Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women’s Health Initiative Study Findings

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Tetyana P. Shippee¹  Candyce H. Kroenke²  Nkechinyere N. Ijioma³  Chloe Bird⁴  Shawnita Sealy‐Jefferson⁵  Khadijah Breathett⁶  Matthew Allison⁷  Milagros C. Rosal⁸  Giselle Corbie‐Smith⁹  Khushnood Faraz⁹  Crystal W. Cené⁹  Mace Coday^1,10  Xiaoyan Iris Leng^1,11  Randi Foraker^1,12 

[1] Division of Health Policy and Management University of Minnesota Minneapolis MN;Kaiser Permanente Northern California Oakland CA;Mayo Clinic College of Medicine Rochester MN;Rand Santa Monica CA;The Ohio State University Columbus OH;University of Arizona Tucson AZ;University of California San Diego La Jolla CA;University of Massachusetts Medical School Worcester MA;University of North Carolina at Chapel Hill NC;University of Tennessee Health Science Center Memphis TN;Wake Forest School of Medicine Winston‐Salem NC;Washington University in St. Louis School of Medicine St. Louis MO;

关键词: heart failure;    older adults;    social isolation;    women;   

DOI  :  10.1161/JAHA.120.022907

来源: DOAJ

【 摘 要 】

Background 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. Methods and Results 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. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.

【 授权许可】

Unknown