Social isolation, social support and loneliness as predictors of cardiovascular disease incidence and mortality

BMC Geriatrics

Carlene Britt¹  Alice J. Owen¹  Robyn L. Woods¹  Andrew Tonkin¹  John J. McNeil¹  Joanne Ryan¹  Rosanne Freak-Poli¹  Johannes T. Neumann²  Michael Berk³  Mark Nelson⁴  Christopher M. Reid⁵  Nigel Stocks⁶ 

[1] Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004, Melbourne, Victoria, VIC, Australia;Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004, Melbourne, Victoria, VIC, Australia;Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany;German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel, Lübeck, Germany;Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004, Melbourne, Victoria, VIC, Australia;IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, Australia;Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry, Florey Institute for Neuroscience and Centre for Mental Health, University of Melbourne, Parkville, Victoria, Australia;Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004, Melbourne, Victoria, VIC, Australia;Menzies Institute for Medical Research, University of Tasmania, 7000, Hobart, TAS, Australia;Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004, Melbourne, Victoria, VIC, Australia;School of Public Health, Curtin University, 6102, Perth, WA, Australia;Discipline of General Practice, Adelaide Medical School, University of Adelaide, 5005, Adelaide, SA, Australia;

关键词: Social Support;    Social Isolation;    Loneliness;    Cardiovascular Diseases;    Geriatrics;    Aging;    Interpersonal Relations;   

DOI  :  10.1186/s12877-021-02602-2

来源: Springer

【 摘 要 】

BackgroundPoor social health is associated with increased risk of cardiovascular disease (CVD). Recent research suggests that different social health domains should be considered separately as the implications for health and possible interventions may differ.AimTo assess social isolation, low social support and loneliness as predictors of CVD.MethodsSecondary analysis of 11,486 community-dwelling, Australians, aged 70 years and over, free of CVD, dementia, or significant physical disability, from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Social isolation, social support (Revised Lubben Social Network Scale), and loneliness were assessed as predictors of CVD using Cox proportional-hazard regression. CVD events included fatal CVD, heart failure hospitalization, myocardial infarction and stroke. Analyses were adjusted for established CVD risk factors.ResultsIndividuals with poor social health were 42 % more likely to develop CVD (p = 0.01) and twice as likely to die from CVD (p = 0.02) over a median 4.5 years follow-up. Interaction effects indicated that poorer social health more strongly predicted CVD in smokers (HR 4.83, p = 0.001, p-interaction = 0.01), major city dwellers (HR 1.94, p < 0.001, p-interaction=0.03), and younger older adults (70-75 years; HR 2.12, p < 0.001, p-interaction = 0.01). Social isolation (HR 1.66, p = 0.04) and low social support (HR 2.05, p = 0.002), but not loneliness (HR 1.4, p = 0.1), predicted incident CVD. All measures of poor social health predicted ischemic stroke (HR 1.73 to 3.16).ConclusionsAmong healthy older adults, social isolation and low social support may be more important than loneliness as cardiovascular risk factors. Social health domains should be considered in future CVD risk prediction models.

【 授权许可】

CC BY