The prevalence of loneliness across 113 countries: systematic review and meta-analysis.
The prevalence of loneliness across 113 countries: systematic review and meta-analysis.
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DOI：
10.1136/bmj-2021-067068
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发表时间：
2022-02-09
期刊：
影响因子：
--
通讯作者：
Ding D
中科院分区：
文献类型：
--
作者：
Surkalim DL;Luo M;Eres R;Gebel K;van Buskirk J;Bauman A;Ding D
确定数据的可获得性、差距和全球人群水平孤独流行率的模式，通过荟萃分析在可行的情况下总结世界卫生组织区域内的流行率估计，并审查有数据的国家孤独的时间趋势。系统综述和荟萃分析。EMbase、Medline、PancINFO和SCOPUS用于同行评议文献，谷歌学者和Open Grey用于灰色文献，并辅之以反向参考搜索(至2021年9月1日)基于全国代表性样本(n≥292)、经验证的工具和2000年至2019年的流行数据的观察性研究。两名研究人员独立提取了数据，并使用乔安娜·布里格斯研究所的核对表评估了偏见的风险。随机效应Meta分析在研究方法相对相同的研究子集中进行，按测量工具、年龄组和WHO地区进行。根据世卫组织对区域的官方命名法，从57项研究中获得了113个国家或地区的流行数据。有77个国家或地区的青少年(12-17岁)、30个国家的青壮年(18-29岁)、32个国家的中年人(30-59岁)和40个国家的老年人(≥60岁)的数据。除青少年外，所有年龄段的数据都缺乏欧洲以外的地区。总体而言，来自24个研究的106个国家的212项估计数据被纳入荟萃分析。青少年孤独感的综合流行率在东南亚为9.2%(95%可信区间为6.8%至12.4%)，在东地中海地区为14.4%(12.2%至17.1%)。对于成年人，只对欧洲地区进行了荟萃分析，所有成年年龄组都显示了一致的地理模式。北欧国家的孤独患病率一直最低(年轻人为2.9%，1.8%至4.5%；中年人为2.7%，2.4%至3.0%；老年人为5.2%，4.2%至6.5%)，东欧国家最高(年轻人为7.5%，5.9%至9.4%；中年人为9.6%，7.7%至12.0%；老年人分别为21.3%、18.7%和24.2%)。在许多国家，相当大比例的人口都经历了严重的孤独。高收入国家(特别是欧洲)与低收入和中等收入国家之间的数据复盖面有很大差异，这提出了一个重要的公平问题。关于孤独的时间趋势的证据不足。这一荟萃分析的结果受到数据稀缺性和方法异质性的限制。应使用标准化和有效的测量工具，将孤独纳入一般健康监测，覆盖更广泛的地理和年龄范围。PROSPERO CRD42019131448。
To identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist. Systematic review and meta-analysis. Embase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021) Observational studies based on nationally representative samples (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region. Prevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults; 2.7%, 2.4% to 3.0% for middle aged adults; and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults; 9.6%, 7.7% to 12.0% for middle aged adults; and 21.3%, 18.7% to 24.2% for older adults). Problematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools. PROSPERO CRD42019131448.
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