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Hajek A. Editorial: Correlates of loneliness and social isolation in old age. Arch Gerontol Geriatr 2024; 125:105528. [PMID: 38879349 DOI: 10.1016/j.archger.2024.105528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
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Teshale AB, Htun HL, Vered M, Owen AJ, Freak-Poli R. A Systematic Review of Artificial Intelligence Models for Time-to-Event Outcome Applied in Cardiovascular Disease Risk Prediction. J Med Syst 2024; 48:68. [PMID: 39028429 PMCID: PMC11271333 DOI: 10.1007/s10916-024-02087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
Artificial intelligence (AI) based predictive models for early detection of cardiovascular disease (CVD) risk are increasingly being utilised. However, AI based risk prediction models that account for right-censored data have been overlooked. This systematic review (PROSPERO protocol CRD42023492655) includes 33 studies that utilised machine learning (ML) and deep learning (DL) models for survival outcome in CVD prediction. We provided details on the employed ML and DL models, eXplainable AI (XAI) techniques, and type of included variables, with a focus on social determinants of health (SDoH) and gender-stratification. Approximately half of the studies were published in 2023 with the majority from the United States. Random Survival Forest (RSF), Survival Gradient Boosting models, and Penalised Cox models were the most frequently employed ML models. DeepSurv was the most frequently employed DL model. DL models were better at predicting CVD outcomes than ML models. Permutation-based feature importance and Shapley values were the most utilised XAI methods for explaining AI models. Moreover, only one in five studies performed gender-stratification analysis and very few incorporate the wide range of SDoH factors in their prediction model. In conclusion, the evidence indicates that RSF and DeepSurv models are currently the optimal models for predicting CVD outcomes. This study also highlights the better predictive ability of DL survival models, compared to ML models. Future research should ensure the appropriate interpretation of AI models, accounting for SDoH, and gender stratification, as gender plays a significant role in CVD occurrence.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mor Vered
- Department of Data Science and AI, Faculty of Information Technology, Monash University, Clayton, VIC, Australia
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
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Teshale AB, Htun HL, Owen AJ, Ryan J, Baker JR, Vered M, Reid CM, Woods RL, Berk M, Tonkin A, Neumann JT, Kilkenny MF, Phyo AZZ, Nelson MR, Stocks N, Britt C, Freak-Poli R. Gender-specific aspects of socialisation and risk of cardiovascular disease among community-dwelling older adults: a prospective cohort study using machine learning algorithms and a conventional method. J Epidemiol Community Health 2024:jech-2023-221860. [PMID: 38839108 DOI: 10.1136/jech-2023-221860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Gender influences cardiovascular disease (CVD) through norms, social relations, roles and behaviours. This study identified gender-specific aspects of socialisation associated with CVD. METHODS A longitudinal study was conducted, involving 9936 (5,231 women and 4705 men) initially healthy, community-dwelling Australians aged 70 years or more from the ASPirin in Reducing Events in the Elderly (ASPREE) study and ASPREE Longitudinal Study of Older Persons, with a median follow-up time of 6.4 years. Variable categorisation, variable selection (using machine learning (ML) models; Elastic Net and extreme gradient boosting) and Cox-regression were employed separately by binary gender to identity socialisation factors (n=25 considered) associated with CVD. RESULTS Different socialisation factors were identified using the ML models. In the Cox model, for both genders, being married/partnered was associated with a reduced risk of CVD (men: HR 0.76, 95% CI 0.60 to 0.96; women: HR 0.67, 95% CI 0.58 to 0.95). For men, having 3-8 relatives they felt close to and could call on for help (HR 0.76, 95% CI 0.58 to 0.99; reference <3 relatives), having 3-8 relatives they felt at ease talking with about private matters (HR 0.70, 95% CI 0.55 to 0.90; reference <3 relatives) or playing games such as chess or cards (HR 0.82, 95% CI 0.67 to 1.00) was associated with reduced risk of CVD. For women, living with others (HR 0.71, 95% CI 0.55 to 0.91) or having ≥3 friends they felt at ease talking with about private matters (HR 0.74, 95% CI 0.58 to 0.95; reference <3 friends) was associated with a lower risk of CVD. CONCLUSIONS This study demonstrates the need to prioritise gender-specific social factors to improve cardiovascular health in older adults.
