Biopsychosocial science and medicine最新文献

{"title":"Attachment Insecurity and Well-Being in Dementia Spousal Caregivers: The Moderating Role of Marital Satisfaction.","authors":"Vincent D Lai, Daniel L Argueta, Kelly N Brice, Bryan T Denny, Charles Green, Luis D Medina, Jensine Paoletti-Hatcher, Paul E Schulz, Jennifer M Stinson, E Lydia Wu-Chung, Cobi J Heijnen, Christopher P Fagundes","doi":"10.1097/PSY.0000000000001466","DOIUrl":"10.1097/PSY.0000000000001466","url":null,"abstract":"<p><strong>Objective: </strong>Caregivers for spouses with Alzheimer disease and related dementias (AD/ADRD) who exhibit insecure attachment orientations-specifically, greater attachment anxiety and/or avoidance-are at risk for poorer physical and mental well-being. Marital satisfaction, or caregivers' general evaluations of their relationship with their spouses, may buffer this risk. We tested marital satisfaction as a potential buffer of the associations between attachment orientation and psychological and physiological indices of well-being.</p><p><strong>Methods: </strong>A cross-sectional sample of 264 AD/ADRD spousal caregivers completed self-report measures of attachment orientation, marital satisfaction, and depressive symptoms and provided blood samples. We conducted multiple regression models to test study hypotheses.</p><p><strong>Results: </strong>Greater attachment avoidance was associated with more depressive symptoms ( P = .002) and higher lipopolysaccharide (LPS)-stimulated cytokine production ( P = .001). The associations between attachment avoidance and depressive symptoms ( P = .045) or LPS-stimulated cytokine production ( P = .028) were weaker at higher levels of marital satisfaction. Greater attachment anxiety was associated with more depressive symptoms ( P < .001), and, unexpectedly, this association was stronger as caregivers reported higher levels of marital satisfaction ( P = .028). Marital satisfaction did not moderate the association between attachment anxiety and LPS-stimulated cytokine production ( P = .20).</p><p><strong>Conclusions: </strong>Our work contributes to the body of research examining psychosocial factors that shape well-being among caregivers. Our findings may inform future interventions focusing on the marital relationship to improve caregiver well-being; although these interventions may benefit avoidantly attached caregivers, anxiously attached caregivers may benefit most from intervention approaches tailored to their specific attachment orientation.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"408-420"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatic Symptom Distress, Health Anxiety, Alexithymia, and Emotion Generation: Results of an Evidence Accumulation Model.","authors":"Karoline Sophie Sauer, Ann-Kathrin Mohr, Michael Witthöft","doi":"10.1097/PSY.0000000000001459","DOIUrl":"10.1097/PSY.0000000000001459","url":null,"abstract":"<p><strong>Objective: </strong>High levels of somatic symptom distress and health anxiety have been linked to difficulties in emotion generation, identification, and regulation. However, these findings stem largely from correlational studies using questionnaires. Mechanistic experimental evidence is scarce and inconclusive.</p><p><strong>Methods: </strong>The present study investigated associations between somatic symptom distress (SSS-8), health anxiety (MK-HAI), alexithymia (TAS-20), and experimental indicators of emotion generation in N = 78 participants (age: M = 23.12, SD = 3.50; sex: 80.8% females, 19.2% males). An innovative experimental paradigm of emotion generation by Givon and colleagues (2023) was used, which assesses emotional responses to normed negative or positive pictures. It allows the calculation of evidence accumulation parameters that reflect emotion processing efficiency (drift-rate) and response bias in emotion reporting (threshold), based on a linear ballistic accumulator model.</p><p><strong>Results: </strong>Somatic symptom distress was not associated with emotion processing efficiency (drift-rate) for negative emotions (BF inclusion = 0.49). There was anecdotal evidence for an effect of health anxiety (BF inclusion = 2.53), but the effect was small and inconclusive [ b = -0.01, SD = 0.004, 95% CI (-0.01, <0.001)], thus failing to support a strong association. Experimental indicators of emotion generation were also unrelated to self-reported alexithymia (0.14 < BF 10 < 0.18).