1
|
CAI JY, WANG X, ZHENG CY, CAO X, HU Z, GU RQ, TIAN YX, TIAN Y, SHAO L, ZHANG LF, WANG ZW. Effects of loneliness and isolation on cardiovascular diseases: a two sample Mendelian Randomization Study. J Geriatr Cardiol 2024; 21:340-348. [PMID: 38665286 PMCID: PMC11040057 DOI: 10.26599/1671-5411.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Loneliness and isolation are associated with multiple cardiovascular diseases (CVDs), but there is a lack of research on whether they were causally linked. We conducted a Mendelian Randomization (MR) study to explore causal relationships between loneliness and isolation and multiple CVDs. METHODS Single nucleotide polymorphisms associated with loneliness and isolation were identified from a genome-wide association study (GWAS) of 455,364 individuals of European ancestry in the IEU GWAS database. Summary data for 15 CVDs were also obtained from the IEU GWAS database. We used three MR methods including inverse variance weighting, MR-Egger, and weighted median estimation to assess the causal effect of exposure on outcomes. Cochran's Q test and MR-Egger intercept test were used to evaluate the heterogeneity and pleiotropy. RESULTS MR analysis showed that loneliness and isolation were significantly associated with essential hypertension (OR = 1.07, 95% CI: 1.03-1.12), atherosclerotic heart disease (OR = 1.04; 95% CI: 1.02-1.06), myocardial infarction (OR = 1.02; 95% CI: 1-1.04) and angina (OR = 1.04; 95% CI =1.02-1.06). No heterogeneity and pleiotropy effects were found in this study. CONCLUSIONS Causal relationship of loneliness and isolation with CVDs were found in this study.
Collapse
Affiliation(s)
- Jia-Yin CAI
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xin WANG
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Cong-Yi ZHENG
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xue CAO
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen HU
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Qing GU
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yi-Xin TIAN
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Ye TIAN
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lan SHAO
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lin-Feng ZHANG
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zeng-Wu WANG
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
2
|
Lameirinhas J, Gorostiaga A, Etxeberria I. Defining and assessing psychological frailty in older adults: a scoping review protocol. BMJ Open 2024; 14:e080179. [PMID: 38443084 PMCID: PMC11086467 DOI: 10.1136/bmjopen-2023-080179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Frailty is widely acknowledged as a multidimensional construct encompassing physical, psychological and social aspects. However, the lack of consensus in defining and operationalising psychological frailty challenges the holistic approach to frailty advocated by health professionals. Consequently, there is a need to develop a comprehensive definition of psychological frailty based on contributions made by experts in the field, primarily existing frailty assessment tools. This scoping review will aim to identify the key psychological variables that are considered in frailty assessment tools used with older adults as well as to analyse how these psychological variables have been operationalised. METHODS AND ANALYSIS The study will be conducted in accordance with recommendations from several methodological frameworks for scoping reviews and will be reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews statement guidelines. A systematic literature search will be performed in the CINAHL, MEDLINE, PsycInfo, Scopus and Web of Science databases, supplemented by a search in Google Scholar and reference lists. The focus will be on studies that describe the development of multicomponent frailty assessment tools including at least one psychological variable. Study selection and data extraction will be independently conducted by three reviewers working in pairs. Data will be presented in tabular form, and the data will be analysed using qualitative content analysis. ETHICS AND DISSEMINATION This study does not require ethical approval since it is based on secondary data analysis. The findings of the review will be disseminated through publication in a peer-reviewed scientific journal and will be presented at conferences and seminars. TRIAL REGISTRATION NUMBER The scoping review was registered in Open Science Framework on 29 March 2022 (https://osf.io/bn24y).
Collapse
Affiliation(s)
- Joanes Lameirinhas
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
| | - Arantxa Gorostiaga
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
| | - Igone Etxeberria
- Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Donostia/San Sebastián, Gipuzkoa, Spain
| |
Collapse
|
3
|
Fan W, Ma KK, Yang CX, Guo YL. The mediating effect of stigma between self-perceived burden and loneliness in stroke patients. Front Psychiatry 2023; 14:1219805. [PMID: 37575575 PMCID: PMC10412817 DOI: 10.3389/fpsyt.2023.1219805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Stroke patients may experience reduced socialization and feelings of isolation due to post-stroke sequelae such as impaired motor function and cognitive deficits. Factors associated with loneliness need to be explored to develop targeted interventions. However, little is known about the impact of self-perceived burden and illness stigma on loneliness in this population.The aim of this study was to explore the mediating effect of stigma on self-perceived burden and loneliness in stroke patients. Methods The cluster random sampling method was adopted to select 1028 stroke patients from the neurology department of third-grade A hospitals and second-grade A hospitals in 5 cities of Henan Province from May 2022 to August 2022. A general data questionnaire, self-perceived burden scale, stroke stigma scale, and loneliness scale were used to investigate. The structural equation model was used to analyze the mediating effect of stigma between self-perceived burden and stigma. Results The loneliness of stroke patients was positively correlated with self-perceived burden and stigma. The results of the mediation analysis showed that stigma played a complete mediating role between self-perceived burden and loneliness. Discussion The results of the study revealed the relationship between self-perceived burden, stigma, and loneliness in stroke patients. Stigma mediated the relationship between self-perceived burden and loneliness in this population.Stigma should be emphasized as an important modifiable psychological factor that affects loneliness of stroke patients.
