The incidence of social isolation in Chinese elderly population: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WU Qiao ,  TAN Jiarong , LIAO Xiaogang , CHEN Shu , WANG Jiayi

Chongqing Public Health Medical Treatment Center, Chongqing 400010, P. R. China;

Corresponding?author：

TAN Jiarong, Email: 2589249953@qq.com

Keywords：

China; Elderly population; Social isolation; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202208051

Video：

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Objective To systematically review the incidence of social isolation in Chinese elderly population. Methods CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Web of Science and CENTRAL databases were electronically searched to collect studies on the incidence of social isolation in China from inception to May 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies, then, meta-analysis was performed by using Stata 15.1 software. Results A total of 20 studies involving 86 111 subjects were included. Meta-analysis results showed that the incidence of social isolation among the elderly in China was 27.54% (95%CI 22.15% to 57.74%). The results of subgroup analysis showed that gender, age, educational level, marital status, self-assessment of health, living style, year of publication, and region surveyed were all influential factors of the incidence of social isolation among the elderly in China. Conclusion Current evidence shows that the incidence of social isolation among the elderly in China is relatively high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： WU Qiao, TAN Jiarong, LIAO Xiaogang, CHEN Shu, WANG Jiayi. The incidence of social isolation in Chinese elderly population: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(4): 398-403. doi: 10.7507/1672-2531.202208051 Copy

