Feelings of Loneliness and Living Alone as Predictors of Mortality in the Elderly: The PAQUID Study
Feelings of Loneliness and Living Alone as Predictors of Mortality in the Elderly: The PAQUID Study
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DOI：
10.1097/psy.0000000000000386
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发表时间：
2016-10-01
影响因子：
3.3
通讯作者：
Dartigues, Jean-Francois
中科院分区：
文献类型：
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作者：
Teguo, Maturin Tabue;Simo-Tabue, Nadine;Dartigues, Jean-Francois
目的本研究的目的是确定2个指标的预测价值的心理社会隔离（独居和孤独感）在老年people.Methods 22年的随访队列研究的3,620名社区居住的老年人参加了PAQUID研究，法国前瞻性的人口为基础的研究。参与者完成了一系列测试，包括流行病学研究中心抑郁量表和一个关于生活条件的问题（独自生活或与另一个人生活）。孤独感是用流行病学研究中心抑郁量表法语版的第14项（我感到孤独）来测量的。在基线评估访视后的22年随访期内测量死亡率。死亡的风险估计使用考克斯比例风险模型，调整年龄，性别和教育level.Results在基线，1,535名参与者（42.4%）是独居，和498人（13.8%）报告频繁的孤独感（FoL）。报告FoL的参与者更常见于女性（82.7%），平均（SD）年龄为76.5（7.1）岁。在随访结束时，发生了3，116例死亡（86.6%）。独居和FoL分别是22年随访后死亡的独立预测因素（风险比，1.14; 95%置信区间，1.05-1.23; p = .001）和（风险比，1.20; 95%置信区间，1.08-1.33; p = .001）。孤独感和独居之间没有发现显著的相互作用，表明联合暴露仅具有累加效应（= 0.08;相对风险=（0.85; 1.40）; p = 0.48）。在调整健康状况后，这两项措施的关联仍然存在。调整抑郁减弱了FoL.Conclusions的预测值独居和FoL独立与较高的死亡风险。这些因素可能是有用的现成的心理社会措施，以确定社区居住的老年人的脆弱性。
Objective The aim of this work was to determine the predictive value of 2 indicators of psychosocial isolation (living alone and feelings of loneliness) in elderly people.Methods Twenty-two-year follow-up cohort study of 3,620 community-dwelling elderly people enrolled in the PAQUID study, a French prospective population-based study. Participants completed a battery of tests including the Centre for Epidemiological Studies Depression scale and a question regarding living conditions (living alone or living with another person). Feelings of loneliness were measured using the Item 14 (I felt lonely) of the French version of the Centre for Epidemiological Studies Depression scale. Mortality rate was measured over a 22-year follow-up period after the baseline assessment visit. The risk of death was estimated using Cox proportional hazards models, adjusted for age, sex, and educational level.Results At baseline, 1,535 participants (42.4%) were living alone, and a total of 498 persons (13.8%) reported frequent feelings of loneliness (FoL). The participants reporting FoL were more frequently women (82.7%), and the mean (SD) age was 76.5 (7.1) years. At the end of the follow-up, 3,116 deaths (86.6%) occurred. Living alone and FoL were both independent predictors of death after 22 years of follow-up (hazard ratio, 1.14; 95% confidence of interval, 1.05-1.23; p = .001) and (hazard ratio, 1.20; 95% confidence of interval, 1.08-1.33; p = .001), respectively. No significant interaction was found between feelings of loneliness and living alone, suggesting that a joint exposure has only an additive effect ( = 0.08; relative risk = (0.85; 1.40); p = .48). The associations of both measures persisted after adjusting for health status. Adjusting for depression attenuated the predictive value of FoL.Conclusions Living alone and FoL were independently associated with higher risk of mortality. These factors may be useful as readily available psychosocial measures to identify vulnerability in community-dwelling older adults.