</p><p><strong>Conclusions: </strong>The study did not provide evidence that somatic symptom distress or health anxiety are linked to a markedly reduced efficiency in processing of negative emotions. As this was a convenience sample with predominantly nonclinical symptom levels, future studies should test the generalizability of these findings to clinical samples.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"350-359"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Affect and Plasma Aldosterone in Working Adults.","authors":"William D Eckerle, Bethany Barone-Gibbs, Thomas Kamarck, Subashan Perera, Matthew F Muldoon","doi":"10.1097/PSY.0000000000001477","DOIUrl":"10.1097/PSY.0000000000001477","url":null,"abstract":"<p><strong>Objective: </strong>Previous research suggests that psychological stress and its correlates, such as heightened negative affect, are associated with increased risk for cardiovascular disease. It has been suggested that activity of the renin-angiotensin-aldosterone system (RAAS) may be a mechanism linking stress and negative affect to risk for cardiovascular disease, but evidence in support of an association between negative affect and RAAS activity is inconsistent. The present study sought to test the hypothesis that individuals who report greater levels of negative affect would have heightened plasma aldosterone concentrations.</p><p><strong>Methods: </strong>Using preintervention baseline data from the RESET-BP trial, we examined the association between negative affect, measured by the Profile of Mood States and Short-Form 36 questionnaires, and plasma aldosterone in 193 adult men and women (aged 24 to 65 years, 55% females).</p><p><strong>Results: </strong>Correlational and linear regression analyses showed no evidence of an association between aldosterone and negative affect, with or without controlling for sex, age, BMI, education, and race.</p><p><strong>Conclusions: </strong>Negative affect may not be related to concentrations of aldosterone, and additional research is required to understand the psychological mediators of previously observed associations between mood-related psychopathology and aldosterone.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"399-407"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omicron Infection and Severity After Life Adversities: Evidence From a Trauma Injury Cohort Study in China.","authors":"Jiesiwei Luo, Shu Wen, Huazhen Yang, Yueyao Xu, Yu Zeng, Wenwen Chen, Yanan Zhang, Guanglin Wang, Wei Zhang, Fang Fang, Unnur A Valdimarsdóttir, Huan Song, Jie Song","doi":"10.1097/PSY.0000000000001469","DOIUrl":"10.1097/PSY.0000000000001469","url":null,"abstract":"<p><strong>Objective: </strong>Life adversities may have long-lasting effects on mental and physical health, including respiratory infectious diseases. However, studies on different types of life adversities and their effects on COVID-19, especially omicron infection and severity, are scarce.</p><p><strong>Methods: </strong>We established a cohort of 3567 patients admitted for physical injury to a trauma medical center in Southwest China between June 2020 and February 2024. Three types of life adversities-childhood maltreatment, adverse lifetime experiences, and index injury-were assessed through interviews. Omicron infection, severity, and symptoms were collected through a self-report questionnaire. Logistic regression was used to examine associations with subsequent omicron infection and severity, with further stratification by a polygenic risk score (PRS) of severe COVID-19. Mediation analyses were conducted to evaluate the contribution of post-injury psychiatric symptoms.</p><p><strong>Results: </strong>More severe index injury was associated with a higher risk of omicron infection (ORs = 1.64 to 1.67), partially mediated by posttrauma anxiety, depression, and stress-related symptoms (28.66 to 34.16%). Childhood physical abuse and severe index injury (ORs = 1.86 to 2.16) were associated with a higher risk of severe omicron infection requiring essential treatment or hospitalization. Childhood sexual abuse and individual adverse lifetime experiences (ORs = 1.48 to 2.89) were associated with a greater number of severe omicron infection symptoms ( N ≥3 vs no symptoms). Similar patterns were observed in individuals with a high PRS of severe COVID-19.</p><p><strong>Conclusions: </strong>Our findings suggest that individuals with greater exposure to traumatic experiences are at increased risk of severe omicron infection, adding to the growing knowledge that recent and early life adversities may have both short and long-term negative influences on health outcomes.