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Affiliation(s)
| | - Htet Lin Htun
- 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
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J R Baker
- Primary & Community Care Services Ltd, Thornleigh, New South Wales, Australia
| | - Mor Vered
- Department of Data Science and AI, Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Berk
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Deakin University and Barwon Health, Geelong, Victoria, Australia
| | - Andrew Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Johannes T Neumann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Cardiology, University Heart & Vascular Centre, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Monique F Kilkenny
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, The University of Melbourne, Heidelberg, Victoria, Australia
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Carlene Britt
- 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
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Albasheer O, Abdelwahab SI, Zaino MR, Altraifi AAA, Hakami N, El-Amin EI, Alshehri MM, Alghamdi SM, Alqahtani AS, Alenazi AM, Alqahtani B, Alhowimel A, Uddin S, Khalafalla HEE, Medani IE. The impact of social isolation and loneliness on cardiovascular disease risk factors: a systematic review, meta-analysis, and bibliometric investigation. Sci Rep 2024; 14:12871. [PMID: 38834606 DOI: 10.1038/s41598-024-63528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
Data on the association between social isolation, loneliness, and risk of incident coronary heart disease (CVD) are conflicting. The objective of this study is to determine the relationship between social isolation and loneliness, and the risk of developing cardiovascular disease (CVD) in middle age and elderly using meta-analysis. The purpose of the bibliometric analysis is to systematically evaluate the existing literature on the relationship between social isolation, loneliness, and the risk of developing cardiovascular disease (CVD) in middle-aged and elderly individuals. A comprehensive search through four electronic databases (MEDLINE, Google Scholar, Scopus, and Web of Science) was conducted for published articles that determined the association between social isolation and/or loneliness and the risk of developing coronary heart disease from June 2015 to May 2023. Two independent reviewers reviewed the titles and abstracts of the records. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to conduct the systematic review and meta-analysis. Data for the bibliometric analysis was obtained from the Scopus database and analyzed using VOSviewer and Bibliometrix applications. Six studies involving 104,511 patients were included in the final qualitative review and meta-analysis after screening the records. The prevalence of loneliness ranged from 5 to 65.3%, and social isolation ranged from 2 to 56.5%. A total of 5073 cardiovascular events were recorded after follow-up, ranging between 4 and 13 years. Poor social relationships were associated with a 16% increase in the risk of incident CVD (Hazard Ratio of new CVD when comparing high versus low loneliness or social isolation was 1.16 (95% Confidence Interval (CI) 1.10-1.22). The bibliometric analysis shows a rapidly growing field (9.77% annual growth) with common collaboration (6.37 co-authors/document, 26.53% international). The US leads research output, followed by the UK and Australia. Top institutions include University College London, Inserm, and the University of Glasgow. Research focuses on "elderly," "cardiovascular disease," and "psychosocial stress," with recent trends in "mental health," "social determinants," and "COVID-19". Social isolation and loneliness increase the risk of and worsen outcomes in incident cardiovascular diseases. However, the observed effect estimate is small, and this may be attributable to residual confounding from incomplete measurement of potentially confounding or mediating factors. The results of the bibliometric analysis highlight the multidimensional nature of CVD research, covering factors such as social, psychological, and environmental determinants, as well as their interplay with various demographic and health-related variables.
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Affiliation(s)
- Osama Albasheer
- Family and Community Medicine Department, Faculty of Medicine, College of Medicine, Jazan University, 45142, Jazan, Saudi Arabia.
