Geras Centre for Aging Research, Hamilton, Ontario, Canada.
Department of Health Research Methods, Evidence and Impact, Master University, Hamilton, Ontario, Canada.
PLoS One. 2023 Oct 18;18(10):e0292788. doi: 10.1371/journal.pone.0292788. eCollection 2023.
The aim is to investigate whether social isolation and loneliness are associated with changes in grip strength, gait speed, BMD, and fractures.
Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort participants aged 65 years and older at baseline (2012-2015) who completed the three-year follow-up interview (2015-2018) were included in this analysis (n = 11,344). Social isolation and loneliness were measured using the CLSA social isolation index (CLSA-SII, range 0-10). We calculated absolute and percent change in grip strength (kg) and gait speed (m/s) and annualized absolute (g/cm2) and percent change in femoral neck and total hip BMD during the three-year follow-up. Self-reported incident fractures of all skeletal sites in the previous 12 months were measured at three-year follow-up. Multivariable analyses were conducted. Odd ratio (OR) and 95% confidence interval (CI) are reported.
The mean age (standard deviation [SD]) was 72.9 (5.6) years and 49.9% were female. The mean (SD) of CLSA-SII at baseline was 3.5 (1.4). Mean absolute and percentage change (SD) in grip strength (kg) and gait speed (m/s) were -1.33 (4.60), -3.02% (16.65), and -0.05 (0.17), -3.06% (19.28) during the three-year follow-up, respectively. Mean annualized absolute (g/cm2) and percentage change (SD) in femoral neck and total hip BMD were -0.004 (0.010), -0.47% (1.43) and -0.005 (0.009), -0.57% (1.09), respectively. 345 (3.1%) participants had incident fractures. As CLSA-SII increased (per one unit change), participants had 1.13 (adjusted OR 1.13, 95% CI 1.01-1.27) times greater odds for incident fractures. The interaction term between the CLSA-SII and centre for epidemiology studies depression 9 scale (CES-D 9) for self-reported incident fractures was shown (interaction OR 1.02, 95% CI 1.00-1.04).
Socially isolated and lonely older adults were more likely to have had incident fractures, but social isolation was not associated with the three-year changes in grip strength, gait speed, or BMD.
本研究旨在探讨社会隔离和孤独感是否与握力、步态速度、骨密度和骨折的变化有关。
本研究纳入了基线年龄（2012-2015 年）在 65 岁及以上且完成了三年随访访谈（2015-2018 年）的加拿大老龄化纵向研究（CLSA）综合队列参与者（n=11344）。使用 CLSA 社会隔离指数（CLSA-SII，范围 0-10）来测量社会隔离和孤独感。我们计算了三年内握力（kg）和步态速度（m/s）的绝对和百分比变化，以及股骨颈和全髋骨密度的年化绝对（g/cm2）和百分比变化。在三年随访时，测量了过去 12 个月内所有骨骼部位的自报告骨折情况。采用多变量分析。报告比值比（OR）和 95%置信区间（CI）。
平均年龄（标准差）为 72.9（5.6）岁，49.9%为女性。基线时 CLSA-SII 的平均值（标准差）为 3.5（1.4）。三年内握力（kg）和步态速度（m/s）的平均绝对和百分比变化（标准差）分别为-1.33（4.60）、-3.02%（16.65）和-0.05（0.17）、-3.06%（19.28）。股骨颈和全髋骨密度的年化绝对（g/cm2）和百分比变化（标准差）分别为-0.004（0.010）、-0.47%（1.43）和-0.005（0.009）、-0.57%（1.09）。345（3.1%）名参与者发生了骨折事件。随着 CLSA-SII 的增加（每单位变化），参与者发生骨折事件的几率增加了 1.13 倍（调整后的 OR 1.13，95%CI 1.01-1.27）。在报告的骨折事件中，CLSA-SII 与流行病学研究抑郁量表 9 项（CES-D 9）之间的交互项显示（交互 OR 1.02，95%CI 1.00-1.04）。
社会隔离和孤独的老年人更容易发生骨折事件，但社会隔离与三年内握力、步态速度或骨密度的变化无关。
