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六大洲老年人孤独感的流行情况概述及相关危险因素:一项荟萃分析。

Overview of the prevalence of loneliness and associated risk factors among older adults across six continents: A meta-analysis.

机构信息

Nurse Profession Education Study Program, Faculty of Medicine, Universitas Halu Oleo, Kendari, Indonesia.

Department of Community Nursing, Faculty of Nursing, Universitas Jenderal Achmad Yani, Cimahi, Indonesia.

出版信息

Arch Gerontol Geriatr. 2025 Jan;128:105627. doi: 10.1016/j.archger.2024.105627. Epub 2024 Sep 12.

Abstract

BACKGROUND

Globally, loneliness is a growing public health concern associated with poor mental and physical health among older adults. Therefore, we performed a meta-analysis to explore the prevalence of loneliness and associated risk factors among older adults across six continents.

METHODS

Web of Science, PubMed, Embase, CINAHL, Cochrane Library, and references lists were comprehensively searched until April 2024. Data analysis was performed using Logit Transformation model in R-Software for pooled prevalence and DerSimonian-Lard random-effects model in Comprehensive Meta-Analysis for associated factors of loneliness. Heterogeneity was quantified by I and τ statistics. The funnel plot and Egger's regression test assessed publication bias.

RESULTS

A total of 70 studies with 462,083 older adults were included. The pooled prevalence of loneliness was 26 % (95 %CI, 23 %-30 %) with 38 % for North America, 34 % for Africa, 32 % for Asia and South America, 23 % for Europe, and 13 % for Oceania. Cognitive impairment (2.98; 95 %CI, 1.30-6.81), poor health (2.35; 95 %CI, 1.59-3.45), female (1.92; 95 %CI, 1.53-2.41), depression (1.74; 95 %CI, 1.40-2.16), widowed (1.67; 95 %CI, 1.13-2.48), single (1.51; 95 %CI, 1.06-2.17), institutionalization (2.95; 95 %CI, 1.48-5.88), rural residency (1.18; 95 %CI, 1.04-1.34) were associated with increased risk of loneliness. Being married (0.51; 95 %CI, 0.31-0.82), male (0.55; 95 %CI, 0.43-0.70), and non-institutionalization (0.34; 95 %CI, 0.17-0.68) were associated with lower risk of loneliness.

CONCLUSION

Approximately, three among ten older adults aged ≥ 60 years are lonely worldwide. Early detection, prevention, and management of loneliness among older adults should consider diverse needs using gender-specific approaches.

摘要

背景

在全球范围内,孤独感是一种日益严重的公共卫生问题,与老年人的身心健康不良有关。因此,我们进行了一项荟萃分析,以探讨六大洲老年人孤独感的流行率及其相关危险因素。

方法

我们全面检索了 Web of Science、PubMed、Embase、CINAHL、Cochrane Library 以及参考文献列表,检索时间截至 2024 年 4 月。使用 R 软件中的 Logit 转换模型对汇总流行率进行数据分析,使用 Comprehensive Meta-Analysis 中的 DerSimonian-Lard 随机效应模型对孤独感的相关因素进行数据分析。采用 I 和 τ 统计量来量化异质性。使用漏斗图和 Egger 回归检验评估发表偏倚。

结果

共纳入 70 项研究,涉及 462083 名老年人。孤独感的总流行率为 26%(95%CI,23%-30%),其中北美为 38%,非洲为 34%,亚洲和南美洲为 32%,欧洲为 23%,大洋洲为 13%。认知障碍(2.98;95%CI,1.30-6.81)、健康状况差(2.35;95%CI,1.59-3.45)、女性(1.92;95%CI,1.53-2.41)、抑郁(1.74;95%CI,1.40-2.16)、丧偶(1.67;95%CI,1.13-2.48)、单身(1.51;95%CI,1.06-2.17)、机构化(2.95;95%CI,1.48-5.88)、农村居住(1.18;95%CI,1.04-1.34)与孤独感风险增加相关。已婚(0.51;95%CI,0.31-0.82)、男性(0.55;95%CI,0.43-0.70)和非机构化(0.34;95%CI,0.17-0.68)与孤独感风险降低相关。

结论

全球约有十分之三的 60 岁及以上老年人感到孤独。应该采用针对不同性别的特定方法,早期发现、预防和管理老年人的孤独感,以满足他们的多样化需求。

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