Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women's Health Initiative Study Findings.
Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women's Health Initiative Study Findings.
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DOI：
10.1161/jaha.120.022907
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发表时间：
2022-03
影响因子：
5.4
通讯作者：
Kroenke, Candyce H.
中科院分区：
文献类型：
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作者：
Cene, Crystal W.;Leng, Xiaoyan Iris;Faraz, Khushnood;Allison, Matthew;Breathett, Khadijah;Bird, Chloe;Coday, Mace;Corbie-Smith, Giselle;Foraker, Randi;Ijioma, Nkechinyere N.;Rosal, Milagros C.;Sealy-Jefferson, Shawnita;Shippee, Tetyana P.;Kroenke, Candyce H.
老年人社会孤立或缺乏社会网络联系的关联尚不清楚。这种知识差距很重要，因为心力衰竭（HF）和社会孤立的风险随着年龄的增长而增加。该研究探讨了社会隔离是否与老年妇女的HF事件有关，并将抑郁症状作为潜在的中介因素，将年龄、种族和民族作为影响因素。本研究纳入了来自WHI（妇女健康倡议）研究的44174名不同种族和民族的绝经后妇女，这些妇女从基线入组（1993-1998）至2018年接受了HF裁定的年度评估。我们进行了一项中介分析，以检查抑郁症状作为一个潜在的调解人，并进一步检查年龄，种族和民族的影响修改。需要住院治疗的HF事件是主要结局。社会孤立是一个基于婚姻/伴侣状况、宗教关系和社区关系的复合变量。使用CES-D（流行病学研究-抑郁中心）评估抑郁症状。在中位随访15.0年的时间里，我们分析了36457名女性的数据，发生了2364例（6.5%）HF事件; 2510例（6.9%）参与者被社会隔离。在调整了社会人口统计学、行为、临床和一般健康/功能的多变量分析中，社会隔离女性发生HF的风险高于非隔离女性（HR，1.23; 95%CI，1.08-1.41）。在模型中添加抑郁症状并没有改变这种关联（HR，1.22; 95%CI，1.07-1.40）。无论是种族和民族，也没有年龄缓和社会隔离和事件HF之间的关联。与社会隔离的老年女性发生HF的风险增加，与传统HF风险因素无关。URL：http://www.clinicaltrials.gov;唯一标识符：NCT 00000611。
The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993–1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES‐D (Center for Epidemiology Studies‐Depression). Over a median follow‐up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08–1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07–1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.