Zhu Shuai, Kong Xiangjie, Han Fulei, Tian Huimin, Sun Shuqin, Sun Yanping, Feng Wenjing, Wu Yili
Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China.
Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China.
J Affect Disord. 2024 Apr 1;350:182-187. doi: 10.1016/j.jad.2024.01.106. Epub 2024 Jan 12.
Increasing evidence shows that social isolation and depression are likely to interact with each other, yet the direction and causality of the association are not clear. This study aims to examine the possible reciprocity in the relationship between social isolation and depression.
This study fitted a cross-lagged panel model (CLPM) by using data from the English Longitudinal Study of Aging (ELSA, 2014-2019, n = 6787) to examine the temporal relationship between social isolation and depressive symptoms in older adults. We then conducted two-sample bidirectional Mendelian randomization (MR) analyses by using independent genetic variants associated with multiple social isolation phenotypes (n = 448,858-487,647) and with depression (n = 215,644-2,113,907) as genetic instruments from genome-wide association studies to assess the causality between social isolation and onset of depression.
The CLPM in the ELSA cohort showed a significant and positive lagged effect of social isolation on depressive symptoms (β = 0.037, P < .001). The reverse cross-lagged path from depressive symptoms to social isolation was also statistically significant (β = 0.039, P < .001). In two-sample bidirectional MR, the genetically predicted loneliness and social isolation combined phenotype (LNL-ISO) was positively associated with occurrence of depression (OR = 1.88, 95 % CI: 1.41-2.50, P < .001), vice versa (OR = 1.16, 95 % CI:1.13-1.20, P < .001).
The self-report nature of the assessments and missing data are study limitations.
These findings suggest a bidirectional relationship between social isolation and depression. It is important to develop interventions that highlight the reciprocal consequences of improving either mental health or social connection in older adults.
越来越多的证据表明，社会孤立与抑郁症可能相互影响，然而这种关联的方向和因果关系尚不清楚。本研究旨在探讨社会孤立与抑郁症之间关系中可能存在的相互作用。
本研究使用英国老龄化纵向研究（ELSA，2014 - 2019年，n = 6787）的数据拟合交叉滞后面板模型（CLPM），以检验老年人社会孤立与抑郁症状之间的时间关系。然后，我们通过使用来自全基因组关联研究的与多种社会孤立表型（n = 448,858 - 487,647）和抑郁症（n = 215,644 - 2,113,907）相关的独立基因变异作为基因工具，进行两样本双向孟德尔随机化（MR）分析，以评估社会孤立与抑郁症发病之间的因果关系。
ELSA队列中的CLPM显示社会孤立对抑郁症状有显著的正向滞后效应（β = 0.037，P <.001）。从抑郁症状到社会孤立的反向交叉滞后路径也具有统计学意义（β = 0.039，P <.001）。在两样本双向MR中，基因预测的孤独和社会孤立综合表型（LNL - ISO）与抑郁症的发生呈正相关（OR = 1.88，95% CI：1.41 - 2.50，P <.001），反之亦然（OR = 1.16，95% CI：1.13 - 1.20，P <.001）。
评估的自我报告性质和缺失数据是本研究的局限性。
这些发现表明社会孤立与抑郁症之间存在双向关系。制定强调改善老年人心理健康或社会联系的相互影响的干预措施很重要。