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"386-398"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Cognitive Impairment in Patients With Pancreatic Cancer.","authors":"Yang-Chen Shen, Amornthep Jankaew, Cheng-Feng Lin, Chia-Jui Yen, Yan-Shen Shan, Po See Chen","doi":"10.1097/PSY.0000000000001465","DOIUrl":"10.1097/PSY.0000000000001465","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is increasingly recognized as having a significant influence on cancer prognosis; however, its relevance in pancreatic cancer remains underexplored. This study aims to evaluate the prevalence of cognitive impairment in patients with pancreatic cancer and examine its association with overall survival (OS).</p><p><strong>Methods: </strong>In this prospective study, 516 patients with newly diagnosed pancreatic cancer were enrolled. Baseline cognitive function was assessed using the Montreal Cognitive Assessment, with cognitive impairment defined as a Montreal Cognitive Assessment score <24. Kaplan-Meier survival analysis and Cox proportional hazards models were used to examine the prognostic significance of cognitive impairment, adjusting for demographic and clinical covariates.</p><p><strong>Results: </strong>The study cohort had a mean age of 64.30 years (SD=10.85), and 54.0% of the patients were diagnosed with stage IV pancreatic cancer. The median OS for the entire cohort was 17.18 months (95% CI=14.48-19.88). Cognitive impairment was observed in 53.5% of patients. Median OS was significantly shorter in patients with cognitive impairment than in those without (14.71 vs. 26.80 mo, log-rank p <.001). Cognitive impairment (hazard ratio=1.765, 95% CI=1.206-2.583, p =.003) and tumor stage (hazard ratio=2.582, 95% CI=1.853-3.598, p <.001) were independent prognostic factors for OS.</p><p><strong>Conclusions: </strong>Cognitive impairment is highly prevalent and independently associated with poorer OS in pancreatic cancer. These findings support routine cognitive assessments in pancreatic cancer management and highlight the need for further investigation into underlying mechanisms.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"379-385"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shift-and-Persist Strategies and Their Association With Cardiometabolic Outcomes Among Young Adults in Puerto Rico.","authors":"Andrea López-Cepero, Shakira F Suglia, Tanya Spruill, Polaris Torres Rodríguez, Milagros C Rosal, Cynthia M Pérez","doi":"10.1097/PSY.0000000000001473","DOIUrl":"10.1097/PSY.0000000000001473","url":null,"abstract":"<p><strong>Objective: </strong>Shift-and-persist (SP-the ability to adapt the self to stressors while preserving focus in the future) is associated with favorable cardiometabolic outcomes. SP may be relevant in Puerto Rico (PR), a population with a high burden of cardiometabolic diseases and stressors. We examined the association between SP and cardiometabolic markers among young adults in PR.</p><p><strong>Methods: </strong>Cross-sectional analysis of baseline PR-OUTLOOK data (September 2020 to March 2024). The analytic sample (n=2707) was aged 18 to 29 and 62% female. SP was measured with the Chen and Miller scale and categorized into tertiles (low, moderate, and high). Anthropometric measurements and fasting blood samples assessed cardiometabolic markers: BMI and waist circumference, blood pressure, blood glucose, HbA1c, and blood lipids (cholesterol, HDL, LDL, and triglycerides). Analyses included adjusted linear regression models.</p><p><strong>Results: </strong>In adjusted models, persons with moderate and high SP had a BMI that was on average 0.96 (95% CI = -1.63,-0.29) and 0.83 (95% CI = -1.55,-0.12) units lower, respectively, than those with low SP. Similarly, those with moderate and high SP had a waist circumference that was 1.89 (95% CI = -3.45,-0.34) and 1.96 (95% CI = -3.62,-0.30) units lower, respectively, than those with low SP. In addition, persons with moderate and high SP had glucose readings that were 2.45 (95% CI = -4.31,-0.60) and 2.81 (95% CI = -5.79,-0.83) units lower, respectively, than those with low SP, whereas only those with high SP had a lower HbA1c (β=-0.10; 95% CI = -0.16,-0.04). Only those with moderate SP (vs. low) had significantly higher HDL (β=1.16; 95% CI = 0.16, 2.17). No significant associations were found for blood pressure and other blood lipids.</p><p><strong>Conclusion: </strong>Greater SP was associated with lower adiposity, lower concentration of markers of glucose metabolism, and, to some extent, with higher HDL. Longitudinal studies are needed to confirm study findings and understand how SP may promote biobehavioral mechanisms for cardiometabolic health.