中国老年人的社会孤立、健康生活方式和内在能力：一项纵向研究

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-05-22 DOI:10.1016/j.jnha.2025.100583

Xiao Yue , Quan Yuan , Rong Zhou , Mei Wang

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引用次数: 0

摘要

目的探讨社会隔离与健康生活方式对中国老年人内在能力（IC）的独立和互动关系。设计与设置采用中国健康与退休纵向研究（CHARLS）的数据进行纵向队列研究，跨越三波（2011年、2013年和2015年），涉及60岁及以上的成年人。最终分析共纳入4495名老年人，他们在基线时具有IC、社会隔离、健康生活方式和相关协变量的完整数据。测量使用五个领域的综合评分进行评估：运动、认知、感觉、活力和心理。社会孤立是通过一个基于生活安排、婚姻状况、与儿童接触和社会参与的指数来衡量的。健康生活方式的定义基于五个因素：吸烟、饮酒、体育活动、睡眠时间和身体质量指数（BMI）。多元线性回归和线性混合效应模型用于检验横断面和纵向关联。分析了社会孤立与健康生活方式之间的互动关系。根据年龄和性别对参与者进行分层，进行敏感性分析。结果在基线中，31.0%、62.3%和6.7%的参与者的社会隔离得分分别为0、1−2和3−4，而28.5%、37.0%和34.6%的参与者的健康生活方式得分分别为0−2、3和4−5。与没有社会隔离的参与者（得分= 0）相比，社会隔离得分为1 - 2和3 - 4的参与者的IC得分分别下降（β = - 0.36, 95%可信区间[CI]: - 0.42至- 0.30）和（β = - 0.65, 95%可信区间[CI]: - 0.77至- 0.53）。相反，坚持健康的生活方式与IC的改善相关(β = 0.27, 95% CI: 0.20至0.34，评分3；β = 0.54, 95% CI: 0.47至0.60，评分为4 - 5)。互动分析表明，健康的生活方式减轻了社会隔离对IC的不利影响，但这种保护作用随着社会隔离的增加而减弱。敏感性分析证实了这些发现的稳健性。结论本研究发现中国老年人社会孤立、健康生活方式和内在能力之间存在显著关联。社会隔离与IC呈负相关，而健康的生活方式与IC呈正相关。观察到的社会隔离和健康生活方式之间的相互作用强调了针对社会参与和健康行为的综合干预在支持老年IC方面的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Social isolation, healthy lifestyle, and intrinsic capacity among older adults in China: A longitudinal study

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Social isolation, healthy lifestyle, and intrinsic capacity among older adults in China: A longitudinal study

Objectives

This study aimed to investigate the independent and interactive associations of social isolation and a healthy lifestyle on intrinsic capacity (IC) among older adults in China.

Design and setting

A longitudinal cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS), spanning three waves (2011, 2013, and 2015) and involving adults aged 60 years and older.

Participants

A total of 4495 older adults with complete data on IC, social isolation, healthy lifestyle, and relevant covariates at baseline were included in the final analysis.

Measurements

IC was assessed using a composite score across five domains: locomotor, cognitive, sensory, vitality, and psychological. Social isolation was measured using an index based on living arrangements, marital status, contact with children, and social participation. A healthy lifestyle was defined based on five factors: smoking, alcohol consumption, physical activity, sleep duration, and body mass index (BMI). Multiple linear regression and linear mixed-effects models were used to examine cross-sectional and longitudinal associations. Interactive terms between social isolation and a healthy lifestyle were analyzed. Sensitivity analyses were performed by stratifying participants by age and gender.

Results

At baseline, 31.0%, 62.3%, and 6.7% of participants had social isolation scores of 0, 1−2, and 3−4, respectively, while 28.5%, 37.0%, and 34.6% had healthy lifestyle scores of 0−2, 3, and 4−5, respectively. Compared to participants with no social isolation (score = 0), the IC scores decreased for participants with social isolation scores of 1−2 and 3−4 (β = −0.36, 95% confidence interval [CI]: −0.42 to −0.30) and (β = −0.65, 95% CI: −0.77 to −0.53), respectively. In contrast, adherence to a healthy lifestyle was associated with improved IC (β = 0.27, 95% CI: 0.20 to 0.34 for score 3; β = 0.54, 95% CI: 0.47 to 0.60 for score 4−5). Interactive analysis showed that a healthy lifestyle mitigated the adverse associations of social isolation on IC, but this protective effect weakened as social isolation increased. Sensitivity analyses confirmed the robustness of these findings.

Conclusion

This study identified significant associations between social isolation, healthy lifestyle, and intrinsic capacity in older Chinese adults. Social isolation was negatively associated with IC, while a healthy lifestyle was positively associated with IC. The observed interaction between social isolation and healthy lifestyle highlights the importance of integrated interventions targeting both social engagement and health behaviors in supporting IC during aging.

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.