Socially-isolated neighborhoods and the risk of all-cause mortality among nursing home residents in the United States: A multilevel study.
Socially-isolated neighborhoods and the risk of all-cause mortality among nursing home residents in the United States: A multilevel study.
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DOI：
10.1016/j.pmedr.2020.101285
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发表时间：
2021-03
影响因子：
2.8
通讯作者：
Briesacher BA
中科院分区：
文献类型：
--
作者：
Kim D;Park C;Briesacher BA
预计到2060年，65岁及以上的美国人总数将增加近一倍，进入养老院的美国人数量也将增加。研究发现，独居是死亡的一个重要风险因素。然而，人们对生活在一个许多老年居民独自生活的社区可能产生的溢出健康影响知之甚少。更不知道这些风险是否在进入养老院后持续存在。我们的研究人群包括874，162名2011年新入住养老院的美国老年人，如3.0最小数据集所示。这些人的数据与医疗保险索赔和2010年人口普查数据有关。在这项队列研究中，我们估计了2013年12月31日之前县级65岁或以上独居家庭比例的四分位数与个人全因死亡风险之间的关联的多变量调整风险比，控制了县，养老院设施和个人水平因素。与属于最低四分位数的县相比，属于最高四分位数的老年单人家庭的县的老年人在进入养老院后死亡的风险高8%（HR = 1.08; 95%CI = 1.04-1.12，p < 0.001）。存在线性趋势的证据（趋势p < 0.001）。如果这些发现在未来的研究中得到证实，这将表明老年社区的生活安排可能会对居民的健康产生溢出效应。改变这种生活安排的计划和干预措施可能会在美国老年人中产生更有利的健康轨迹，这些老年人越来越老，进入养老院的风险也越来越大。
The total number of Americans age 65 and older is expected to nearly double by 2060, and the number of Americans admitted to nursing homes is likewise anticipated to escalate. Studies have found living alone to be an important risk factor for mortality. Yet little is known about possible spillover health effects of living in a community where many elderly residents live alone. Even less is known about whether these risks persist after entering nursing homes. Our study population consisted of 874,162 US elderly adults newly admitted to nursing homes in 2011, as identified from the 3.0 Minimum Data Set. Data on these individuals were linked to Medicare claims and 2010 Census data. In this cohort study, we estimated multivariable-adjusted hazard ratios for the associations between the quartiles of county-level percentage of households with those age 65 or older living alone and the individual-level risks of all-cause mortality until December 31, 2013, controlling for county-, nursing home facility-, and individual-level factors. Older adults in counties belonging to the highest quartile of elderly single-occupancy households had a 8% higher risk of dying (HR = 1.08; 95% CI = 1.04–1.12, p < 0.001) after entering nursing homes compared to those in counties belonging to the lowest quartile. There was evidence of a linear trend (p for trend < 0.001). Should these findings be confirmed in future studies, it would suggest that living arrangements in elderly communities may have spillover health effects onto their residents. Programs and interventions that modify such living arrangements may yield more favorable health trajectories among older Americans, who are increasingly aging in place and at growing risk of entering nursing homes.
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影响因子：
3
作者：
Gambassi, G;Landi, F;Bernabei, R
通讯作者：
Bernabei, R
DOI：
10.1016/j.socscimed.2008.10.013
发表时间：
2009-01
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Li LW;Zhang J;Liang J
通讯作者：
Liang J
影响因子：
12.7
作者：
Pantell, Matthew;Rehkopf, David;Adler, Nancy
通讯作者：
Adler, Nancy
影响因子：
12.6
作者：
Holt-Lunstad, Julianne;Smith, Timothy B.;Stephenson, David
通讯作者：
Stephenson, David
影响因子：
5
作者：
Eng, PM;Rimm, EB;Kawachi, I
通讯作者：
Kawachi, I