{"title":"为公众大脑、认知和心理健康辨别数据驱动的理论知情策略的广义加性混合模型。","authors":"Laurenz Lammer,Frauke Beyer,Steffi Riedel-Heller,Julia Sacher,Heide Glaesmer,Arno Villringer,A Veronica Witte","doi":"10.1007/s10654-025-01296-9","DOIUrl":null,"url":null,"abstract":"Social isolation is recognized as a public health emergency. However, major guidelines provide vastly different recommendations on how to target it, and no strategy has been substantiated on firm theoretical or empirical grounds, yet. Rose's seminal The Strategy of Preventive Medicine provided a theoretical framework for such arbitrations between approaches. Therein, determining the shape of the relationship between risk factor and outcome is of paramount importance. However, quantitative approaches immediately applying this theory to evidence are still lacking. Thus, in this pre-registered analysis, we pursued a novel approach and employed generalized additive mixed models to model the shape of social isolation's Links to brain, cognitive and mental health outcomes in a well-characterised population-based sample. We derived brain measures from 3T MRIs, assessed cognitive functions with extensive neuropsychological testing and measured social isolation and mental health outcomes using established questionnaires. Overall, we studied over 10,000 (mean age 58a, 53% women) participants at baseline and over 5500 (mean age 64a, 53% women) at follow-up after ~ 6 years. The relationship of social contact with almost all outcomes was firmly linear and did not differ above and below the standard threshold for social isolation. Only for processing speed did we detect a steeper slope amongst socially isolated individuals. Hence, most of the health effects of social contact were observed in individuals that would not be categorised as socially isolated. Applying advanced statistical methods to a large and well-characterised dataset we provide evidence in support of a shift in focus away from individual-level and towards population-level preventive approaches.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"20 1","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Generalized additive mixed models to discern data-driven theoretically informed strategies for public brain, cognitive and mental health.\",\"authors\":\"Laurenz Lammer,Frauke Beyer,Steffi Riedel-Heller,Julia Sacher,Heide Glaesmer,Arno Villringer,A Veronica Witte\",\"doi\":\"10.1007/s10654-025-01296-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Social isolation is recognized as a public health emergency. However, major guidelines provide vastly different recommendations on how to target it, and no strategy has been substantiated on firm theoretical or empirical grounds, yet. Rose's seminal The Strategy of Preventive Medicine provided a theoretical framework for such arbitrations between approaches. Therein, determining the shape of the relationship between risk factor and outcome is of paramount importance. However, quantitative approaches immediately applying this theory to evidence are still lacking. Thus, in this pre-registered analysis, we pursued a novel approach and employed generalized additive mixed models to model the shape of social isolation's Links to brain, cognitive and mental health outcomes in a well-characterised population-based sample. We derived brain measures from 3T MRIs, assessed cognitive functions with extensive neuropsychological testing and measured social isolation and mental health outcomes using established questionnaires. Overall, we studied over 10,000 (mean age 58a, 53% women) participants at baseline and over 5500 (mean age 64a, 53% women) at follow-up after ~ 6 years. The relationship of social contact with almost all outcomes was firmly linear and did not differ above and below the standard threshold for social isolation. Only for processing speed did we detect a steeper slope amongst socially isolated individuals. Hence, most of the health effects of social contact were observed in individuals that would not be categorised as socially isolated. Applying advanced statistical methods to a large and well-characterised dataset we provide evidence in support of a shift in focus away from individual-level and towards population-level preventive approaches.\",\"PeriodicalId\":11907,\"journal\":{\"name\":\"European Journal of Epidemiology\",\"volume\":\"20 1\",\"pages\":\"\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10654-025-01296-9\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10654-025-01296-9","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Generalized additive mixed models to discern data-driven theoretically informed strategies for public brain, cognitive and mental health.
Social isolation is recognized as a public health emergency. However, major guidelines provide vastly different recommendations on how to target it, and no strategy has been substantiated on firm theoretical or empirical grounds, yet. Rose's seminal The Strategy of Preventive Medicine provided a theoretical framework for such arbitrations between approaches. Therein, determining the shape of the relationship between risk factor and outcome is of paramount importance. However, quantitative approaches immediately applying this theory to evidence are still lacking. Thus, in this pre-registered analysis, we pursued a novel approach and employed generalized additive mixed models to model the shape of social isolation's Links to brain, cognitive and mental health outcomes in a well-characterised population-based sample. We derived brain measures from 3T MRIs, assessed cognitive functions with extensive neuropsychological testing and measured social isolation and mental health outcomes using established questionnaires. Overall, we studied over 10,000 (mean age 58a, 53% women) participants at baseline and over 5500 (mean age 64a, 53% women) at follow-up after ~ 6 years. The relationship of social contact with almost all outcomes was firmly linear and did not differ above and below the standard threshold for social isolation. Only for processing speed did we detect a steeper slope amongst socially isolated individuals. Hence, most of the health effects of social contact were observed in individuals that would not be categorised as socially isolated. Applying advanced statistical methods to a large and well-characterised dataset we provide evidence in support of a shift in focus away from individual-level and towards population-level preventive approaches.
期刊介绍:
The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.