Center on Aging and Population Sciences, The University of Texas at Austin, Austin, Texas, United States of America.
Department of Sociology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America.
PLoS One. 2024 Mar 13;19(3):e0299096. doi: 10.1371/journal.pone.0299096. eCollection 2024.
Given a well-known overlapping prevalence of social isolation with loneliness and depression among older adults, this study aimed to contextually investigate the relationship of these constructs with weight loss of more than 5kg in a year, with a special focus on the intersection of living alone and marital dissolution as key dimensions of isolation. The data were obtained from the Korean Longitudinal Study of Aging (KLoSA) from 2006, 2008, 2010, 2012, 2014, 2016, and 2018, with an adult sample of those aged 65 and older (n = 5,481). The study evaluated several critical dimensions of social isolation: living alone, transition to living alone, infrequent social contact with children or friends, and infrequent social participation. These dimensions were examined individually and as a composite scale, along with loneliness and depressive symptoms, to determine their association with weight loss of 5kg or greater among older men and women. Generalized Estimating Equation (GEE) regression models enabled investigation of whether socially isolated men and women tended to lose 5kg or more in weight, given other confounding factors. Surprisingly, the results showed no evidence of such a trend. However, significant associations were found between weight loss and changes in living alone and marital status. For older men, transitioning to living alone without a change in marital status was linked to significant weight loss. For older women, transitioning to living alone following widowhood or divorce was the risk factor. These relationships remained significant even after adjusting for depression and a wide range of covariates. Additional analysis testing a cumulative effect revealed that only depression was a risk factor for being underweight at the last observation. Therefore, to prevent a clinically risky extent of weight loss, health policies for older Koreans should focus on those who transition to living alone, especially due to spousal bereavement or divorce (among women) and separation from living with children (among men).
鉴于老年人社交孤立、孤独和抑郁的重叠患病率较高，本研究旨在从上下文角度调查这些结构与一年内体重减轻 5 公斤以上的关系，特别关注独居和婚姻解体作为隔离的关键维度的交集。数据来自 2006 年、2008 年、2010 年、2012 年、2014 年、2016 年和 2018 年的韩国老龄化纵向研究（KLoSA），样本为 65 岁及以上的成年人（n=5481）。该研究评估了社交隔离的几个关键维度：独居、独居转变、与子女或朋友社交接触不频繁以及社交参与不频繁。这些维度单独和作为一个综合量表进行了评估，同时还评估了孤独感和抑郁症状，以确定它们与老年男女体重减轻 5 公斤或更多的关系。广义估计方程（GEE）回归模型用于调查在其他混杂因素的情况下，社交孤立的男性和女性是否更容易体重减轻 5 公斤或更多。令人惊讶的是，结果没有显示出这种趋势的证据。然而，体重减轻与独居和婚姻状况的变化之间存在显著关联。对于老年男性，独居转变而婚姻状况不变与显著的体重减轻有关。对于老年女性，丧偶或离婚后独居转变是风险因素。即使在调整了抑郁和广泛的协变量后，这些关系仍然显著。进一步的分析测试了累积效应，结果表明只有抑郁是体重不足的风险因素。因此，为了防止体重下降达到临床风险程度，韩国的老年人健康政策应关注独居转变的人群，尤其是由于丧偶或离婚（女性）以及与子女分居（男性）导致独居转变的人群。
