Loneliness and all-cause mortality in community-dwelling elderly Singaporeans
Loneliness and all-cause mortality in community-dwelling elderly Singaporeans
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DOI：
10.4054/demres.2015.32.49
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发表时间：
2015-06-03
影响因子：
2.1
通讯作者：
Malhotra, Rahul
中科院分区：
文献类型：
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作者：
Chan, Angelique;Raman, Prassana;Malhotra, Rahul
背景孤独是老年人死亡的一个重要危险因素。孤独感可能通过几种途径增加死亡风险，从生物反应和个人感知到社会互动和环境因素。在过去十年中，新加坡单身老年人（65岁以上）家庭的比例翻了一番。然而，在新加坡和整个亚洲背景下，人们对老年人中孤独、社会隔离和死亡风险之间的关系知之甚少。控制人口统计学特征和健康状况的基线。方法我们使用的数据从一个纵向调查的社区居住的新加坡老年人（N= 4，522）。使用UCLA三项孤独量表评估孤独感。未校正和校正的考克斯比例风险回归被用来估计死亡风险。在最终的校正模型中，家庭外的生活安排和社交网络与全因死亡率无关。孤独增加了全因死亡的风险;那些有时孤独和大多数孤独的人比那些不孤独的人死亡的可能性高44.0%（p = 0.005）和39.0%（p= 0.059）。老年人的心理健康是一个主要的公共卫生问题，需要采取社区干预措施，以更有效地识别，提高认识，并增加对社区孤独老人的照顾。
BACKGROUNDLoneliness is a significant risk factor for mortality among older adults. There are several pathways through which loneliness may operate to increase mortality risk, ranging from biological responses and individual perceptions to social interactions and environmental factors. The proportion of single older (65+) person households has doubled in the last ten years in Singapore. Yet little is understood about the relationship between loneliness, social isolation, and mortality risk among older adults, in Singapore and in Asian contexts in general.OBJECTIVETo assess the impact of loneliness and social isolation on the risk of all-cause mortality over a four-year period, controlling for demographic characteristics and health status at baseline.METHODSWe used data from a longitudinal survey of community-dwelling Singaporean elderly (N=4,522). Loneliness was assessed using the UCLA three-item loneliness scale. Unadjusted and adjusted Cox proportional hazards regressions were used to estimate mortality risk.RESULTSIn the final adjusted model, living arrangements and social networks outside the household were not associated with all-cause mortality. Loneliness increased the risk of all-cause mortality; those sometimes lonely and mostly lonely were 44.0% (p= 0.005) and 39.0% (p= 0.059) more likely to die compared to those not lonely.CONCLUSIONSLoneliness is associated with higher mortality risks among Singaporean elderly. Mental health among the older population is a major public health concern and community interventions are needed to more efficiently identify, raise awareness of, and increase care for the lonely elderly in the community.