Baumann A, Filipiak B, Stieber J, Löwel H
Institut für Epidemiologie GSF-Forschungszentrum für Umwelt und Gesundheit.
Z Gerontol Geriatr. 1998 Jun;31(3):184-92. doi: 10.1007/s003910050033.
The relation between marital status, social integration and the mortality from all causes was examined in a population based cohort study. The 5-year-cohort consisted of 1,030 men and 957 women, aged 55-74 years who participated in the second MONICA Survey Augsburg, F.R.G., 1989/90 (MONICA = Monitoring of trends and determinants of cardiovascular disease). They were followed for mortality until 1995. Altogether 120 men and 45 women had died. Social integration was measured by an index of social ties. The index of social ties examined in these analyses includes (a) presence of a spouse, (b) number of close friends and relatives, (c) reported contact with close friends and relatives. Age standardized mortality rates (per 10,000 person years) were computed for men and women. Sex-specific Cox-proportional hazard models were used and hazard rate ratios (HRR) were calculated adjusting for age, hypertension, cigarette smoking, cholesterol, drinking alcohol, number of chronic diseases and self-reported health. Mortality rates were higher for men who were living alone (437.3) than for married men (235.3). Respectively in women the rates were 121.6 compared to 80.7. After controlling for age and self-reported health a HRR of 1.5 (95% CI: 1.0-2.4) was observed for single, divorced or widowed men and a HRR of 1.6 (95% CI: 0.8-3.0) for women living alone. Low mortality rates were observed in people with many social ties (men: 180.1, women: 29.9). Mortality rates of people who gave no informations about social ties (men: 349.5, women: 124.9) were similar to those who had only few social ties (men: 321.1, women: 132.5). The findings showed that people with few social ties were more likely to die in the follow-up period than those with more extensive contacts. After adjusting for age and self-reported health the HRR for those with few ties compared to those with many social ties were 1.6 (95% CI: 1.1-2.5) for men and 2.7 (95% CI: 1.1-6.6) for women. Similar results were found for people who gave no informations about their social ties (men: HRR = 1.4, 95% CI: 0.9-2.3; women: HRR = 2.6, 95% CI: 1.0-6.9). Social relationships were shown to be important predictors of mortality in elderly women and men. These findings confirm the need for further research, which enables to take steps against high mortality of the social isolated elderly.
在一项基于人群的队列研究中，对婚姻状况、社会融合与全因死亡率之间的关系进行了考察。该5年队列由1030名男性和957名女性组成，年龄在55 - 74岁之间，他们参与了1989/90年在德意志联邦共和国奥格斯堡进行的第二次莫尼卡调查（莫尼卡=心血管疾病趋势和决定因素监测）。对他们进行随访直至1995年。共有120名男性和45名女性死亡。社会融合通过社会关系指数来衡量。这些分析中所考察的社会关系指数包括：（a）配偶的存在情况；（b）亲密朋友和亲属的数量；（c）与亲密朋友和亲属的报告接触情况。计算了男性和女性的年龄标准化死亡率（每10000人年）。使用了性别特异性的Cox比例风险模型，并计算了风险率比（HRR），同时对年龄、高血压、吸烟、胆固醇、饮酒、慢性病数量和自我报告的健康状况进行了调整。独居男性的死亡率（437.3）高于已婚男性（235.3）。女性中相应的比率分别为121.6和80.7。在控制了年龄和自我报告的健康状况后，单身、离异或丧偶男性的HRR为1.5（95%置信区间：1.0 - 2.4），独居女性的HRR为1.6（95%置信区间：0.8 - 3.0）。社会关系多的人死亡率较低（男性：180.1，女性：29.9）。未提供社会关系信息的人的死亡率（男性：349.5，女性：124.9）与社会关系少的人相似（男性：321.1，女性：132.5）。研究结果表明，社会关系少的人在随访期间比社会关系广泛的人更有可能死亡。在调整了年龄和自我报告的健康状况后，社会关系少的人与社会关系多的人相比，男性的HRR为1.6（95%置信区间：1.1 - 2.5），女性为2.7（95%置信区间：1.1 - 6.6）。对于未提供社会关系信息的人也发现了类似结果（男性：HRR = 1.4，95%置信区间：0.9 - 2.3；女性：HRR = 2.6，95%置信区间：1.0 - 6.9）。社会关系被证明是老年男性和女性死亡率的重要预测因素。这些发现证实了进一步研究的必要性，以便能够采取措施应对社会孤立老年人的高死亡率。
