑郁相关代谢失调中的重要作用，包括短期（并发代谢风险）和长期（慢性疾病发展）。此外，涉及有孤独感的抑郁人群代谢变化的性别特异性机制似乎也参与其中。这项研究呼吁采取行动，减轻孤独感对老年人的影响，促进健康老龄化。
