Yue Xiao, Yuan Quan, Zhou Rong, Wang Mei
Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, China.
Department of Geriatric Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, WuHan, China.
J Nutr Health Aging. 2025 May 22;29(8):100583. doi: 10.1016/j.jnha.2025.100583.
This study aimed to investigate the independent and interactive associations of social isolation and a healthy lifestyle on intrinsic capacity (IC) among older adults in China.
A longitudinal cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS), spanning three waves (2011, 2013, and 2015) and involving adults aged 60 years and older.
A total of 4495 older adults with complete data on IC, social isolation, healthy lifestyle, and relevant covariates at baseline were included in the final analysis.
IC was assessed using a composite score across five domains: locomotor, cognitive, sensory, vitality, and psychological. Social isolation was measured using an index based on living arrangements, marital status, contact with children, and social participation. A healthy lifestyle was defined based on five factors: smoking, alcohol consumption, physical activity, sleep duration, and body mass index (BMI). Multiple linear regression and linear mixed-effects models were used to examine cross-sectional and longitudinal associations. Interactive terms between social isolation and a healthy lifestyle were analyzed. Sensitivity analyses were performed by stratifying participants by age and gender.
At baseline, 31.0%, 62.3%, and 6.7% of participants had social isolation scores of 0, 1-2, and 3-4, respectively, while 28.5%, 37.0%, and 34.6% had healthy lifestyle scores of 0-2, 3, and 4-5, respectively. Compared to participants with no social isolation (score = 0), the IC scores decreased for participants with social isolation scores of 1-2 and 3-4 (β = -0.36, 95% confidence interval [CI]: -0.42 to -0.30) and (β = -0.65, 95% CI: -0.77 to -0.53), respectively. In contrast, adherence to a healthy lifestyle was associated with improved IC (β = 0.27, 95% CI: 0.20 to 0.34 for score 3; β = 0.54, 95% CI: 0.47 to 0.60 for score 4-5). Interactive analysis showed that a healthy lifestyle mitigated the adverse associations of social isolation on IC, but this protective effect weakened as social isolation increased. Sensitivity analyses confirmed the robustness of these findings.
This study identified significant associations between social isolation, healthy lifestyle, and intrinsic capacity in older Chinese adults. Social isolation was negatively associated with IC, while a healthy lifestyle was positively associated with IC. The observed interaction between social isolation and healthy lifestyle highlights the importance of integrated interventions targeting both social engagement and health behaviors in supporting IC during aging.
本研究旨在探讨社会隔离与健康生活方式对中国老年人内在能力（IC）的独立及交互作用。
利用中国健康与养老追踪调查（CHARLS）的数据进行纵向队列研究，涵盖三个时间段（2011年、2013年和2015年），涉及60岁及以上成年人。
最终分析纳入了4495名在基线时具有IC、社会隔离、健康生活方式及相关协变量完整数据的老年人。
IC通过五个领域的综合评分进行评估：运动、认知、感官、活力和心理。社会隔离采用基于居住安排、婚姻状况、与子女联系及社会参与的指数进行测量。健康生活方式基于五个因素定义：吸烟、饮酒、身体活动、睡眠时间和体重指数（BMI）。采用多元线性回归和线性混合效应模型检验横断面和纵向关联。分析社会隔离与健康生活方式之间的交互项。通过按年龄和性别对参与者进行分层进行敏感性分析。
在基线时，分别有31.0%、62.3%和6.7%的参与者社会隔离得分0、1 - 2和3 - 4，而分别有28.5%、37.0%和34.6%的参与者健康生活方式得分0 - 2、3和4 - 5。与无社会隔离的参与者（得分 = 0）相比，社会隔离得分1 - 2和3 - 4的参与者IC得分降低（β = -0.36，95%置信区间[CI]：-0.42至-0.30）和（β = -0.65，95%CI：-0.77至-0.53）。相反，坚持健康生活方式与IC改善相关（得分3时β = 0.27，95%CI：0.20至0.34；得分4 - 5时β = 0.54，95%CI：0.47至0.60）。交互分析表明，健康生活方式减轻了社会隔离对IC的不良关联，但随着社会隔离增加，这种保护作用减弱。敏感性分析证实了这些发现的稳健性。
本研究确定了中国老年人群中社会隔离、健康生活方式与内在能力之间的显著关联。社会隔离与IC呈负相关，而健康生活方式与IC呈正相关。观察到的社会隔离与健康生活方式之间的相互作用凸显了在老龄化过程中针对社会参与和健康行为进行综合干预以支持IC的重要性。
