Department of Behavioural Science and Health, University College London, London, UK.
Department of Behavioural Science and Health, University College London, London, UK
J Epidemiol Community Health. 2021 Aug;75(8):749-754. doi: 10.1136/jech-2020-215539. Epub 2021 Jan 6.
There is growing research into the effects of psychological and social factors such as loneliness and isolation on cardiovascular disease (CVD). However, it is unclear whether individuals with particular clusters of CVD risk factors are more strongly affected by loneliness and isolation. This study aimed to identify latent clustering of modifiable risk factors among adults aged 50+ and explore the relationship between loneliness, social isolation and risk factor patterns.
Data from 8218 adults of English Longitudinal Study of Ageing were used in latent class analyses to identify latent classes of cardiovascular risk factors and predictors of class membership.
There were four latent classes: low-risk (30.2%), high-risk (15.0%), clinical-risk (42.6%) and lifestyle-risk (12.2%) classes. Loneliness was associated with a greater risk of being in the high-risk class (relative risk ratio (RRR) 2.40, 95% CI 2.40 to 1.96) and lifestyle-risk class (RRR 1.36, 95% CI 1.10 to 1.67) and a lower risk of being in the clinical-risk class (RRR 0.84, 95% CI 0.72 to 0.98) relative to the low-risk class. Social disengagement, living alone and low social contact were also differentially associated with latent class memberships.
These findings supplement our existing knowledge of modifiable risk factors for CVD by showing how risk factors cluster together and how the risk patterns are related to social factors, offering important implications for clinical practice and preventive interventions.
越来越多的研究关注心理和社会因素(如孤独和隔离)对心血管疾病(CVD)的影响。然而,目前尚不清楚是否具有特定 CVD 危险因素集群的个体受孤独和隔离的影响更大。本研究旨在确定 50 岁以上成年人可改变危险因素的潜在聚类,并探讨孤独感和社会隔离与危险因素模式之间的关系。
使用英国老龄化纵向研究 8218 名成年人的数据进行潜在类别分析,以确定心血管危险因素的潜在类别和类别成员的预测因素。
存在四个潜在类别:低危(30.2%)、高危(15.0%)、临床高危(42.6%)和生活方式高危(12.2%)类别。孤独感与处于高危类别(相对风险比(RRR)2.40,95%CI 2.40 至 1.96)和生活方式高危类别(RRR 1.36,95%CI 1.10 至 1.67)的风险增加相关,而与低危类别(RRR 0.84,95%CI 0.72 至 0.98)的风险降低相关。社会脱离、独居和低社会接触也与潜在的类别成员身份存在差异相关。
这些发现通过显示危险因素如何聚集以及风险模式与社会因素的关系,补充了我们对 CVD 可改变危险因素的现有认识,为临床实践和预防干预提供了重要意义。