Risk for all-cause mortality elevated in older adults with COPD, social isolation
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Key takeaways:
- The adjusted mortality hazard ratio was 1.35 in the group with vs. without social isolation.
- Researchers found a smaller 5-year survival rate with social isolation.
Among older adults with COPD, the risk for all-cause mortality was heightened with vs. without social isolation, according to a research letter published in JAMA Internal Medicine.
“Social isolation and loneliness are highly prevalent in people with COPD, affecting nearly one in five U.S. adults with COPD,” Angela O. Suen, MD, clinical instructor and research fellow in the division of pulmonary, critical care, allergy and sleep medicine at UCSF, told Healio. “Clinicians should consider asking about social connections as part of their routine management in COPD.”
Suen and colleagues assessed 1,241 adults (mean age, 68.4 years; 59.3% women; 79.8% non-Hispanic white) aged 51 years or older with COPD from the 2006 to 2022 Health and Retirement Survey to establish how social isolation impacts all-cause mortality risk.
As Healio previously reported, among adults aged 50 years and older, those with COPD experienced social isolation and loneliness more frequently than those without COPD.
To measure social isolation, researchers used a 6-point scale. According to the study, responses that made up the total score focused on marital status, living situation, community participation and social contact with three groups of people: children, family and friends.
Within the study population, fewer adults had a score signaling social isolation (n = 293; mean age, 68 years; 65.8% women; 76.3% non-Hispanic white) vs. signaling no social isolation (n = 948; mean age, 68.5 years; 57.2% women; 80.9% non-Hispanic white).
A significantly greater proportion of adults with vs. without social isolation reported single marital status (87% vs. 31.4%), supplemental oxygen use (19.6% vs. 12.3%), high depressive symptoms (31.9% vs. 23.8%), cognitive impairment (19% vs. 15.4%) and dementia (5.9% vs. 2.9%), according to the study.
The median follow-up period was 4.4 years, during which researchers reported 539 deaths.
Following adjustment for several variables (age, sex, race and ethnicity, loneliness, education, comorbidities, cognitive impairment, depression and tobacco use), the risk for all-cause mortality was heightened among adults with vs. without social isolation (adjusted HR = 1.35; 95% CI, 1.04-1.75), according to the study.
“I wasn’t surprised social isolation was associated with mortality because this has been shown in other studies,” Suen told Healio. “I think what is novel is that social isolation impacted mortality in those with COPD more than in the U.S. general population.
“We hypothesize that social connections may be an important factor in patient resilience, such as helping patients with disease management, or even working through exacerbations or disease progression,” Suen said.
In the social isolation group, 7 years was the median survival time, whereas in the group without social isolation, survival time was 9.1 years.
Similar to above, researchers found a smaller 5-year survival rate with vs. without social isolation (62.9% vs. 71.1%).
“We don’t know yet if interventions aimed to prevent or reduce social isolation could improve COPD outcomes and this could be a future area of study,” Suen told Healio.
For more information:
Angela O. Suen, MD, can be reached at angela.suen@ucsf.edu.