1.	Nicholson NR. Social isolation in older adults: an evolutionary concept analysis. J Adv Nurs, 2009, 65(6): 1342-1352.
2.	張碩, 陳功. 中國城市老年人社會隔離現狀與影響因素研究. 人口學刊, 2015, 37(4): 66-76.
3.	Faulkner KA, Cauley JA, Zmuda JM, et al. Is social integration associated with the risk of falling in older community-dwelling women. J Gerontol A Biol Sci Med Sci, 2003, 58(10): M954-M959.
4.	Béland F, Zunzunegui MV, Alvarado B, et al. Trajectories of cognitive decline and social relations. J Gerontol B Psychol Sci Soc Sci, 2005, 60(6): P320-P330.
5.	Berkman LF. Assessing the physical health effects of social networks and social support. Annu Rev Public Health, 1984, 5: 413-432.
6.	Taylor HO, Taylor RJ, Nguyen AW, et al. Social isolation, depression, and psychological distress among older adults. J Aging Health, 2018, 30(2): 229-246.
7.	Boden-Albala B, Litwak E, Elkind MS, et al. Social isolation and outcomes post stroke. Neurology, 2005, 64(11): 1888-1892.
8.	Leigh-Hunt N, Bagguley D, Bash K, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 2017, 152: 157-171.
9.	Yi ES, Hwang HJ. A study on the social behavior and social isolation of the elderly Korea. J Exerc Rehabil, 2015, 11(3): 125-132.
10.	Dury R. Social isolation and loneliness in the elderly: an exploration of some of the issues. Br J Community Nurs, 2014, 19(3): 125-128.
11.	龐慧, 趙改梅, 張美霞, 等. 老年人社會隔離評估工具的研究進展. 全科護理, 2020, 18(31): 4264-4268.
12.	Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas, 2018, 113: 80-84.
13.	張文娟, 劉瑞平. 中國老年人社會隔離的影響因素分析. 人口研究, 2016, 40(5): 75-91.
14.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
15.	趙迪, 趙夢璐, 王娜, 等. 青島市592名社區老年人社會隔離現狀及影響因素研究. 護理學報, 2020, 27(11): 6-10.
16.	楊春曉, 尹文強, 李秋莎, 等. 社會隔離對老年人醫療服務利用的影響—基于中國家庭追蹤調查數據的實證研究. 現代預防醫學, 2021, 48(24): 4461-4466.
17.	謝穎, 趙慶華, 肖明朝, 等. 社區老年人孤獨感、社會隔離現狀及影響因素分析. 護士進修雜志, 2021, 36(9): 769-774.
18.	吳凡, 繩宇. 社區老年人社會隔離與健康促進行為的差異化研究. 中國全科醫學, 2019, 22(22): 2744-2748.
19.	王艷紅, 黃菲蕓, 鄭媛, 等. 黑龍江省大慶市社區老年人社會隔離與認知功能關聯的研究. 中華流行病學雜志, 2017, 38(4): 472-477.
20.	潘靜宜, 黃曉潔, 管婭琦, 等. 浙江省養老機構老年人孤獨狀況與社會網絡的關系研究. 護理與康復, 2018, 17(8): 19-23.
21.	馬佳平. 中國中老年人社會隔離、抑郁與腦卒中發病風險的因果關系研究. 廈門: 廈門大學, 2016.
22.	連至煒, 李晉磊, 金平閱, 等. 社交網絡對城市社區老人生活滿意度影響. 中國公共衛生, 2021, 37(1): 5-9.
23.	李少杰, 尹永田, 陳莉軍, 等. 濟南市農村老年人社會隔離現狀及其影響因素分析. 中國公共衛生, 2021, 37(1): 28-31.
24.	李少杰, 崔光輝, 尹永田. 社區老年人社會隔離及孤獨感對衰弱影響. 中國公共衛生, 2022, 38(4): 399-403.
25.	李茜, 張海茹, 易子涵, 等. 社區老年人社會隔離及自我感知老化現狀調查. 廣西醫學, 2021, 43(6): 763-767.
26.	金佳瑤. 社區老年人社會隔離、營養不足與能力下降的關系研究. 錦州: 錦州醫科大學, 2019.
27.	韓悅, 石婷婷. 濟南市老年人社會隔離與睡眠質量及其交互作用對抑郁的影響. 現代預防醫學, 2021, 48(3): 511-514,519.
28.	范榕, 白亞麗, 劉瑤, 等. 社區功能和社區公共服務對不同年齡老年人社會隔離的影響. 中國全科醫學, 2020, 23(28): 3583-3589.
29.	杜亞男, 陳長香, 王雪輝, 等. 中國共病老年人社會隔離流行狀況及影響因素. 現代預防醫學, 2021, 48(6): 1050-1054.
30.	Zhang D, Lin Z, Chen F, et al. What could interfere with a good night's sleep. The risks of social isolation, poor physical and psychological health among older adults in China. Res Aging, 2022, 44(7-8): 519-530.
31.	張焱, 劉方, 徐瑞, 等. 養老機構老年人社會隔離、抑郁與衰弱的關系. 護理研究, 2022, 36(9): 1543-1546.
32.	Yu B, Steptoe A, Chen Y. Social isolation, loneliness, and all-cause mortality: a cohort study of 35, 254 Chinese older adults. J Am Geriatr Soc, 2022, 70(6): 1717-1725.
33.	Yang Y, Yeung WJ, Feng Q. Social exclusion and cognitive impairment - A triple jeopardy for Chinese rural elderly women. Health Place, 2018, 53: 117-127.
