孤独是现代老年病学巨人的预测指标吗？来自欧洲健康、衰老和退休调查的分析。
Is loneliness a predictor of the modern geriatric giants? Analysis from the survey of health, ageing, and retirement in Europe.
机构信息
Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain; Department of Physiotherapy, Faculty of Health Sciences Blanquerna, Ramon Llull University, Barcelona, Spain.
Research Group on Methodology, Methods, Models and Outcome of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain.
出版信息
Maturitas. 2021 Feb;144:93-101. doi: 10.1016/j.maturitas.2020.11.010. Epub 2020 Dec 2.
BACKGROUND
The modern Geriatric Giants have evolved to encompass four new syndromes, of frailty (linked to fatigue and physical inactivity), sarcopenia, anorexia of ageing, and cognitive impairment. In parallel, loneliness has been established as a risk factor for adverse mental and physical health outcomes among older adults.
OBJECTIVE
To analyse loneliness as a predictor of the modern Geriatric Giants in European older adults, using a longitudinal design of nationally representative data.
DESIGN
Longitudinal population-based cohort study.
SUBJECTS
Data from countries that participated in waves 5 and 6 of the Survey of Health, Ageing, and Retirement in Europe project. The sizes of the subsamples analysed ranged from 17,742 for physical inactivity to 24,524 for anorexia of ageing.
METHODS
Loneliness (measured from wave 5) was the independent variable of interest. The dependent variables were incidence of fatigue, physical inactivity, sarcopenia, anorexia of ageing, and cognitive impairment from wave 5 (baseline) to wave 6. Poisson regression models were used for multivariable analysis, obtaining Relative Risk (RR) and 95 % confidence intervals (CI).
RESULTS
The prevalence of loneliness ranged from 9.2%-12.4% at wave 5. The 2-year incidence of fatigue was 16 % (95 % CI: 15.5-16.5), physical inactivity 9.8 % (95 % CI: 9.4-10.3), sarcopenia 5.6 % (95 % CI: 5.3-5.9), anorexia of aging 5.4 % (95 % CI: 5.1-5.7), and cognitive impairment 10.3 % (95 % CI: 9.9-10.8). The multivariable analysis showed that loneliness was a predictive factor for fatigue (30 %, CI: 17-45 % higher risk), physical inactivity (24 %, CI: 7-43 % higher risk) and cognitive impairment (26 %, CI: 9-46 % higher risk), adjusted by age, sex, number of chronic diseases, education level, region and depression.
CONCLUSIONS
Loneliness is an independent risk factor for fatigue, physical inactivity, and cognitive impairment in older adults. The incidence of anorexia of ageing and sarcopenia was not associated with loneliness over the 2-year observation period.
背景
现代老年病学的发展已经涵盖了四种新的综合征，包括衰弱（与疲劳和身体活动减少有关）、肌肉减少症、老年厌食症和认知障碍。与此同时，孤独已经被确定为老年人心理健康和身体健康不良后果的一个风险因素。
目的
使用具有全国代表性数据的纵向设计，分析孤独感作为欧洲老年人现代老年病学四大综合征的预测因子。
设计
基于人群的纵向队列研究。
受试者
来自参加欧洲健康、老龄化和退休调查项目第五和第六波调查的国家的数据。分析的子样本规模从身体活动减少的 17742 人到老年厌食症的 24524 人不等。
方法
孤独感（从第五波测量）是感兴趣的独立变量。从第五波（基线）到第六波，依赖变量是疲劳、身体活动减少、肌肉减少症、老年厌食症和认知障碍的发生率。多变量分析采用泊松回归模型，得出相对风险（RR）和 95%置信区间（CI）。
结果
第五波孤独感的患病率为 9.2%-12.4%。疲劳的 2 年发病率为 16%（95%CI：15.5-16.5），身体活动减少 9.8%（95%CI：9.4-10.3），肌肉减少症 5.6%（95%CI：5.3-5.9），老年厌食症 5.4%（95%CI：5.1-5.7），认知障碍 10.3%（95%CI：9.9-10.8）。多变量分析表明，孤独感是疲劳（30%，CI：17-45%的风险更高）、身体活动减少（24%，CI：7-43%的风险更高）和认知障碍（26%，CI：9-46%的风险更高）的预测因素，调整因素为年龄、性别、慢性疾病数量、教育水平、地区和抑郁。
结论
孤独感是老年人疲劳、身体活动减少和认知障碍的独立危险因素。在 2 年的观察期内，老年厌食症和肌肉减少症的发生率与孤独感无关。
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