Association of social isolation and loneliness with incident rheumatoid arthritis in a population-based cohort study.

OBJECTIVE

This study endeavors to reveal the link between social isolation, loneliness, and the incidence of rheumatoid arthritis (RA) and to explore whether genetic factors may receive interference.

METHODS

A prospective cohort study supported by the UK Biobank database. Social isolation and loneliness were considered major exposures, which were captured through self-report questionnaires. The primary endpoint was incident RA. Multivariable Cox proportional hazard regression was utilized to explore the connection between social isolation and loneliness and RA events. Conjoint and interaction analyses were conducted to determine whether social independence and loneliness were independent predictors of RA. Additional sensitivity analyses and subgroup analyses were carried out to evaluate the stability of the results.

RESULTS

A total of 3949 RA cases were documented during a median follow-up of 12.39 years eventually among the 345,324 subjects. Social isolation (Moderately isolated: HR: 1.080, 95 % CI: 1.009-1.156; most isolated: HR: 1.121, 95 % CI: 1.018-1.234) was markedly related to an increased risk of RA, and these associations were not modified by genetic risk for RA. Cumulative risk map results observed that social isolation and loneliness and their subcomponents increase the cumulative incidence of RA over time.

CONCLUSION

Social isolation is independently associated with an enhanced prevalence of RA, and the correlation remained significant after accounting for genetic susceptibility to RA. Further exploration of the association between social isolation and RA may help to refine the etiology of RA and provide scientific evidence for primary health care of RA.