Social Isolation and Risk of Mortality in Middle-aged and Older Adults with Arthritis: a Prospective Cohort Study of Four Cohorts

Overview

Journal Sci Rep

Specialty Science

Date 2025 Mar 8

PMID 40057562

Authors

Chuchu Ma

Siyu He

Jin Luo

Zequn Zhang

Hui Zhang

Wenze Xiao

Hejian Zou

Affiliations

Soon will be listed here.

Abstract

Social isolation is common and associated with many adverse outcomes. The evidence regarding social isolation and mortality among middle-aged and older adults with arthritis was lacking. The study aimed to examine the association between social isolation and mortality in this population. This study used data from four prospective cohorts: National Health and Aging Trends Study (NHATS), English Longitudinal Study of Ageing (ELSA), China Health and Retirement Longitudinal Study (CHARLS), and Chinese Longitudinal Healthy Longevity Survey (CLHLS). Individuals with arthritis (including osteoarthritis and rheumatoid arthritis) in these cohorts were included. Social isolation was assessed using self-reported questionnaires. Cox proportional hazards regression models were conducted to evaluate these associations. At baseline, a total of 16,035 individuals with arthritis (3872 from NHATS, 3259 from ELSA, 5645 CHARLS, and 3259 from CLHLS) were included. Social isolation was associated with increased risk of mortality in meta-analysis (hazard ratio [HR] 1.42, 95% confidence interval [CI]: 1.26-1.59), and individual cohorts (NHATS: HR 1.53, 95% CI 1.19-1.97; ELSA: HR 1.31, 95% CI 1.02-1.67; CLHLS: HR 1.50, 95% CI 1.36-1.64) after being adjusted for confounder factors. Additionally, with increasing social isolation score, the risk of mortality also increased in meta-analysis (HR 1.19, 95% CI 1.15-1.24), as well as in individual cohorts (NHATS: HR 1.22, 95% CI 1.14-1.30; CLHLS: HR 1.19, 95% CI 1.13-1.26). Subgroups analysis results suggested that social isolation was independently associated with a higher likelihood of mortality in middle-aged and older adults with arthritis, regardless of gender, lifestyles, and chronic diseases.

References

. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024; 403(10440):2100-2132. PMC: 11126520. DOI: 10.1016/S0140-6736(24)00367-2. View

Liang Y, Chen Y, Feng H, Liu X, Ai Q, Xue H . Association of Social Isolation and Loneliness With Incident Heart Failure in a Population-Based Cohort Study. JACC Heart Fail. 2023; 11(3):334-344. PMC: 9891238. DOI: 10.1016/j.jchf.2022.11.028. View

Zhang X, Ma N, Lin Q, Chen K, Zheng F, Wu J . Body Roundness Index and All-Cause Mortality Among US Adults. JAMA Netw Open. 2024; 7(6):e2415051. PMC: 11154161. DOI: 10.1001/jamanetworkopen.2024.15051. View

Chen L, Wu B, Mo L, Chen H, Zhao Y, Tan T . Associations between biological ageing and the risk of, genetic susceptibility to, and life expectancy associated with rheumatoid arthritis: a secondary analysis of two observational studies. Lancet Healthy Longev. 2023; 5(1):e45-e55. DOI: 10.1016/S2666-7568(23)00220-9. View

Kadier K, Dilixiati D, Zhang X, Li H, Kuang L, Huang J . Rheumatoid arthritis increases the risk of heart failure: results from the cross-sectional study in the US population and mendelian randomization analysis in the European population. Front Immunol. 2024; 15:1377432. PMC: 11165030. DOI: 10.3389/fimmu.2024.1377432. View

. Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-up Study of Alameda County Residents. Am J Epidemiol. 2018; 185(11):1070-1088. DOI: 10.1093/aje/kwx103. View

Pan C, Cao N . Patterns of Social Isolation and Low Social Support and Frailty Trajectories Among Chinese Older Adults. J Appl Gerontol. 2023; 42(12):2325-2334. DOI: 10.1177/07334648231194508. View

Wang F, Gao Y, Han Z, Yu Y, Long Z, Jiang X . A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav. 2023; 7(8):1307-1319. DOI: 10.1038/s41562-023-01617-6. View

Sha S, Gwenzi T, Chen L, Brenner H, Schottker B . About the associations of vitamin D deficiency and biomarkers of systemic inflammatory response with all-cause and cause-specific mortality in a general population sample of almost 400,000 UK Biobank participants. Eur J Epidemiol. 2023; 38(9):957-971. PMC: 10501954. DOI: 10.1007/s10654-023-01023-2. View

10.

Koh-Bell A, Chan J, Mann A, Kapp D . Social isolation, inflammation, and cancer mortality from the National Health and Nutrition Examination Survey - a study of 3,360 women. BMC Public Health. 2021; 21(1):1289. PMC: 8252233. DOI: 10.1186/s12889-021-11352-0. View

11.

Zhang Y, Pan X, Chen J, Cao A, Xia L, Zhang Y . Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. J Epidemiol Community Health. 2020; 75(1):92-99. DOI: 10.1136/jech-2020-214050. View

12.

Videm V, Houge I, Liff M, Hoff M . Inflammation mediates approximately one quarter of excess relative all-cause mortality in persons with rheumatoid arthritis: the Trøndelag Health Study. Sci Rep. 2022; 12(1):18599. PMC: 9633644. DOI: 10.1038/s41598-022-21977-9. View

13.

Teo R, Cheng W, Cheng L, Lau Y, Lau S . Global prevalence of social isolation among community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr. 2022; 107:104904. DOI: 10.1016/j.archger.2022.104904. View

14.

Zhang H, Hsu-Hage B, Wahlqvist M . The use of knee height to estimate maximum stature in elderly Chinese. J Nutr Health Aging. 2000; 2(2):84-7. View

15.

Zhou J, Tang R, Wang X, Li X, Heianza Y, Qi L . Improvement of Social Isolation and Loneliness and Excess Mortality Risk in People With Obesity. JAMA Netw Open. 2024; 7(1):e2352824. PMC: 10804268. DOI: 10.1001/jamanetworkopen.2023.52824. View

16.

Luo J, Hendryx M . Mediation analysis of social isolation and mortality by health behaviors. Prev Med. 2021; 154:106881. DOI: 10.1016/j.ypmed.2021.106881. View

17.

Matthews T, Hartmann Rasmussen L, Ambler A, Danese A, Eugen-Olsen J, Fancourt D . Social isolation, loneliness, and inflammation: A multi-cohort investigation in early and mid-adulthood. Brain Behav Immun. 2023; 115:727-736. PMC: 11194667. DOI: 10.1016/j.bbi.2023.11.022. View

18.

Freedman V, Kasper J . Cohort Profile: The National Health and Aging Trends Study (NHATS). Int J Epidemiol. 2019; 48(4):1044-1045g. PMC: 6934030. DOI: 10.1093/ije/dyz109. View

19.

Chen Z, Glisic M, Song M, Aliahmad H, Zhang X, Moumdjian A . Dietary protein intake and all-cause and cause-specific mortality: results from the Rotterdam Study and a meta-analysis of prospective cohort studies. Eur J Epidemiol. 2020; 35(5):411-429. PMC: 7250948. DOI: 10.1007/s10654-020-00607-6. View

20.

Steptoe A, Breeze E, Banks J, Nazroo J . Cohort profile: the English longitudinal study of ageing. Int J Epidemiol. 2012; 42(6):1640-8. PMC: 3900867. DOI: 10.1093/ije/dys168. View