Warren Alpert Medical School of Brown University, Providence, RI, USA.
Department of Public Health and Primary Care, University of Cambridge, UK.
Public Health. 2022 Jan;202:58-64. doi: 10.1016/j.puhe.2021.10.017. Epub 2021 Dec 8.
There is growing evidence of an association between social participation and improved physical and mental health among older individuals. The aims of this study were to explore the relationship between self-reported participation in groups, clubs, or organizations and all-cause mortality among older adults and examine the role of physical activity as a potential modifier of the health effects of social participation.
EPIC-Norfolk is a prospective cohort study that recruited 25,639 individuals between the ages of 40 and 79 in Norfolk County, England. This study involved a retrospective analysis of 8623 participants who had returned for the third health check between 2004 and 2011.
Participants were categorized into those who reported participating socially and those who did not and were stratified by involvement in 0, 1, or 2 or more groups. Cox Proportional Hazards models were constructed to compare all-cause mortality between the groups. Stratum-specific hazard ratios were calculated by physical activity level to assess for effect modification.
Of the participants, 861 (9.98%) died during the follow-up period. After adjustment for confounding, social participation was associated with lower all-cause mortality (HR 0.84, 95% CI 0.73-0.97). Involvement in 2 or more groups was associated with lower all-cause mortality (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-0.97), but the association was not statistically significant for people involved in only 1 group (HR 0.86, 95% CI 0.73-1.03). Physical activity appeared to modify the effect of social participation on mortality.
This study's findings provide evidence of an association between social participation and lower all-cause mortality for older adults. They also suggest that the effect of social participation on health is greater for people who are more physically active. Population-level interventions to facilitate social participation may contribute to improving health and wellbeing among older individuals.
越来越多的证据表明，社会参与与老年人身心健康的改善之间存在关联。本研究旨在探讨老年人自述的群体、俱乐部或组织参与与全因死亡率之间的关系，并研究身体活动作为社会参与对健康影响的潜在调节剂的作用。
EPIC-Norfolk 是一项前瞻性队列研究，在英格兰诺福克郡招募了 25639 名年龄在 40 至 79 岁之间的个体。本研究回顾性分析了 2004 年至 2011 年间第三次健康检查时返回的 8623 名参与者。
参与者分为有社会参与和无社会参与两类，并按参与 0、1 或 2 个或更多群体进行分层。构建 Cox 比例风险模型比较各组之间的全因死亡率。通过身体活动水平计算分层特异性危险比，以评估效应修饰。
在随访期间，861 名（9.98%）参与者死亡。调整混杂因素后，社会参与与全因死亡率降低相关（HR 0.84，95%CI 0.73-0.97）。参与 2 个或更多群体与全因死亡率降低相关（危险比 [HR] 0.83，95%置信区间 [CI] 0.70-0.97），但仅参与 1 个群体的人相关性无统计学意义（HR 0.86，95%CI 0.73-1.03）。身体活动似乎修饰了社会参与对死亡率的影响。
本研究结果为老年人社会参与与全因死亡率降低之间存在关联提供了证据。它们还表明，身体活动对健康的影响对于更活跃的人更大。促进社会参与的人群干预措施可能有助于改善老年人的健康和幸福感。
