Abstract

Objectives: To assess whether social isolation, social support, and loneliness are independently associated with health-related quality of life (HRQoL).

Method: Retrospective analysis including 10,517 women aged 70–75 years from the Australian Longitudinal Study on Women’s Health (ALSWH). Social isolation, social support (Duke Social Support Index), and loneliness (single item) were investigated for their association with standardised HRQoL (physical [PCS] and mental [MCS] components of the SF-36® questionnaire). Analyses were adjusted for sociodemographic variables and number of medical conditions.

Results: Only 3% reported being socially isolated, having low social support and being lonely, and 34% reported being not socially isolated, high social support and not being lonely. Each construct was independently associated with HRQoL, with loneliness having the strongest inverse association (PCS: isolation −0.98, low support −2.01, loneliness −2.03; MCS: isolation −1.97, low support −4.79, loneliness −10.20; p-value < 0.001 for each). Women who were not isolated or lonely and with high social support had the greatest HRQoL (compared to isolated, low social support and lonely; MCS: 17 to 18 points higher, PCS: 5 to 8 points higher). Other combinations of social isolation, social support and loneliness varied in their associations with HRQoL.

Conclusion: Ageing populations face the challenge of supporting older people to maintain longer, healthy, meaningful and community-dwelling lives. Among older women, social isolation, low social support and loneliness are distinct, partially overlapping yet interconnected concepts that coexist and are each adversely associated with HRQoL. Findings should be replicated in other cohorts to ensure generalisability across other age groups and men.

摘要

目的：评估社会孤立、社会支持和孤独感是否与健康相关生活质量 (HRQoL) 独立相关。

方法：回顾性分析包括来自澳大利亚妇女健康纵向研究 (ALSWH) 的 10,517 名 70-75 岁的女性。调查了社会隔离、社会支持（杜克社会支持指数）和孤独感（单项）与标准化 HRQoL（SF-36® 问卷的物理 [PCS] 和心理 [MCS] 组成部分）的关联。分析针对社会人口学变量和医疗条件的数量进行了调整。

结果：只有 3% 的人报告社会孤立、缺乏社会支持和孤独，34% 的人报告没有社会孤立、高社会支持和不孤独。每个构造都与 HRQoL 独立相关，孤独感具有最强的负相关（PCS：隔离-0.98，低支持-2.01，孤独-2.03；MCS：隔离-1.97，低支持-4.79，孤独-10.20；p 值<每个 0.001）。没有孤立或孤独且具有高社会支持的女性的 HRQoL 最高（与孤立、低社会支持和孤独相比；MCS：高 17 至 18 分，PCS：高 5 至 8 分）。社会孤立、社会支持和孤独感的其他组合在与 HRQoL 的关联中有所不同。

结论：老龄化人口面临着支持老年人维持更长、健康、有意义和社区居住生活的挑战。在老年女性中，社会孤立、低社会支持和孤独感是不同的、部分重叠但相互关联的概念，这些概念并存，并且每个都与 HRQoL 负相关。研究结果应在其他队列中复制，以确保其他年龄组和男性的普遍性。