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"360-368"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Support, Loneliness, and Inflammation in LGB+ Subgroups: Health Disparities in a Partnered US Cohort.","authors":"Annelise A Madison, Claire M Kamp Dush, Thomas W McDade, Juan Peng, Rebecca R Andridge, Steve W Cole, Tessa Blevins, Nithya Kasibhatla, Wendy Manning, Lisa M Christian","doi":"10.1097/PSY.0000000000001476","DOIUrl":"10.1097/PSY.0000000000001476","url":null,"abstract":"<p><strong>Objective: </strong>To examine differences in social support, loneliness, and immune function by sexual orientation and to explore whether social support and loneliness mediate immune outcomes.</p><p><strong>Methods: </strong>Participants (394 heterosexual, 144 gay/lesbian, 144 plurisexual) completed the Perceived Social Support Questionnaire and the UCLA Loneliness short-form and provided dried blood spot samples to index i mmune markers [Epstein-Barr virus (EBV) titers, C-reactive protein (CRP), interleukin-6 (IL-6)] between September 2020 and November 2021.</p><p><strong>Results: </strong>Plurisexual (Cohen's d =-0.80) and heterosexual ( d =-0.64) males had lower friend support than gay males ( p' s < .0015), plurisexual ( d =-0.42) and gay/lesbian ( d =-0.40) adults reported lower family support than their heterosexual peers ( p' s < .001), and plurisexual people had higher CRP levels compared with gay/lesbian ( d =0.37) and heterosexual people ( d =0.22) ( p 's < .039). Lower social support did not explain plurisexual adults' higher inflammation, but BMI partially explained plurisexual adults' higher IL-6 [indirect effect: 0.15 (0.04 to 0.26)] and CRP [indirect effect: 0.21 (0.04 to 0.38)], compared with heterosexual adults.</p><p><strong>Conclusions: </strong>Partnered plurisexual individuals face lower social support and greater inflammation-suggesting that partnered status alone does not ensure health equity. These findings underscore the need to better understand and address the unique social and biological vulnerabilities of plurisexual people. BMI may partially explain plurisexuals' higher inflammation, but further longitudinal research is warranted.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"369-378"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamical Cardiovascular Synchrony in Patient-caregiver Dyads Affected by Cancer: An Application of the Coupled Linear Oscillator Model.","authors":"Thomas C Tsai, Robert G Moulder, Steven M Boker, Youngmee Kim","doi":"10.1097/PSY.0000000000001486","DOIUrl":"https://doi.org/10.1097/PSY.0000000000001486","url":null,"abstract":"<p><strong>Objective: </strong>To examine moment-to-moment cardiovascular coordination between patients with cancer and their family caregivers during acute interpersonal stress, using a dynamical systems modeling approach.</p><p><strong>Methods: </strong>Second-by-second interbeat interval (IBI) data from 134 adult patients with colorectal cancer and their family caregivers were continuously recorded across six phases of an experimental stress task: baseline, stress scenario, preparation, caregiver speech, patient speech, and recovery. The coupled linear oscillator (CLO) model was used to estimate each partner's oscillatory frequency and amplitude (damping vs. amplification), as well as cross-partner coupling.</p><p><strong>Results: </strong>Across all task phases, both patients and caregivers showed rhythmic cardiovascular oscillations and cross-partner coupling, indicating synchronized cardiovascular activity. Co-regulation (damping with coupling) and co-agitation (amplification with coupling) were not statistically supported overall. Descriptive trajectory plots suggested phase-dependent patterns: minimal oscillation during baseline, increased amplitude during the stress-evoking scenario, and increased damping and coupling during the speech phases. Additionally, coupling effects were stronger for the speaking partner.</p><p><strong>Conclusions: </strong>This study applied a dynamical systems approach to model moment-to-moment cardiovascular coordination in patient-caregiver dyads during acute stress. Findings revealed unique cardiovascular synchrony patterns in patient-caregiver dyads that varied by stress type (i.e., the specific stress phase) and the roles within the relationship (speaker vs. listener). Future research should examine psychosocial predictors and long-term health outcomes associated with specific cardiovascular co-regulation and co-agitation patterns, and apply this statistical approach to other markers of moment-to-moment interpersonal processes, such as emotional linkage and behavioral synchrony (e.g., rest-activity patterns).