Collapse
Affiliation(s)
- Wenfeng Fan
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Ke ke Ma
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cai xia Yang
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan li Guo
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
4
|
Teshale AB, Htun HL, Hu J, Dalli LL, Lim MH, Neves BB, Baker JR, Phyo AZZ, Reid CM, Ryan J, Owen AJ, Fitzgerald SM, Freak-Poli R. The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review. Arch Gerontol Geriatr 2023; 111:105008. [PMID: 37003026 DOI: 10.1016/j.archger.2023.105008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD. AIM To provide an overview of the relationship between social health and CVD (and its shared risk factors). METHOD In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potential ways in which social health affects CVD, including shared risk factors. RESULTS The current literature highlights an established relationship between social health and CVD with a likelihood for bi-directionality. However, there is speculation and varied evidence regarding how these relationships may be mediated through CVD risk factors. CONCLUSIONS Social health can be considered an established risk factor for CVD. However, the potential bi-directional pathways of social health with CVD risk factors are less established. Further research is needed to understand whether targeting certain constructs of social health may directly improve the management of CVD risk factors. Given the health and economic burdens of poor social health and CVD, improvements to addressing or preventing these interrelated health conditions would have societal benefits.
Collapse
Affiliation(s)
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Jessie Hu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lachlan L Dalli
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Michelle H Lim
- Prevention Research Collaboration, School of Public Health, The University of Sydney, New South Wales, Australia.
| | | | - J R Baker
- School of Health, Southern Cross University, Australia; Primary & Community Care Limited, Australia.
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Sharyn M Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| |
Collapse
|
5
|
Freak-Poli R, Hu J, Phyo AZZ, Barker SF. Social Isolation and Social Support Influence Health Service Utilisation and Survival after a Cardiovascular Disease Event: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4853. [PMID: 36981761 PMCID: PMC10049557 DOI: 10.3390/ijerph20064853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Both cardiovascular disease (CVD) and social health carry high health and economic burdens. We undertook a systematic review to investigate the association between social isolation, low social support, and loneliness with health service utilisation and survival after a CVD event among people living in Australia and New Zealand. Four electronic databases were systematically searched for the period before June 2020. Two reviewers undertook the title/abstract screen. One reviewer undertook a full-text screen and data extraction. A second author checked data extraction. Of 756 records, 25 papers met our inclusion criteria. Included studies recruited 10-12,821 participants, aged 18-98 years, and the majority were males. Greater social support was consistently associated with better outcomes on four of the five themes (discharge destination, outpatient rehabilitation attendance, rehospitalisation and survival outcomes; no papers assessed the length of inpatient stay). Positive social health was consistently associated with better discharge designation to higher independent living. As partner status and living status did not align with social isolation and social support findings in this review, we recommend they not be used as social health proxies. Our systematic review demonstrates that social health is considered in cardiac care decisions and plays a role in how healthcare is being delivered (i.e., outpatient, rehabilitation, or nursing home). This likely contributes to our finding that lower social support is associated with high-intensity healthcare services, lower outpatient rehabilitation attendance, greater rehospitalisation and poorer survival. Given our evidence, the first step to improve cardiac outcomes is acknowledging that social health is part of the decision-making process. Incorporating a formal assessment of social support into healthcare management plans will likely improve cardiac outcomes and survival. Further research is required to assess if support person/s need to engage in the risk reduction behaviours themselves for outpatient rehabilitation to be effective. Further synthesis of the impact of social isolation and loneliness on health service utilisation and survival after a CVD event is required.
Collapse
Affiliation(s)
- Rosanne Freak-Poli
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3168, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - S. Fiona Barker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| |
Collapse
|
6
|
Craig H, Gasevic D, Ryan J, Owen A, McNeil J, Woods R, Britt C, Ward S, Freak-Poli R. Socioeconomic, Behavioural, and Social Health Correlates of Optimism and Pessimism in Older Men and Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3259. [PMID: 36833951 PMCID: PMC9961087 DOI: 10.3390/ijerph20043259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Optimism is a disposition characterised by positive future expectancies, while pessimism is characterised by expecting the worst. High optimism and low pessimism promote the health of older adults and may potentiate full engagement in life. We identified socioeconomic, behavioural, and social factors associated with optimism and pessimism in older adults. METHODS Participants included 10,146 community-dwelling, apparently healthy Australian adults aged 70 years and over from the ASPREE Longitudinal Study of Older Persons (ALSOP). Optimism and pessimism were measured using the revised Life Orientation Test. Cross-sectional ordinal logistic regression was used to determine the socioeconomic, behavioural, and social health factors associated with optimism and pessimism. RESULTS Higher education, greater physical activity, lower loneliness, and volunteering were associated with higher optimism and lower pessimism. Low social support was associated with higher pessimism. Higher socioeconomic advantage, greater income, and living alone were associated with lower pessimism. Women were more optimistic and less pessimistic than men. The association of age, smoking status, and alcohol consumption with optimism and pessimism differed for men and women. CONCLUSIONS Factors associated with higher optimism and lower pessimism were also those demonstrated to support healthy ageing. Health-promotion action at the individual level (e.g., smoking cessation or regular physical activity), health professional level (e.g., social prescribing or improving access and quality of care for all older adults), and community level (e.g., opportunities for volunteer work or low-cost social activities for older adults) may improve optimism and reduce pessimism, possibly also promoting healthy ageing.
Collapse
Affiliation(s)
- Heather Craig
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Global Health, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Robyn Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Carlene Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Stephanie Ward
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3004, Australia
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW Ageing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer. RECENT FINDINGS ILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body. SUMMARY The present review stresses goals of preventing frailty in ILD and preserving general health and well being of people living with ILD of any age, from time of diagnosis and as they age. The development of a prediction score is proposed to classify those at risk of frailty and guide interventions that preserve successful ageing for all levels of ILD severity. VIDEO ABSTRACT http://links.lww.com/COPM/A32.
Collapse
|