34.	Luanaigh CO, Lawlor BA. Loneliness and the health of older people. Int J Geriatr Psychiatry, 2008, 23(12): 1213-1221.
35.	Smith K J, Victor C. Typologies of loneliness, living alone and social isolation, and their associations with physical and mental health. Age Soc, 2019, 39(8): 1709-1730.
36.	Peng S, Roth AR. Social isolation and loneliness before and during the COVID-19 pandemic: a longitudinal study of U. S. adults older than 50. J Gerontol B Psychol Sci Soc Sci, 2022, 77(7): e185-e190.
37.	Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Aust Health Rev, 2008, 32(3): 468-478.
38.	Nicholson NR. A review of social isolation: an important but underassessed condition in older adults. J Prim Prev, 2012, 33(2-3): 137-152.
39.	Su Y, Rao W, Li M, et al. Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: a systematic review and meta-analysis. Int Psychogeriatr, 2022: 1-13.
40.	Henning-Smith C, Ecklund A, Kozhimannil K, et al. Rural-urban differences in social isolation and its relationship to health. Innov Aging, 2018, 2(Suppl 1): 770.
41.	Chatters LM, Taylor HO, Nicklett EJ, et al. Correlates of objective social isolation from family and friends among older adults. Healthcare (Basel), 2018, 6(1): 24.
42.	Klinenberg E. Social Isolation, Loneliness, and living alone: identifying the risks for public health. Am J Public Health, 2016, 106(5): 786-787.
43.	Smith TF, Hirdes JP. Predicting social isolation among geriatric psychiatry patients. Int Psychogeriatr, 2009, 21(1): 50-59.
44.	Cornwell B. Social disadvantage and network turnover. J Gerontol B Psychol Sci Soc Sci, 2015, 70(1): 132-142.
45.	Cattan M, White M, Bond J, et al. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Age Soc, 2005, 25(1): 41-67.
46.	Evans IEM, Llewellyn DJ, Matthews FE, et al. Social isolation, cognitive reserve, and cognition in healthy older people. PLoS One, 2018, 13(8): e0201008.
47.	Wilson RS, Yu L, Lamar M, et al. Education and cognitive reserve in old age. Neurology, 2019, 92(10): e1041-e1050.
48.	Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med, 2012, 172(14): 1078-1083.
49.	Hill MMYS, Yorgason JB, Nelson LJ, et al. Social withdrawal and psychological well-being in later life: does marital status matter. Aging Ment Health, 2022, 26(7): 1368-1376.
50.	Rokach A, Matalon R, Rokach B, et al. The effects of gender and marital status on loneliness of the aged. Soc Beh Person Inter J, 2007, 35(2): 243-254.
51.	Ibrahim R, Abolfathi Momtaz Y, Hamid TA. Social isolation in older Malaysians: prevalence and risk factors. Psychogeriatrics, 2013, 13(2): 71-79.
52.	Pollack CE, von dem Knesebeck O. Social capital and health among the aged: comparisons between the United States and Germany. Health Place, 2004, 10(4): 383-391.
53.	Brownie S. Why are elderly individuals at risk of nutritional deficiency. Int J Nurs Pract, 2006, 12(2): 110-118.
54.	Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med, 2010, 7(7): e1000316.
55.	Nikmat AW, Hawthorne G, Al-Mashoor SH. The comparison of quality of life among people with mild dementia in nursing home and home care-a preliminary report. Dementia, 2015, 14(1): 114-125.
56.	季紅莉, 路孝琴. 養老機構老年人健康狀況與衛生服務需求調查. 中華全科醫學, 2012, 10(11): 1763-1764.
57.	張河川, 岑曉鈺, 郭良驥. 養老機構老年人健康狀況及服務需求調查. 中國公共衛生, 2010, 26(4): 411-412.