| | | | - Mohammad R Zaino
- Physical Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | | | - Nasser Hakami
- Surgical Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ehab I El-Amin
- Department of Epidemiology, College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Mohammed M Alshehri
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Saeed M Alghamdi
- Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aqeel M Alenazi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Bader Alqahtani
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ahmed Alhowimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Husam Eldin Elsawi Khalafalla
- Department of Health Education and Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Isameldin E Medani
- Obstetrics and Gynaecology Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
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Teshale AB, Htun HL, Dalli L, Freak-Poli R. Social Determinants of Cardiovascular Health: understanding their impact and transitioning to a holistic care approach. Eur Heart J 2024; 45:1582-1585. [PMID: 38591554 DOI: 10.1093/eurheartj/ehae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lachlan Dalli
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
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Volkos P, Linardakis M, Stachteas P, Anastasiou F, Tatsioni A, Kampa M, Symvoulakis EK. Association between Levels of Loneliness, Laboratory Measurements, and Behavioral Aspects in a Primary Care Setting in Crete, Greece. Eur J Investig Health Psychol Educ 2024; 14:1055-1067. [PMID: 38667824 PMCID: PMC11049108 DOI: 10.3390/ejihpe14040069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
This paper examines potential associations of loneliness with laboratory data and specific psychosocial and behavioral attitudes. The sample collection took place in an urban Primary Health Care unit between May and July 2023, consecutively, and once exclusion criteria were implemented. Participants were aged between 40 and 75 years. Routine laboratory test results upon study initiation and six months before were used. The University of California, Los Angeles (UCLA), Loneliness Scale (Version 3), blood glucose, serum lipids, Fibrosis-4 index, and Creatinine Clearance (CrCl) were assessed through hierarchical multiple logistic regression analysis. Based on full model (3rd) analysis, those who were engaged in an individual sport or activity or had contacts with more friends presented significantly lower odds for increased loneliness levels (odds ratio (OR): 0.28 [95% confidence interval (CI) 0.09-0.91], p = 0.034 and OR: 0.76 [95%CI 0.66-0.88], p < 0.001, respectively). The consumption of alcohol was associated with increased loneliness (OR: 5.55 [95%CI 1.42-21.63], p = 0.014). Elevated triglyceride levels were linked with moderate or no loneliness (OR: 0.20 [95%CI 0.05-0.83], p = 0.026), while an increased LDL/HDL atherosclerotic index was related to increased subjective loneliness (OR: 4.50 [95%CI 1.12-18.13], p = 0.035). The need for holistic approaches-involving primary care personnel-in understanding and addressing loneliness, recognizing its multifaceted nature as well as the diverse factors that contribute to this issue, is considered challenging.
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Affiliation(s)
- Panagiotis Volkos
- Fourth Local Health Team—Academic Unit of Heraklion, 71303 Heraklion, Greece
| | - Manolis Linardakis
- Department of Social Medicine, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Panagiotis Stachteas
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Foteini Anastasiou
- Fourth Local Primary Care Team (TOMY), Municipality Practice, Academic Practice of Heraklion, University of Crete, 71303 Heraklion, Greece
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, University of Ioannina, 45110 Ioannina, Greece
| | - Marilena Kampa
- Laboratory of Experimental Endocrinology, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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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).
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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
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Datta BK, Gummadi A, Coughlin SS. Role of life satisfaction, emotional support, and feeling of social isolation on adherence to breast cancer screening recommendations among US women. J Cancer Policy 2024; 39:100467. [PMID: 38253239 DOI: 10.1016/j.jcpo.2024.100467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Psychosocial factors can play important roles in promoting preventive health behaviors. This study aimed to assess how life satisfaction, receipt of emotional support, and feeling of social isolation were associated with adherence to the USPSTF recommendation of breast cancer screening in a nationally representative US population. METHODS Using data on 71,583 women aged 50 to 74 years, from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey, we estimated multivariable logistic regressions to assess the odds of adherence across different categories of the respective psychosocial constructs. We accounted for various demographic and socioeconomic correlates and checked the robustness of the relationship within income and educational sub-groups. RESULTS We found that women who were dissatisfied with their life were 52.0% less likely to adhere compared to women who reported to be very satisfied. Similarly, women who rarely/never got emotional support and who always/usually felt socially isolated were 51.6% and 39.9% less likely to adhere, compared to women who always got support and never felt isolated, respectively. These results were robust across different levels of income and educational attainment. CONCLUSION Our findings demonstrated a strong association between social environment, psychological wellbeing, and adherence to breast cancer screening, and thus suggested scope of potential psychosocial interventions to improve adherence. POLICY SUMMARY Efforts to improve women's psychosocial wellbeing could facilitate compliance with breast cancer screening recommendations.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA; Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA.
