Rajai Nazanin, Medina-Inojosa Jose R, Lewis Bradley R, Sheffeh Mohammad Ali, Baez-Suarez Abraham, Nyman Mark, Attia Zachi I, Lerman Lilach O, Medina-Inojosa Betsy J, Friedman Paul A, Lopez-Jimenez Francisco, Lerman Amir
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Division of Biomedical Statistics and Informatics, Mayo College of Medicine, Rochester, Minnesota, USA.
JACC Adv. 2024 Mar 20;3(9):100890. doi: 10.1016/j.jacadv.2024.100890. eCollection 2024 Sep.
Loneliness and social isolation are associated with poor health outcomes such as an increased risk of cardiovascular diseases.
The authors aimed to explore the association between social isolation with biological aging which was determined by artificial intelligence-enabled electrocardiography (AI-ECG) as well as the risk of all-cause mortality.
The study included adults aged ≥18 years seen at Mayo Clinic from 2019 to 2022 who respond to a survey for social isolation assessment and had a 12-lead ECG within 1 year of completing the questionnaire. Biological age was determined from ECGs using a previously developed and validated convolutional neural network (AI-ECG age). Age-Gap was defined as AI-ECG age minus chronological age, where positive values reflect an older-than-expected age. The status of social isolation was measured by the previously validated multiple-choice questions based on Social Network Index (SNI) with score ranges between 0 (most isolated) and 4 (least isolated).
A total of 280,324 subjects were included (chronological age 59.8 ± 16.4 years, 50.9% female). The mean Age-Gap was -0.2 ± 9.16 years. A higher SNI was associated with a lower Age-Gap (β of SNI = 4 was -0.11; 95% CI: -0.22 to -0.01; < 0.001, adjusted to covariates). Cox proportional hazard analysis revealed the association between social connection and all-cause mortality (HR for SNI = 4, 0.47; 95% CI: 0.43-0.5; < 0.001).
Social isolation is associated with accelerating biological aging and all-cause mortality independent of conventional cardiovascular risk factors. This observation underscores the need to address social connection as a health care determinant.
孤独和社会隔离与不良健康结果相关，如心血管疾病风险增加。
作者旨在探讨社会隔离与通过人工智能心电图（AI-ECG）确定的生物衰老之间的关联以及全因死亡率风险。
该研究纳入了2019年至2022年在梅奥诊所就诊的年龄≥18岁的成年人，这些人对社会隔离评估调查做出了回应，并在完成问卷后1年内进行了12导联心电图检查。使用先前开发并验证的卷积神经网络（AI-ECG年龄）从心电图中确定生物年龄。年龄差距定义为AI-ECG年龄减去实际年龄，正值反映年龄比预期大。社会隔离状态通过先前验证的基于社交网络指数（SNI）的多项选择题进行测量，得分范围在0（最隔离）至4（最不隔离）之间。
共纳入280,324名受试者（实际年龄59.8±16.4岁，50.9%为女性）。平均年龄差距为-0.2±9.16岁。较高的SNI与较低的年龄差距相关（SNI = 4时的β为-0.11；95%CI：-0.22至-0.01；<0.001，经协变量调整）。Cox比例风险分析揭示了社会联系与全因死亡率之间的关联（SNI = 4时的HR为0.47；95%CI：0.43 - 0.5；<0.001）。
社会隔离与加速生物衰老和全因死亡率相关，独立于传统心血管危险因素。这一观察结果强调了将社会联系作为医疗保健决定因素加以解决的必要性。
