Loneliness in older primary care patients and its relationship to physical and mental health-related quality of life.
Loneliness in older primary care patients and its relationship to physical and mental health-related quality of life.
复制标题
老年初级保健患者的孤独感及其与身心健康相关生活质量的关系。
DOI：
10.1111/jgs.18762
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发表时间：
2024
影响因子：
6.3
通讯作者：
Fowler,NicoleR
中科院分区：
文献类型：
--
作者：
Williams-Farrelly,MonicaM;Schroeder,MatthewW;Li,Claudia;Perkins,AnthonyJ;Bakas,Tamilyn;Head,KatharineJ;Boustani,Malaz;Fowler,NicoleR
背景孤独是美国的一个重大公共卫生挑战，尤其是对老年人而言。初级保健中老年人孤独感的流行病学缺乏，需要针对孤独感如何影响老年初级患者的身体、心理和认知健康进行具体研究。在 COVID-19 大流行期间，招募了大量老年初级保健患者进行试验，以衡量孤独感与身心生活质量 (QOL) 之间的关系。方法基线数据来自阿尔茨海默病筛查护理结果 (COADS) 研究，这是一项正在进行的随机对照试验，评估 65 岁及以上初级保健患者中阿尔茨海默病和相关痴呆症筛查的益处和风险，收集于 2020 年 4 月至 2021 年 9 月。使用 NIH 工具箱情绪电池中的 18 岁以上孤独固定形式 5 项测量孤独感，使用 SF-36v2 测量身心健康相关的生活质量，分别使用 PHQ-9 和 GAD-7 测量抑郁和焦虑的严重程度。 结果斯皮尔曼相关分析显示，孤独感与心理健康生活质量中度相关(r[601] = −0.43,p< 0.001)、焦虑严重程度 (r[601] = 0.44,p< 0.001) 和抑郁严重程度 (r[601] = 0.42,p< 0.001)，但与身体健康 QOL 相关性较弱(r[601] = −0.15,p< 0.001)。在进行未调整和调整的线性回归模型后，我们发现孤独感与较低的心理（p< 0.001）和身体（p< 0.001）生活质量显着相关。此外，在调整年龄、性别、种族、民族、教育水平、感知收入状况、邻里劣势、合并症的严重程度以及合并症抑郁和焦虑后，孤独感仍然与较差的心理生活质量显着相关。结论初级保健提供者应与老年患者讨论孤独感，并提供资源帮助患者发展和维持有意义的社会关系。
BackgroundLoneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID‐19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL).MethodsBaseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5‐item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health‐related QOL was measured with the SF‐36v2, and depression and anxiety severity were measured with the PHQ‐9 and GAD‐7, respectively.ResultsSpearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = −0.43,p< 0.001), anxiety severity (r[601] = 0.44,p< 0.001), and depression severity (r[601] = 0.42,p< 0.001), while weakly correlated with physical health QOL (r[601] = −0.15,p< 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p< 0.001) and physical (p< 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety.ConclusionPrimary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.