Li Sangsang, Zhang Mei, Han Dan, Wu Yunyi, Zhao Jie, Liao Hui, Ma Ying, Yan Chaoyang, Wang Jing
Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China.
The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China.
Aging Ment Health. 2023 Nov-Dec;27(11):2120-2127. doi: 10.1080/13607863.2023.2191926. Epub 2023 Mar 23.
This article aimed to examine the effects of social connection comprising loneliness and social isolation on cognitive impairment-free life expectancy (CIFLE).
Data on 28,563 older adults (aged 65+) were drawn from the Chinese Longitudinal Healthy Longevity Survey with a median follow-up of 4.00 years. Multistate Markov models were used to estimate the independent and joint effects of social connection with CIFLE. Cognitive impairment was measured by the modified Mini-Mental State Examination.
For men and women, respectively, reduced CIFLEs at age 65 associated with loneliness were 0.95 (95% CI: 0.41-1.48) and 1.35 (95%: CI 0.77-1.90) years, and those associated with social isolation were 2.23 (95% CI: 1.67-2.78) and 2.49 (95% CI: 1.67-3.30) years. Compared with those with neither loneliness nor social isolation ('neither' group), older adults at age 65 with both loneliness and social isolation ('both group') lost CIFLEs of 2.68 (95% CI: 1.89-3.48) and 3.51 (95% CI, 2.55-4.47) years for men and women, respectively. Similar patterns were observed in the oldest-old adults (age 85 or over). A growth trend transpired in the difference of the proportion of the remaining CIFLE between 'neither' group and 'both' group with age.
Loneliness and social isolation are associated with decreased CIFLE in older Chinese adults. Policy makers and the public must be informed that early identification and management of loneliness and social isolation, especially when coexisting, are crucial.
本文旨在研究包括孤独感和社会隔离在内的社会联系对认知功能正常预期寿命（CIFLE）的影响。
从中国老年健康长寿纵向调查中提取了28563名65岁及以上老年人的数据，中位随访时间为4.00年。采用多状态马尔可夫模型来估计社会联系对CIFLE的独立和联合影响。认知功能障碍通过改良的简易精神状态检查表进行测量。
对于男性和女性，65岁时与孤独感相关的CIFLE减少分别为0.95年（95%置信区间：0.41 - 1.48）和1.35年（95%置信区间：0.77 - 1.90），与社会隔离相关的分别为2.23年（95%置信区间：1.67 - 2.78）和2.49年（95%置信区间：1.67 - 3.30）。与既无孤独感也无社会隔离的老年人（“两者皆无”组）相比，65岁时既有孤独感又有社会隔离的老年人（“两者皆有”组），男性和女性的CIFLE分别减少了2.68年（95%置信区间：1.89 - 3.48）和3.51年（95%置信区间：2.55 - 4.47）。在最年长的老年人（85岁及以上）中也观察到了类似的模式。随着年龄增长，“两者皆无”组和“两者皆有”组之间剩余CIFLE比例的差异呈现出增长趋势。
孤独感和社会隔离与中国老年人CIFLE的降低有关。必须让政策制定者和公众了解，尽早识别和处理孤独感和社会隔离，尤其是当两者并存时，至关重要。
