Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Gerontol B Psychol Sci Soc Sci. 2021 Oct 30;76(9):1756-1766. doi: 10.1093/geronb/gbaa196.
To investigate the association of loneliness and its component subscales with the risk of dementia in a general Japanese older population.
A total of 1,141 community-dwelling Japanese residents aged ≥65 years without dementia were prospectively followed up for a median 5.0 years. We evaluated any loneliness and its component subscales-namely, social and emotional loneliness-by using the 6-item de Jong Gierveld Loneliness Scale. Cox proportional hazards models were used to estimate hazard ratios (HRs) of each loneliness type on the risk of dementia controlling for demographic factors, lifestyle factors, physical factors, social isolation factors, and depression.
During the follow-up, 114 participants developed dementia. The age- and sex-adjusted incidence rate of dementia was significantly greater in participants with any loneliness and emotional loneliness than those without. The multivariable-adjusted HRs (95% confidence intervals) of participants with any loneliness and emotional loneliness on incident dementia were 1.61 (1.08-2.40) and 1.65 (1.07-2.54), respectively, as compared to those without. However, there was no significant association between social loneliness and dementia risk. In subgroup analyses of social isolation factors, excess risks of dementia associated with emotional loneliness were observed in participants who had a partner, lived with someone, or rarely communicated with relatives or friends, but such association was not significant in participants who had no partner, lived alone, or frequently communicated with friends or relatives.
The present study suggested that loneliness, especially emotional loneliness, was a significant risk factor for the development of dementia in the general older population in Japan.
调查孤独感及其分量表与日本一般老年人群痴呆风险的关系。
对 1141 名无痴呆的 65 岁以上社区居住的日本居民进行前瞻性随访，中位随访时间为 5.0 年。我们使用 6 项 Jong Gierveld 孤独量表评估了任何孤独感及其分量表-即社交和情感孤独感。使用 Cox 比例风险模型，在控制人口统计学因素、生活方式因素、身体因素、社会隔离因素和抑郁的情况下，估计每种孤独类型发生痴呆的风险比 (HR)。
在随访期间，114 名参与者发生了痴呆。有任何孤独感和情感孤独感的参与者的年龄和性别调整后痴呆发生率明显高于无孤独感的参与者。有任何孤独感和情感孤独感的参与者发生痴呆的多变量调整 HR（95%置信区间）分别为 1.61（1.08-2.40）和 1.65（1.07-2.54），与无孤独感的参与者相比。然而，社交孤独感与痴呆风险之间没有显著关联。在社会隔离因素的亚组分析中，与情感孤独感相关的痴呆风险增加仅见于有伴侣、与他人同住或很少与亲属或朋友交流的参与者，但在没有伴侣、独居或经常与朋友或亲属交流的参与者中，这种关联并不显著。
本研究表明，孤独感，尤其是情感孤独感，是日本一般老年人群发生痴呆的一个重要危险因素。
