High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor
High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor
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DOI：
10.1017/s1041610218002120
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发表时间：
2019-10-01
影响因子：
7
通讯作者：
Jeste, Dilip, V
中科院分区：
文献类型：
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作者：
Lee, Ellen E.;Depp, Colin;Jeste, Dilip, V
目的：这项关于成年人一生中孤独感的研究考察了孤独感与社会人口统计学、心理健康（积极和消极的心理状态和特征）、主观认知抱怨和身体功能的关系。设计图：横断面数据分析参与者：340名居住在加州圣地亚哥的社区成年人，平均年龄62（SD = 18）岁，范围27-101岁，他们参加了三项以社区为基础的研究。测量值：孤独测量包括UCLA孤独量表第3版（UCLA-3）、4项患者报告结局测量信息系统（PROMIS）社会隔离量表和流行病学研究中心抑郁量表（CESD）的单项测量。其他测量包括圣地亚哥智慧量表（SD-WISE）和医疗结局调查-简表36。结果：76%的受试者在UCLA-3上有中度-高度的孤独感。孤独与心理健康状况较差相关，与积极的心理状态/特质呈负相关。即使是中等程度的孤独也与更差的精神和身体功能有关。孤独的严重程度和年龄有着复杂的关系，在20多岁后期，50多岁中期和80多岁后期孤独感增加。在孤独的患病率、严重程度和年龄关系上没有性别差异。最佳拟合的多元回归模型解释了UCLA-3分数的45%的方差，三个因素出现了中小效应量：智慧，独居和心理健康。结论：孤独的流行率高得令人震惊，而且孤独与健康相关措施的恶化相关联，这突出表明了社会面临的重大挑战。年龄与孤独严重程度的非线性关系值得进一步研究。智慧与孤独的强烈负相关突出了智慧作为心理社会/行为干预以减少孤独的目标的潜在关键作用。建立一个更明智的社会可以帮助我们发展一个更紧密的联系，更少的孤独和更幸福的社会。
Objectives: This study of loneliness across adult lifespan examined its associations with sociodemographics, mental health (positive and negative psychological states and traits), subjective cognitive complaints, and physical functioning. Design: Analysis of cross-sectional data Participants: 340 community-dwelling adults in San Diego, California, mean age 62 (SD = 18) years, range 27-101 years, who participated in three community-based studies. Measurements: Loneliness measures included UCLA Loneliness Scale Version 3 (UCLA-3), 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation Scale, and a single-item measure from the Center for Epidemiologic Studies Depression (CESD) scale. Other measures included the San Diego Wisdom Scale (SD-WISE) and Medical Outcomes Survey- Short form 36. Results: Seventy-six percent of subjects had moderate-high levels of loneliness on UCLA-3, using standardized cut-points. Loneliness was correlated with worse mental health and inversely with positive psychological states/traits. Even moderate severity of loneliness was associated with worse mental and physical functioning. Loneliness severity and age had a complex relationship, with increased loneliness in the late-20s, mid-50s, and late-80s. There were no sex differences in loneliness prevalence, severity, and age relationships. The best-fit multiple regression model accounted for 45% of the variance in UCLA-3 scores, and three factors emerged with small-medium effect sizes: wisdom, living alone and mental well-being. Conclusions: The alarmingly high prevalence of loneliness and its association with worse health-related measures underscore major challenges for society. The non-linear age-loneliness severity relationship deserves further study. The strong negative association of wisdom with loneliness highlights the potentially critical role of wisdom as a target for psychosocial/behavioral interventions to reduce loneliness. Building a wiser society may help us develop a more connected, less lonely, and happier society.