We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Improvement of Social Isolation and Loneliness and Excess Mortality Risk in People With Obesity.
- Authors
Zhou, Jian; Tang, Rui; Wang, Xuan; Li, Xiang; Heianza, Yoriko; Qi, Lu
- Abstract
Key Points: Question: Could the excess risk of mortality related to obesity be attenuated through the improvement of social isolation and loneliness? Findings: In this cohort study of 398 972 UK Biobank participants, as the index of social isolation and loneliness went from highest to lowest, the risk of all-cause mortality decreased by 36% and 9%, respectively, in people with obesity compared with people without obesity. Social isolation ranked higher than loneliness, depression, anxiety, and lifestyle-related risk factors for estimating the risk of mortality. Meaning: These findings support the improvement of social isolation and loneliness in people with obesity to decrease obesity-related excess risk of mortality. This cohort study investigates whether improving social isolation or loneliness is associated with lower obesity-related excess risk of mortality. Importance: Individuals with obesity experience markedly higher levels of social isolation and loneliness than those without obesity, but little is known about whether improvement of social isolation or loneliness might attenuate obesity-related excess risk of mortality. Objective: To investigate whether improvement of social isolation or loneliness is associated with lower obesity-related excess risk of mortality. Design, Setting, and Participants: This cohort study included individuals without cancer or cardiovascular disease (CVD) at baseline from the UK Biobank with follow-up beginning in March 2006 and ending in November 2021. Main Outcomes and Measures: All-cause, cancer-related, and CVD-related mortality were estimated. Results: A total of 398 972 participants were included in this study (mean [SD] age, 55.85 [8.08] years; 220 469 [55.26%] women; 13 734 [3.44%] Asian, 14 179 [3.55%] multiracial, and 363 685 [91.16%] White participants). Overall, 93 357 (23.40%) had obesity, and 305 615 (76.60%) did not. During a median (IQR) follow-up of 12.73 (12.01-13.43) years, a total of 22 872 incident deaths were recorded. Compared with participants with obesity with an index of 2 or greater for social isolation, the multivariable adjusted hazard ratios (HRs) for all-cause mortality were 0.85 (95% CI, 0.79-0.91) and 0.74 (95% CI, 0.69-0.80) for participants with obesity and a social isolation index of 1 and 0, respectively (P for trend <.001); compared with participants with obesity and an index of 2 for loneliness, the HRs and 0.97 (95% CI, 0.89-1.06) and 0.86 (95% CI, 0.79-0.94) for participants with obesity and a loneliness index of 1 and 0, respectively (P for trend <.001). As the index of social isolation and loneliness went from highest to lowest, the HR for all-cause mortality decreased by 36% and 9%, respectively, in people with obesity compared with people without obesity using the multivariable model. Social isolation was ranked higher than loneliness, depression, anxiety, and lifestyle-related risk factors including alcohol, physical activity, and healthy diet for estimating the risks of all-cause mortality, cancer-related mortality, and CVD-related mortality. Conclusions and Relevance: In this cohort study of UK Biobank participants, a lower index of social isolation or loneliness was associated with a decreased risk of all-cause mortality among people with obesity, and improvement of social isolation and loneliness attenuated obesity-related excess risk of all-cause mortality.
- Subjects
UNITED Kingdom; MORTALITY prevention; CARDIOVASCULAR disease related mortality; OBESITY; CAUSES of death; FOOD habits; UK Biobank Ltd.; ALCOHOLISM; CONFIDENCE intervals; MULTIVARIATE analysis; DISEASE incidence; FISHER exact test; MANN Whitney U Test; SOCIAL isolation; COMPARATIVE studies; PHYSICAL activity; RISK assessment; LONELINESS; MENTAL depression; HEALTH behavior; DESCRIPTIVE statistics; KAPLAN-Meier estimator; DISEASE prevalence; RESEARCH funding; ANXIETY disorders; TUMORS; DATA analysis software; LONGITUDINAL method; BEHAVIOR modification; PROPORTIONAL hazards models
- Publication
JAMA Network Open, 2024, Vol 7, Issue 1, pe2352824
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.52824