Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
The Finnish Association for the Welfare of Older Adults, Helsinki, Finland.
Gerontology. 2024;70(10):1103-1112. doi: 10.1159/000540345. Epub 2024 Aug 16.
Loneliness, social inactivity, and social isolation are intertwined concepts. When assessed separately, they indicate poor well-being, adverse health effects, and increased mortality. Studies exploring overlapping and comparing the prognosis of these concepts are scarce. We investigated (1) overlapping of concepts of loneliness, social inactivity, and social isolation, (2) characteristics of groups: group 0 (not lonely, socially inactive, or socially isolated), group 1 (lonely), group 2 (not lonely but socially inactive and/or socially isolated), and (3) the health-related quality of life (HRQoL), psychological well-being (PWB), and 3.6-year mortality of these groups.
The home-dwelling older adults (n = 989; 75 y+) of the Helsinki Aging Study in 2019-2022 completing all required questionnaires were assessed. Group 0 included 494, group 1 included 280, and group 2 included 215 participants. Variables studied were demographics, diagnoses, mobility, physical functioning (Barthel index), and cognition (Mini-Mental State Examination). Outcomes were HRQoL (15D) and PWB. Mortality was retrieved from central registers.
Half of the sample was lonely, socially inactive, or socially isolated, but only 2% were simultaneously lonely, socially inactive, and socially isolated. Of lonely participants, 38% were also socially inactive and/or socially isolated. The lonely participants were significantly more often widowed or lived alone and had the lowest HRQoL and poorest PWB compared with the other groups. After adjustments (age, sex, Charlson Comorbidity Index), mortality did not statistically differ between the groups.
Loneliness is an independent determinant of poor HRQoL and PWB, and it should be considered separately from social inactivity and social isolation.
孤独、社会活动减少和社会隔离是相互交织的概念。当分别评估时，它们表明健康状况不佳、对健康的不良影响和死亡率增加。探索这些概念重叠并比较其预后的研究很少。我们调查了（1）孤独、社会活动减少和社会隔离概念的重叠情况，（2）各组的特征：组 0（不孤独、不社会活动减少、不社会隔离）、组 1（孤独）、组 2（不孤独但社会活动减少和/或社会隔离），以及（3）这些组的健康相关生活质量（HRQoL）、心理幸福感（PWB）和 3.6 年死亡率。
2019-2022 年，完成所有必需问卷的赫尔辛基老龄化研究中的居家老年人（n=989；75 岁以上）进行了评估。组 0 包括 494 名参与者，组 1 包括 280 名参与者，组 2 包括 215 名参与者。研究的变量包括人口统计学、诊断、移动能力、身体功能（巴氏指数）和认知（简易精神状态检查）。结果是 HRQoL（15D）和 PWB。死亡率从中央登记处检索。
样本的一半是孤独、社会活动减少或社会隔离，但只有 2%的人同时孤独、社会活动减少和社会隔离。孤独参与者中有 38%也是社会活动减少和/或社会隔离。与其他组相比，孤独参与者丧偶或独居的比例明显更高，HRQoL 和 PWB 最差。调整（年龄、性别、Charlson 合并症指数）后，各组之间的死亡率无统计学差异。
孤独是 HRQoL 和 PWB 不佳的独立决定因素，应与社会活动减少和社会隔离分开考虑。
