社交孤立对老年人心脑血管疾病的影响研究  

Effect of social isolation on cardiovascular and cerebrovascular diseases in the elderly

作　　者：许家培 孟令丙 李剑怡 吴迪珊 张路遥 刘德平 Xu Jiapei;Meng Lingbing;Li Jianyi;Wu Dishan;Zhang Luyao;Liu Deping(Peking University Fifth School of Clinical Medicine,Beijing 100730,China;Department of Cardiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,ChineseAcademy of Medical Sciences,Beijing100730,China)

机构地区：[1]北京大学第五临床医学院,北京100730 [2]北京医院心血管内科国家老年医学中心中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2024年第8期1065-1071,共7页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2020YFC2003001)。

摘　　要：目的分析我国老年人群社交孤立状况及其对心脑血管疾病的影响。方法通过第4次中国城乡老年人生活状况抽样调查数据库, 由婚姻状态、是否独自居住、经常联系的亲友数量、社会参与4个部分内容计算社交孤立评分。通过χ2检验评估社交孤立人群特征、各省级行政区情况及各协变量亚组间的差异性;采用Logistic回归分析社交孤立及相关因素对心脑血管疾病的影响。结果 218 329名老年人纳入最终分析, 山东省社交孤立发生率和人数均为全国最高(18.95%、3 360/17 735), 东部沿海省份社交孤立发生率显著高于西部地区。农村居住、女性、高龄、少数民族、低学历、经济状况差、吸烟、饮酒、缺乏锻炼、孤独、睡眠质量差、对住房条件不满意人群的社交孤立发生率更高。调整了负性情绪体验或不良生活方式后, 社交孤立会增加心脑血管疾病的发病风险(OR=1.190、95%CI:1.016~1.296、P=0.016, OR=1.208、95%CI:1.131~1.291、P<0.001), 在同时调整二者后心脑血管疾病的发病风险进一步增加(OR=1.237, 95%CI:1.160~1.319, P<0.001)。结论社交孤立与不良生活方式、负性情绪结合均会增加心脑血管疾病的发病风险, 应重视老年群体的社交孤立问题。Objective To examine the social isolation(SI)status among the elderly population in China and its effect on cardiovascular and cerebrovascular diseases(CCVD).Methods Utilizing data from the Fourth China Urban and Rural Elderly Living Conditions Sample Survey,the social isolation(SI)score was determined based on four components:marital status,living arrangements,frequency of contact with relatives and friends,and social participation.The χ^(2) test was employed to examine variations among socially isolated individuals,regional disparities within each province,and subgroups within each covariate.Additionally,Logistic regression was conducted to evaluate the impact of SI and its associated factors on CCVD.ResultsThe final analysis included 218329 elderly individuals,revealing that the incidence and number of SI in Shandong Province are the highest in China at 18.95%(3360 out of 17735).The incidence of SI in the Eastern coastal provinces is notably higher than in the Western region.Factors contributing to a higher prevalence of SI include living in rural areas,being female,older age,belonging to ethnic minorities,having low educational attainment,facing economic disadvantages,smoking,drinking alcohol,lack of exercise,loneliness,poor sleep quality,and dissatisfaction with housing conditions.The study found that SI increased the risk of developing cardiovascular disease even after adjusting for negative emotional experiences or poor lifestyle choices(OR=1.190,95%CI:1.016-1.296,P=0.016,OR=1.208,95%CI:1.131-1.291,P<0.001),and the risk further increased when both factors were simultaneously adjusted for(OR=1.237,95%CI:1.160-1.319,P<0.001).Conclusions Combining SI with poor lifestyle and negative emotions significantly raises the risk of cardiovascular disease,highlighting the importance of addressing these factors in the elderly population.

关 键 词：社交行为 生活方式 心脑血管疾病 孤独 

分 类 号：R54[医药卫生—心血管疾病] R743[医药卫生—内科学]