</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Associations of Type D Personality and Allostatic Load With Coronary Artery Disease in Type 2 Diabetes: Evaluating the Role of Allostatic Load.","authors":"Lin Liu, Ting Han, Qingfang Ye, Yini Wang, Ping Lin","doi":"10.1097/PSY.0000000000001456","DOIUrl":"10.1097/PSY.0000000000001456","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to (1) evaluate and compare the independent associations and predictive strength of type D personality and allostatic load (AL) against traditional risk factors for coronary artery disease (CAD) in patients with type 2 diabetes (T2DM), (2) explore the potential mediating role of AL in the association between type D personality and CAD, and (3) investigate their joint effect on CAD risk.</p><p><strong>Methods: </strong>This cross-sectional study included 1089 patients with diabetes (aged 45 years or more). Type D personality was assessed using the type D scale-14. The AL index comprised 10 biomarkers from cardiovascular, metabolic, and immune systems, selected based on established criteria.</p><p><strong>Results: </strong>Among 1089 patients, 305 (28.0%) had CAD. The XGBoost machine learning model identified both AL and type D personality as factors exhibiting stronger associations with CAD prevalence than most traditional cardiovascular risk factors. Furthermore, mediation analysis revealed a significant indirect effect, suggesting that AL accounted for 16.67% of the observed association between type D personality and CAD. Regarding their combined impact, compared with the reference group (non-type D+low AL), adjusted odds ratios for CAD were 1.68 (95% CI = 1.12-2.52) for type D alone, 1.87 (95% CI = 1.33-2.63) for high AL alone, and 2.74 (95% CI = 1.77-4.25) for both factors combined.</p><p><strong>Conclusions: </strong>AL partially explained the type D-CAD association, and their co-occurrence conferred the highest CAD risk, suggesting potential utility for combined risk stratification.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"341-348"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Isolation and Loneliness Elevating Osteoporosis and Fracture Morbidity, Mediated by Frailty and Systemic Inflammation.","authors":"Xin Wang, Xiaowen Ma, Haolong Zhou, Shuo Zheng, Shujie Zhao, Yingxi Wei, Qi Wang","doi":"10.1097/PSY.0000000000001461","DOIUrl":"10.1097/PSY.0000000000001461","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis (OP) and fractures impose an increasingly heavy burden on aging populations. The social isolation and loneliness commonly experienced by older adults may influence skeletal health through multiple pathways. Therefore, we aim to examine the associations of social isolation and loneliness with the risk of OP and fractures.</p><p><strong>Methods: </strong>We included 432,635 participants from the UK Biobank cohort, with 14,810 OP and 21,758 fracture incident cases during a 14.8-year (median) follow-up. Associations between social isolation and loneliness with incident OP and fracture risks were analyzed by using Cox regression models. With polygenetic risk scores constructed by genome-wide significant genetic variants, we analyzed joint and interaction effects of social isolation and loneliness and genetic predisposed OP and fracture risk. Mediation effects of frailty and systemic inflammation were also explored.</p><p><strong>Results: </strong>Social isolation and loneliness were associated with increased hazards of OP [hazard ratio (HR)=1.12 (95% CI=1.07-1.19) and 1.19 (1.11-1.28), respectively] and fractures [1.11 (1.07-1.17) and 1.18 (1.12-1.26), respectively]. Genetic predispositions did not modify the associations. Frailty and systemic inflammation mediated their effects with 0.68% to 36.87% of total effects for social isolation, loneliness, and OP, and 0.45% to 23.17% of total effects for social isolation, loneliness, and fractures. Subgroup and sensitivity analyses confirmed the robustness of these findings.</p><p><strong>Conclusion: </strong>Social isolation and loneliness contribute to OP and fracture incidence, partially mediated by frailty and systemic inflammation. Our findings implicated the importance of strengthening social connection and target intervention of against frailty in OP and fracture prevention.</p>","PeriodicalId":520402,"journal":{"name":"Biopsychosocial science and medicine","volume":" ","pages":"310-321"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}