Abugroun Ashraf, Shah Sachin J, Covinsky Kenneth, Hubbard Colin, Newman John C, Fang Margaret C
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
J Am Geriatr Soc. 2025 Jul;73(7):2166-2175. doi: 10.1111/jgs.19511. Epub 2025 May 21.
Social engagement contributes to healthy aging, yet the mechanisms linking social engagement to mortality risk remain poorly understood. This study investigated the biological, behavioral, and psychological pathways mediating this relationship.
We conducted a prospective cohort study using Health and Retirement Study (HRS) data on participants aged 60 and older who completed the Psychosocial and Lifestyle Questionnaires and provided blood samples in 2016. Social engagement was assessed using nine items from the HRS Social Participation questionnaire, with responses categorized as low, moderate, or high. Biological age was calculated using the Klemera-Doubal method and compared to chronological age to identify decelerated aging. We explored mediating pathways between social engagement and 4-year mortality risk using counterfactual mediation analyses.
In total, 2268 participants were included. Higher social engagement was associated with lower all-cause mortality rates over 4 years of follow-up. The high social engagement group participants had a lower median biological age, healthier behaviors, and lower prevalence of depressive symptoms than those in the low and moderate engagement groups. High social engagement was associated with lower mortality risk than low engagement (a-HR: 0.58 [95% CI: 0.39, 0.86; p = 0.009]). This effect was partially mediated by regular physical activity (16%) and decelerated biological age (15%). Other factors such as high depressive symptoms, excess alcohol use, and tobacco use showed no significant mediating effects.
Higher social engagement in older adults is associated with reduced mortality risk possibly due to decreased biological aging and increased physical activity levels.
社交参与有助于健康老龄化，但社交参与与死亡风险之间的关联机制仍知之甚少。本研究调查了介导这种关系的生物学、行为学和心理学途径。
我们进行了一项前瞻性队列研究，使用健康与退休研究（HRS）的数据，研究对象为60岁及以上的参与者，他们在2016年完成了社会心理和生活方式问卷调查并提供了血样。社交参与度通过HRS社会参与问卷中的九个项目进行评估，回答分为低、中、高三个类别。使用克莱梅拉-杜巴尔方法计算生物学年龄，并与实际年龄进行比较以确定衰老减缓情况。我们使用反事实中介分析探索了社交参与度与4年死亡风险之间的中介途径。
总共纳入了2268名参与者。在4年的随访中，较高的社交参与度与较低的全因死亡率相关。高社交参与度组的参与者生物学年龄中位数较低，行为更健康，抑郁症状的患病率低于低社交参与度和中等社交参与度组。与低社交参与度相比，高社交参与度与较低的死亡风险相关（调整后风险比：0.58 [95%置信区间：0.39, 0.86；p = 0.009]）。这种效应部分由规律的体育活动（16%）和生物学年龄减缓（15%）介导。其他因素，如高抑郁症状、过量饮酒和吸烟，未显示出显著的中介作用。
老年人较高的社交参与度与降低的死亡风险相关，这可能是由于生物衰老的减少和身体活动水平的提高。
