Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Am Med Dir Assoc. 2021 Aug;22(8):1720-1725.e5. doi: 10.1016/j.jamda.2021.04.004. Epub 2021 May 8.
Loneliness and social isolation are important factors for morbidity and mortality. However, little is known about whether increases in loneliness and perceived social isolation contribute to decreased expectations of longevity and an increased frequency of dealing with death and dying. Consequently, our aim was to clarify these relationships.
Longitudinal data were derived from a nationally representative sample of individuals ≥40 years (analytical sample, n=7952 observations).
Community-dwelling individuals aged ≥40 years.
Loneliness and perceived social isolation were both measured using well-established tools. In accordance with other large cohort studies, the expectations of longevity were assessed using the question "What age do you think you will live to?" Moreover, the frequency of dealing with death and dying (from 1 = never to 5 = very often) served as outcome measure. In regression analysis, it was adjusted for several sociodemographic and health-related factors.
Fixed effects regressions showed that both increases in loneliness (β = -0.99, P < .001) and in perceived social isolation (β = -0.59, P < .05) were associated with decreases in expectations of longevity. Furthermore, both loneliness [incidence rate ratio (IRR) = 1.02, P < .05] and perceived social isolation (IRR = 1.02, P < .05) were associated with increases in the frequency of dealing with death and dying.
Beyond the impact of various covariates, findings still point to a longitudinal association between both perceived social isolation and loneliness and lower expectations of longevity as well as an increased frequency of dealing with death and dying. Efforts in reducing loneliness and perceived social isolation can contribute to increased expected longevity and a decreased frequency of dealing with death and dying which ultimately can contribute to longevity in older age.
孤独感和社会隔离是导致发病和死亡的重要因素。然而,目前尚不清楚孤独感和感知到的社会隔离的增加是否会导致预期寿命缩短和处理死亡和濒死的频率增加。因此,我们的目的是澄清这些关系。
纵向数据来自≥40 岁的全国代表性样本(分析样本,n=7952 次观察)。
≥40 岁的社区居民。
孤独感和感知到的社会隔离均使用成熟的工具进行测量。根据其他大型队列研究,使用“您认为自己能活到多大年龄?”来评估对长寿的期望。此外,处理死亡和濒死的频率(从 1=从不至 5=非常频繁)作为结果衡量标准。在回归分析中,它调整了几个社会人口统计学和与健康相关的因素。
固定效应回归显示,孤独感(β=-0.99,P<.001)和感知到的社会隔离(β=-0.59,P<.05)的增加均与预期寿命的缩短有关。此外,孤独感(发病率比 [IRR]=1.02,P<.05)和感知到的社会隔离(IRR=1.02,P<.05)都与处理死亡和濒死的频率增加有关。
除了各种协变量的影响外,研究结果仍表明,感知到的社会隔离和孤独感与预期寿命缩短以及处理死亡和濒死频率增加之间存在纵向关联。减少孤独感和感知到的社会隔离的努力可以增加预期寿命,减少处理死亡和濒死的频率,从而有助于老年人的长寿。