中国老年人社会隔离、孤独感和残疾之间的互惠和动态关联。
Reciprocal and Dynamic Associations between Social Isolation, Loneliness, and Disability among Chinese Older Adults.
机构信息
College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
出版信息
J Am Med Dir Assoc. 2024 Jul;25(7):104975. doi: 10.1016/j.jamda.2024.02.013. Epub 2024 Apr 4.
OBJECTIVES
This study aimed to examine reciprocal and dynamic associations between Social Isolation (SI), loneliness, and disability among Chinese older adults.
DESIGN
This is a prospective cohort study.
SETTING AND PARTICIPANTS
The global trend of population aging has resulted in a significant rise in the prevalence of disabilities, SI, and loneliness among older adults. These factors can severely impact the health and well-being of older adults. Therefore, it is crucial to implement more efficient interventions aimed at reducing disabilities, addressing SI, and combating loneliness among older adults in order to improve their overall health and well-being.
METHODS
Using a large, nationally representative sample spanning 16 years, we employed the general cross-lagged panel model to explore the relationships among 50,348 older adults with a mean age of 81.83 at baseline. Disability was measured by a comprehensive index tool that incorporated multiple dimensions. SI was measured using an SI index, and loneliness was evaluated using a single-item measure.
RESULTS
SI emerged as a stronger predictor of disability than loneliness. Longitudinal analysis revealed accumulative disadvantages in the association between SI and disability. Additionally, disability was found to contribute to increased SI and loneliness. However, our study did not detect any variance in the strength of the cross-lagged effects between social isolation and disability.
CONCLUSIONS AND IMPLICATIONS
The findings suggest that reducing SI is crucial for reducing disability among older adults. Initiating early interventions to minimize initial SI could aid in preventing later-life disability. Additionally, addressing disabilities may positively impact the reduction of loneliness and SI within this population.
目的
本研究旨在探讨中国老年人社会隔离(SI)、孤独感和残疾之间的相互关系和动态关系。
设计
这是一项前瞻性队列研究。
地点和参与者
人口老龄化的全球趋势导致老年人残疾、社会隔离和孤独感的患病率显著上升。这些因素会严重影响老年人的健康和幸福。因此,实施更有效的干预措施至关重要,旨在减少老年人的残疾、解决社会隔离问题和对抗孤独感,以改善他们的整体健康和幸福感。
方法
我们使用一个跨越 16 年的大型全国代表性样本,采用一般交叉滞后面板模型,探讨了 50348 名平均年龄为 81.83 岁的老年人之间的关系。残疾通过一个综合指标工具来衡量,该工具纳入了多个维度。社会隔离采用社会隔离指数进行衡量,孤独感采用单项测量来评估。
结果
社会隔离是残疾的一个更强的预测因素,而不是孤独感。纵向分析显示,社会隔离和残疾之间的关联存在累积劣势。此外,残疾被发现会导致社会隔离和孤独感增加。然而,我们的研究没有发现社会隔离和残疾之间的交叉滞后效应强度存在任何差异。
结论和意义
研究结果表明,减少社会隔离对于减少老年人的残疾至关重要。尽早开展干预措施,最大限度地减少初始社会隔离,有助于预防老年残疾。此外,解决残疾问题可能会对减少这一人群的孤独感和社会隔离产生积极影响。