1. Nicholson NR. Social isolation in older adults: an evolutionary concept analysis. J Adv Nurs, 2009, 65(6): 1342-1352.
2. 張碩, 陳功. 中國城市老年人社會隔離現狀與影響因素研究. 人口學刊, 2015, 37(4): 66-76.
3. Faulkner KA, Cauley JA, Zmuda JM, et al. Is social integration associated with the risk of falling in older community-dwelling women. J Gerontol A Biol Sci Med Sci, 2003, 58(10): M954-M959.
4. Béland F, Zunzunegui MV, Alvarado B, et al. Trajectories of cognitive decline and social relations. J Gerontol B Psychol Sci Soc Sci, 2005, 60(6): P320-P330.
5. Berkman LF. Assessing the physical health effects of social networks and social support. Annu Rev Public Health, 1984, 5: 413-432.
6. Taylor HO, Taylor RJ, Nguyen AW, et al. Social isolation, depression, and psychological distress among older adults. J Aging Health, 2018, 30(2): 229-246.
7. Boden-Albala B, Litwak E, Elkind MS, et al. Social isolation and outcomes post stroke. Neurology, 2005, 64(11): 1888-1892.
8. Leigh-Hunt N, Bagguley D, Bash K, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 2017, 152: 157-171.
9. Yi ES, Hwang HJ. A study on the social behavior and social isolation of the elderly Korea. J Exerc Rehabil, 2015, 11(3): 125-132.
10. Dury R. Social isolation and loneliness in the elderly: an exploration of some of the issues. Br J Community Nurs, 2014, 19(3): 125-128.
11. 龐慧, 趙改梅, 張美霞, 等. 老年人社會隔離評估工具的研究進展. 全科護理, 2020, 18(31): 4264-4268.
12. Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas, 2018, 113: 80-84.
13. 張文娟, 劉瑞平. 中國老年人社會隔離的影響因素分析. 人口研究, 2016, 40(5): 75-91.
14. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
15. 趙迪, 趙夢璐, 王娜, 等. 青島市592名社區老年人社會隔離現狀及影響因素研究. 護理學報, 2020, 27(11): 6-10.
16. 楊春曉, 尹文強, 李秋莎, 等. 社會隔離對老年人醫療服務利用的影響—基于中國家庭追蹤調查數據的實證研究. 現代預防醫學, 2021, 48(24): 4461-4466.
17. 謝穎, 趙慶華, 肖明朝, 等. 社區老年人孤獨感、社會隔離現狀及影響因素分析. 護士進修雜志, 2021, 36(9): 769-774.
18. 吳凡, 繩宇. 社區老年人社會隔離與健康促進行為的差異化研究. 中國全科醫學, 2019, 22(22): 2744-2748.
19. 王艷紅, 黃菲蕓, 鄭媛, 等. 黑龍江省大慶市社區老年人社會隔離與認知功能關聯的研究. 中華流行病學雜志, 2017, 38(4): 472-477.
20. 潘靜宜, 黃曉潔, 管婭琦, 等. 浙江省養老機構老年人孤獨狀況與社會網絡的關系研究. 護理與康復, 2018, 17(8): 19-23.
21. 馬佳平. 中國中老年人社會隔離、抑郁與腦卒中發病風險的因果關系研究. 廈門: 廈門大學, 2016.
22. 連至煒, 李晉磊, 金平閱, 等. 社交網絡對城市社區老人生活滿意度影響. 中國公共衛生, 2021, 37(1): 5-9.
23. 李少杰, 尹永田, 陳莉軍, 等. 濟南市農村老年人社會隔離現狀及其影響因素分析. 中國公共衛生, 2021, 37(1): 28-31.
24. 李少杰, 崔光輝, 尹永田. 社區老年人社會隔離及孤獨感對衰弱影響. 中國公共衛生, 2022, 38(4): 399-403.
25. 李茜, 張海茹, 易子涵, 等. 社區老年人社會隔離及自我感知老化現狀調查. 廣西醫學, 2021, 43(6): 763-767.
26. 金佳瑤. 社區老年人社會隔離、營養不足與能力下降的關系研究. 錦州: 錦州醫科大學, 2019.
27. 韓悅, 石婷婷. 濟南市老年人社會隔離與睡眠質量及其交互作用對抑郁的影響. 現代預防醫學, 2021, 48(3): 511-514,519.
28. 范榕, 白亞麗, 劉瑤, 等. 社區功能和社區公共服務對不同年齡老年人社會隔離的影響. 中國全科醫學, 2020, 23(28): 3583-3589.
29. 杜亞男, 陳長香, 王雪輝, 等. 中國共病老年人社會隔離流行狀況及影響因素. 現代預防醫學, 2021, 48(6): 1050-1054.
30. Zhang D, Lin Z, Chen F, et al. What could interfere with a good night's sleep. The risks of social isolation, poor physical and psychological health among older adults in China. Res Aging, 2022, 44(7-8): 519-530.
31. 張焱, 劉方, 徐瑞, 等. 養老機構老年人社會隔離、抑郁與衰弱的關系. 護理研究, 2022, 36(9): 1543-1546.
32. Yu B, Steptoe A, Chen Y. Social isolation, loneliness, and all-cause mortality: a cohort study of 35, 254 Chinese older adults. J Am Geriatr Soc, 2022, 70(6): 1717-1725.
33. Yang Y, Yeung WJ, Feng Q. Social exclusion and cognitive impairment - A triple jeopardy for Chinese rural elderly women. Health Place, 2018, 53: 117-127.