| | - Aneesha Gummadi
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA; Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA
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Morikawa M, Lee S, Makino K, Harada K, Katayama O, Tomida K, Yamaguchi R, Nishijima C, Fujii K, Misu Y, Shimada H. Social isolation and risk of disability in older adults: Effect modification of metabolic syndrome. Arch Gerontol Geriatr 2024; 116:105209. [PMID: 37782966 DOI: 10.1016/j.archger.2023.105209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Delaying the onset of disabilities is a social challenge, especially in an aging society. Social isolation (SI) and metabolic syndrome (MetS) can coexist and pose the risks of disability onset. However, their interaction is not proven in older adults. Therefore, this study investigated whether SI combined with MetS exacerbates disability onset in older adults. MATERIALS AND METHODS A total of 3,738 community-dwelling older adults underwent a health check-up. After baseline assessments, we followed them up to assess disability incidence for five years. SI was defined as a condition in which two or more of the following measures were met: domestic isolation, less social contact, and social disengagement. MetS was defined according to the criteria of the International Diabetes Federation. We used Cox proportional hazard regression used to identify the interaction effect of SI and MetS on the risk of disability onset after adjusting for potential confounding factors. RESULTS Multivariate Cox proportional hazard regression showed a significant interaction effect of SI and MetS on disability onset. In the subgroup analysis stratified by MetS status, SI was identified as a risk factor for disability onset only in the MetS group, but not in the non-MetS group. CONCLUSIONS This five-year longitudinal study showed that the co-occurrence of SI and MetS increased the risk of disability onset in older adults. This indicates that the assessment of MetS in socially isolated older adults is important for healthcare providers to delay the onset of disabilities.
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Affiliation(s)
- Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Keitaro Makino
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kenji Harada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Osamu Katayama
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kouki Tomida
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Yuka Misu
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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Latif A, Tran AM, Ahsan MJ, Niu F, Walters RW, Kim MH. Relationship of health-related social needs and hospital readmissions in patients following a hospitalization for atrial fibrillation. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 36:100340. [PMID: 38510101 PMCID: PMC10946007 DOI: 10.1016/j.ahjo.2023.100340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 03/22/2024]
Abstract
Atrial fibrillation (AF) has a high economic burden on the healthcare system with rehospitalizations as the most significant contributing factor necessitating an understanding of aspects related to hospitalizations to minimize economic costs and improve patient outcomes. Our study aims to assess whether all-cause 30-day hospital readmission following AF-specific hospitalization is associated with health-related social needs (HRSN) using the Nationwide Readmissions Database (NRD). All hospitalization data were abstracted from the 2015-2019 NRD, including hospitalizations for patients at least 18 years of age with a primary discharge diagnosis of AF. For each hospitalization, we identified secondary diagnoses for five HRSN domains including employment, family, housing, psychosocial, and socioeconomic status. Primary outcomes included all-cause 30-day readmission rates. Secondary outcomes included all-cause 90-day readmissions and diagnosis on readmissions. An estimated 1,807,460 index hospitalizations in the United States included a primary discharge diagnosis of AF. Of these, 97.3 % included a diagnosis in only one HRSN domain with the most frequently diagnosed HRSN domain being housing (54.5 %) followed by socioeconomic (29.4 %), family (10.0 %), employment (6.1 %), and psychosocial (2.8 %). Index hospitalizations that included any HRSN diagnosis had 2.2-times greater unadjusted odds of all-cause 30-day readmission (95 % CI: 2.1 to 2.3-times greater, p < .001). Index hospitalizations that included an HRSN diagnosis were associated with higher rates of 90-day readmission due to conduction disorder and COPD. In conclusion, there is a significant association between HRSN and hospital readmissions in patients with AF. Further research is required to explain the true nature of this relationship with a specific emphasis on housing insecurity.
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Affiliation(s)
- Azka Latif
- Department of Cardiovascular Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Amy M. Tran
- School of Medicine, Creighton University, Omaha, NE, United States of America
| | - Muhammad Junaid Ahsan
- Division of Cardiovascular Medicine, Iowa Heart Center, West Des Moines, IA, United States of America
| | - Fang Niu
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Ryan W. Walters
- Department of Clinical Research and Public Health, Creighton University, Omaha, NE, United States of America
| | - Michael H. Kim
- Department of Medicine, Creighton University and CHI Health, Omaha, NE, United States of America
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