Hounkpatin Hilda, Islam Nazrul, Stuart Beth, Santer Miriam, Farmer Andrew, Dambha-Miller Hajira
Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom.
Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom.
Arch Gerontol Geriatr. 2025 Apr;131:105763. doi: 10.1016/j.archger.2025.105763. Epub 2025 Jan 17.
Previous longitudinal studies have linked multimorbidity to loneliness (feeling alienated) and social isolation (having reduced social contact). However, the nature of these associations over time is unclear.
To examine bidirectional associations of multimorbidity with loneliness and social isolation over a 14-year follow-up in a nationally representative cohort of adults aged ≥ 50 years.
This retrospective cohort study used seven waves of data (collected between 2004/2005 and 2018/2019) from adults in the English Longitudinal Study of Ageing. Multimorbidity was defined as the presence of ≥2 long-term conditions. Loneliness was measured using the 3-item University of California Los Angeles (UCLA) scale. Social isolation was derived based on cohabitation status, frequency of contact with children, relatives, and friends, and social organisation membership. We used Cox proportional hazards models adjusted for social isolation or loneliness, demographic and health behaviour variables.
The cohort consisted of 6031 adults with baseline and follow-up data on loneliness, social isolation, multimorbidity, and other covariates. Loneliness was associated with increased risk of incident multimorbidity [aHR (95 % CI): 1.38 (1.15-1.65)], whereas social isolation was not [aHR (95 % CI): 0.97 (0.81-1.16)]. Multimorbidity was associated with increased risk of incident loneliness [aHR (95 % CI): 1.55 (1.30-1.84)], but not significantly associated with subsequent risk of incident social isolation [aHR (95 % CI): 1.09 (0.92-1.28)].
An independent bidirectional association exists between loneliness and multimorbidity. Interventions targeting loneliness may prevent or delay multimorbidity and also improve wellbeing for people with multimorbidity.
以往的纵向研究已将多种疾病并存与孤独感（感觉被疏离）和社会隔离（社会接触减少）联系起来。然而，这些关联随时间变化的本质尚不清楚。
在一个全国代表性的50岁及以上成年人队列中，研究多种疾病并存与孤独感和社会隔离在14年随访期间的双向关联。
这项回顾性队列研究使用了英国老龄化纵向研究中成年人的七轮数据（收集于2004/2005年至2018/2019年之间）。多种疾病并存被定义为存在≥2种长期疾病。孤独感使用3项加利福尼亚大学洛杉矶分校（UCLA）量表进行测量。社会隔离是根据同居状况、与子女、亲属和朋友的接触频率以及社会组织成员身份得出的。我们使用了经社会隔离或孤独感、人口统计学和健康行为变量调整的Cox比例风险模型。
该队列由6031名成年人组成，他们拥有关于孤独感、社会隔离、多种疾病并存及其他协变量的基线和随访数据。孤独感与新发多种疾病并存的风险增加相关[aHR（95%CI）：1.38（1.15 - 1.65）]，而社会隔离则不然[aHR（95%CI）：0.97（0.81 - 1.16）]。多种疾病并存与新发孤独感的风险增加相关[aHR（95%CI）：1.55（1.30 - 1.84）]，但与随后新发社会隔离的风险无显著关联[aHR（95%CI）：1.09（0.92 - 1.28）]。
孤独感与多种疾病并存之间存在独立的双向关联。针对孤独感的干预措施可能预防或延缓多种疾病并存，还能改善患有多种疾病者的幸福感。
