Zhou Xiang, Yang Fang, Gao Yourong
Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China.
Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China.
Psychiatry Res. 2023 Oct;328:115430. doi: 10.1016/j.psychres.2023.115430. Epub 2023 Aug 21.
Despite the well-established association between loneliness and all-cause mortality in older adults, it remains unknown whether this association holds for older adults of different sex and whether it is influenced by different samples and study characteristics. Thus, this meta-analysis aims to examine moderators of the association between loneliness and all-cause mortality in older adults. To this end, relevant literature was retrieved from the PubMed, Embase, PsycINFO, Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases (inception to May 2023) and was processed in the Comprehensive Meta-Analysis 3.3 software. Moreover, subgroup analysis was performed to explore the sources of heterogeneity and further explore potential moderators. Funnel plots, Begg's test, and Egger's linear regression test were used to examine the publication bias, and sensitivity analysis was used to test the robustness of the results. Thirty-six studies involving 128,927 older adults were included in this meta-analysis. In general, loneliness was related to an increase in all-cause mortality in older adults (HR = 1.09, 95% CI = 1.06-1.12, I = 63.31%, p < 0.001). The overall effect size for older men was 1.18 (95% CI = 1.04-1.33, p = 0.010). The association between loneliness and all-cause mortality was found to be significantly influenced by the source country of the data, follow-up length, and covariates for chronic disease as moderators. In conclusion, loneliness among older adults deserves more attention, and services are needed to improve their mental health.
尽管孤独与老年人全因死亡率之间的关联已得到充分证实，但这种关联在不同性别的老年人中是否成立，以及是否受不同样本和研究特征的影响，仍不明确。因此，本荟萃分析旨在研究老年人孤独与全因死亡率之间关联的调节因素。为此，从PubMed、Embase、PsycINFO、Web of Science、中国知网、维普和万方数据库（建库至2023年5月）中检索相关文献，并在Comprehensive Meta-Analysis 3.3软件中进行处理。此外，进行亚组分析以探索异质性来源，并进一步探索潜在的调节因素。采用漏斗图、Begg检验和Egger线性回归检验来检验发表偏倚，并使用敏感性分析来检验结果的稳健性。本荟萃分析纳入了36项涉及128,927名老年人的研究。总体而言，孤独与老年人全因死亡率增加相关（HR = 1.09，95% CI = 1.06 - 1.12，I² = 63.31%，p < 0.001）。老年男性的总体效应量为1.18（95% CI = 1.04 - 1.33，p = 0.010）。孤独与全因死亡率之间的关联被发现受数据来源国、随访时长和慢性病协变量作为调节因素的显著影响。总之，老年人的孤独值得更多关注，需要提供服务来改善他们的心理健康。
