Loneliness in older persons: a predictor of functional decline and death.
Loneliness in older persons: a predictor of functional decline and death.
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DOI：
10.1001/archinternmed.2012.1993
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发表时间：
2012-07-23
影响因子：
--
通讯作者：
Covinsky, Kenneth E.
中科院分区：
文献类型：
--
作者：
Perissinotto, Carla M.;Cenzer, Irena Stijacic;Covinsky, Kenneth E.
孤独是老年人苦恼、痛苦和生活质量受损的常见原因。我们研究了美国60岁以上成年人孤独、功能衰退和死亡之间的关系。这是一项纵向队列研究，1604名参与者参加了健康与退休研究（HRS）的心理社会模块，这是一项具有全国代表性的老年人研究。基线评估是在2002年，随访每两年进行一次，直到2008年。被试者被问到他们是否感到1）被冷落2）孤立或3）缺乏陪伴。如果受试者几乎不回答所有三个问题，则被归类为不孤独，如果他们有时或经常回答三个问题中的任何一个，则被归类为孤独。主要结局为6年内至死亡的时间和6年内4项指标的功能下降：日常生活活动（ADL）次数增加困难、上肢任务次数增加困难、活动能力下降或爬楼梯困难增加。多变量分析调整了人口统计学变量，社会经济地位，生活状况，抑郁症和各种医疗条件。受试者的平均年龄为71岁，59%为女性，81%为白色，11%为黑人，6%为西班牙裔，18%为独居。43%的老年人表示感到孤独。孤独症与所有结局指标相关。孤独的受试者更有可能经历ADL的下降，（24.8% vs. 12.5%，调整后风险比1.59，1.23 - 2.07）;上肢活动困难（41.5% vs. 28.3%，ARR 1.28，1.08 - 1.52）;活动能力下降（38.1% vs. 29.4%，ARR 1.18，0.99 - 1.41）;或攀爬困难（40.8% vs. 27.9%，ARR 1.31，1.10 - 1.57）。孤独症与死亡风险增加相关（22.8% vs. 14.2%，AHR 1.45，1.11 - 1.88）。在60岁以上的参与者中，孤独是功能衰退和死亡的预测因素。
Loneliness is a common source of distress, suffering, and impaired quality of life in older persons. We examined the relationship between loneliness, functional decline and death in adults over age 60 in the United States. This is a longitudinal cohort study of 1604 participants in the psychosocial module of the Health and Retirement Study (HRS), a nationally representative study of older persons. Baseline assessment was in 2002 and follow-up occurred every two years until 2008. Subjects were asked if they feel 1) Left Out 2) Isolated or 3) Lack Companionship. Subjects were categorized as not lonely if they responded hardly ever to all three questions and lonely if they responded some of the time or often to any of the three questions. The primary outcomes were time to death over 6 years, and functional decline over 6 years on 4 measures: difficulty on an increased number of activities of daily living (ADL), difficulty in an increased number of upper extremity tasks, decline in mobility, or increased difficulty in stair climbing. Multivariate analyses adjusted for demographic variables, socioeconomic status, living situation, depression, and various medical conditions. The mean age of subjects was 71 years, 59% were women, 81% White, 11% Black, 6% Hispanic, and 18% lived alone. 43% of elders reported feeling lonely. Loneliness was associated with all outcome measures. Lonely subjects were more likely to experience decline in ADLs, (24.8% vs. 12.5%, Adjusted Risk Ratio 1.59, 1.23-2.07); develop difficulties with upper extremity tasks (41.5% vs. 28.3%, ARR 1.28, 1.08-1.52); decline in mobility (38.1% v. 29.4%, ARR 1.18, 0.99-1.41); or difficulty in climbing (40.8% vs. 27.9%, ARR 1.31, 1.10-1.57). Loneliness was associated with an increased risk of death (22.8% vs. 14.2%, AHR 1.45, 1.11-1.88). Among participants who were older than 60, loneliness was a predictor of functional decline and death.
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影响因子：
3.9
作者：
Segrin, Chris;Domschke, Tricia
通讯作者：
Domschke, Tricia
影响因子：
2.6
作者：
Hughes, ME;Waite, LJ;Cacioppo, JT
通讯作者：
Cacioppo, JT
影响因子：
3.3
作者：
Cacioppo, JT;Hawkley, LC;Berntson, GG
通讯作者：
Berntson, GG
DOI：
10.1046/j.1532-5415.2002.50259.x
发表时间：
2002-06-01
影响因子：
6.3
作者：
Mehta, KM;Yaffe, K;Covinsky, KE
通讯作者：
Covinsky, KE
影响因子：
3.7
作者：
Russell, DW;Cutrona, CE;Wallace, RB
通讯作者：
Wallace, RB