34. Luanaigh CO, Lawlor BA. Loneliness and the health of older people. Int J Geriatr Psychiatry, 2008, 23(12): 1213-1221.
35. Smith K J, Victor C. Typologies of loneliness, living alone and social isolation, and their associations with physical and mental health. Age Soc, 2019, 39(8): 1709-1730.
36. Peng S, Roth AR. Social isolation and loneliness before and during the COVID-19 pandemic: a longitudinal study of U. S. adults older than 50. J Gerontol B Psychol Sci Soc Sci, 2022, 77(7): e185-e190.
37. Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Aust Health Rev, 2008, 32(3): 468-478.
38. Nicholson NR. A review of social isolation: an important but underassessed condition in older adults. J Prim Prev, 2012, 33(2-3): 137-152.
39. Su Y, Rao W, Li M, et al. Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: a systematic review and meta-analysis. Int Psychogeriatr, 2022: 1-13.
40. Henning-Smith C, Ecklund A, Kozhimannil K, et al. Rural-urban differences in social isolation and its relationship to health. Innov Aging, 2018, 2(Suppl 1): 770.
41. Chatters LM, Taylor HO, Nicklett EJ, et al. Correlates of objective social isolation from family and friends among older adults. Healthcare (Basel), 2018, 6(1): 24.
42. Klinenberg E. Social Isolation, Loneliness, and living alone: identifying the risks for public health. Am J Public Health, 2016, 106(5): 786-787.
43. Smith TF, Hirdes JP. Predicting social isolation among geriatric psychiatry patients. Int Psychogeriatr, 2009, 21(1): 50-59.
44. Cornwell B. Social disadvantage and network turnover. J Gerontol B Psychol Sci Soc Sci, 2015, 70(1): 132-142.
45. Cattan M, White M, Bond J, et al. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Age Soc, 2005, 25(1): 41-67.
46. Evans IEM, Llewellyn DJ, Matthews FE, et al. Social isolation, cognitive reserve, and cognition in healthy older people. PLoS One, 2018, 13(8): e0201008.
47. Wilson RS, Yu L, Lamar M, et al. Education and cognitive reserve in old age. Neurology, 2019, 92(10): e1041-e1050.
48. Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med, 2012, 172(14): 1078-1083.
49. Hill MMYS, Yorgason JB, Nelson LJ, et al. Social withdrawal and psychological well-being in later life: does marital status matter. Aging Ment Health, 2022, 26(7): 1368-1376.
50. Rokach A, Matalon R, Rokach B, et al. The effects of gender and marital status on loneliness of the aged. Soc Beh Person Inter J, 2007, 35(2): 243-254.
51. Ibrahim R, Abolfathi Momtaz Y, Hamid TA. Social isolation in older Malaysians: prevalence and risk factors. Psychogeriatrics, 2013, 13(2): 71-79.
52. Pollack CE, von dem Knesebeck O. Social capital and health among the aged: comparisons between the United States and Germany. Health Place, 2004, 10(4): 383-391.
53. Brownie S. Why are elderly individuals at risk of nutritional deficiency. Int J Nurs Pract, 2006, 12(2): 110-118.
54. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med, 2010, 7(7): e1000316.
55. Nikmat AW, Hawthorne G, Al-Mashoor SH. The comparison of quality of life among people with mild dementia in nursing home and home care-a preliminary report. Dementia, 2015, 14(1): 114-125.
56. 季紅莉, 路孝琴. 養老機構老年人健康狀況與衛生服務需求調查. 中華全科醫學, 2012, 10(11): 1763-1764.
57. 張河川, 岑曉鈺, 郭良驥. 養老機構老年人健康狀況及服務需求調查. 中國公共衛生, 2010, 26(4): 411-412.

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