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.	张硕, 陈功. 中国城市老年人社会隔离现状与影响因素研究. 人口学刊, 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.	庞慧, 赵改梅, 张美霞, 等. 老年人社会隔离评估工具的研究进展. 全科护理, 2020, 18(31): 4264-4268.
12.	Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas, 2018, 113: 80-84.
13.	张文娟, 刘瑞平. 中国老年人社会隔离的影响因素分析. 人口研究, 2016, 40(5): 75-91.
14.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
15.	赵迪, 赵梦璐, 王娜, 等. 青岛市592名社区老年人社会隔离现状及影响因素研究. 护理学报, 2020, 27(11): 6-10.
16.	杨春晓, 尹文强, 李秋莎, 等. 社会隔离对老年人医疗服务利用的影响—基于中国家庭追踪调查数据的实证研究. 现代预防医学, 2021, 48(24): 4461-4466.
17.	谢颖, 赵庆华, 肖明朝, 等. 社区老年人孤独感、社会隔离现状及影响因素分析. 护士进修杂志, 2021, 36(9): 769-774.
18.	吴凡, 绳宇. 社区老年人社会隔离与健康促进行为的差异化研究. 中国全科医学, 2019, 22(22): 2744-2748.
19.	王艳红, 黄菲芸, 郑媛, 等. 黑龙江省大庆市社区老年人社会隔离与认知功能关联的研究. 中华流行病学杂志, 2017, 38(4): 472-477.
20.	潘静宜, 黄晓洁, 管娅琦, 等. 浙江省养老机构老年人孤独状况与社会网络的关系研究. 护理与康复, 2018, 17(8): 19-23.
21.	马佳平. 中国中老年人社会隔离、抑郁与脑卒中发病风险的因果关系研究. 厦门: 厦门大学, 2016.
22.	连至炜, 李晋磊, 金平阅, 等. 社交网络对城市社区老人生活满意度影响. 中国公共卫生, 2021, 37(1): 5-9.
23.	李少杰, 尹永田, 陈莉军, 等. 济南市农村老年人社会隔离现状及其影响因素分析. 中国公共卫生, 2021, 37(1): 28-31.
24.	李少杰, 崔光辉, 尹永田. 社区老年人社会隔离及孤独感对衰弱影响. 中国公共卫生, 2022, 38(4): 399-403.
25.	李茜, 张海茹, 易子涵, 等. 社区老年人社会隔离及自我感知老化现状调查. 广西医学, 2021, 43(6): 763-767.
26.	金佳瑶. 社区老年人社会隔离、营养不足与能力下降的关系研究. 锦州: 锦州医科大学, 2019.
27.	韩悦, 石婷婷. 济南市老年人社会隔离与睡眠质量及其交互作用对抑郁的影响. 现代预防医学, 2021, 48(3): 511-514,519.
28.	范榕, 白亚丽, 刘瑶, 等. 社区功能和社区公共服务对不同年龄老年人社会隔离的影响. 中国全科医学, 2020, 23(28): 3583-3589.
29.	杜亚男, 陈长香, 王雪辉, 等. 中国共病老年人社会隔离流行状况及影响因素. 现代预防医学, 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.	张焱, 刘方, 徐瑞, 等. 养老机构老年人社会隔离、抑郁与衰弱的关系. 护理研究, 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.	季红莉, 路孝琴. 养老机构老年人健康状况与卫生服务需求调查. 中华全科医学, 2012, 10(11): 1763-1764.
57.	张河川, 岑晓钰, 郭良骥. 养老机构老年人健康状况及服务需求调查. 中国公共卫生, 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. 张硕, 陈功. 中国城市老年人社会隔离现状与影响因素研究. 人口学刊, 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. 庞慧, 赵改梅, 张美霞, 等. 老年人社会隔离评估工具的研究进展. 全科护理, 2020, 18(31): 4264-4268.
12. Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas, 2018, 113: 80-84.
13. 张文娟, 刘瑞平. 中国老年人社会隔离的影响因素分析. 人口研究, 2016, 40(5): 75-91.
14. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
15. 赵迪, 赵梦璐, 王娜, 等. 青岛市592名社区老年人社会隔离现状及影响因素研究. 护理学报, 2020, 27(11): 6-10.
16. 杨春晓, 尹文强, 李秋莎, 等. 社会隔离对老年人医疗服务利用的影响—基于中国家庭追踪调查数据的实证研究. 现代预防医学, 2021, 48(24): 4461-4466.
17. 谢颖, 赵庆华, 肖明朝, 等. 社区老年人孤独感、社会隔离现状及影响因素分析. 护士进修杂志, 2021, 36(9): 769-774.
18. 吴凡, 绳宇. 社区老年人社会隔离与健康促进行为的差异化研究. 中国全科医学, 2019, 22(22): 2744-2748.
19. 王艳红, 黄菲芸, 郑媛, 等. 黑龙江省大庆市社区老年人社会隔离与认知功能关联的研究. 中华流行病学杂志, 2017, 38(4): 472-477.
20. 潘静宜, 黄晓洁, 管娅琦, 等. 浙江省养老机构老年人孤独状况与社会网络的关系研究. 护理与康复, 2018, 17(8): 19-23.
21. 马佳平. 中国中老年人社会隔离、抑郁与脑卒中发病风险的因果关系研究. 厦门: 厦门大学, 2016.
22. 连至炜, 李晋磊, 金平阅, 等. 社交网络对城市社区老人生活满意度影响. 中国公共卫生, 2021, 37(1): 5-9.
23. 李少杰, 尹永田, 陈莉军, 等. 济南市农村老年人社会隔离现状及其影响因素分析. 中国公共卫生, 2021, 37(1): 28-31.
24. 李少杰, 崔光辉, 尹永田. 社区老年人社会隔离及孤独感对衰弱影响. 中国公共卫生, 2022, 38(4): 399-403.
25. 李茜, 张海茹, 易子涵, 等. 社区老年人社会隔离及自我感知老化现状调查. 广西医学, 2021, 43(6): 763-767.
26. 金佳瑶. 社区老年人社会隔离、营养不足与能力下降的关系研究. 锦州: 锦州医科大学, 2019.
27. 韩悦, 石婷婷. 济南市老年人社会隔离与睡眠质量及其交互作用对抑郁的影响. 现代预防医学, 2021, 48(3): 511-514,519.
28. 范榕, 白亚丽, 刘瑶, 等. 社区功能和社区公共服务对不同年龄老年人社会隔离的影响. 中国全科医学, 2020, 23(28): 3583-3589.
29. 杜亚男, 陈长香, 王雪辉, 等. 中国共病老年人社会隔离流行状况及影响因素. 现代预防医学, 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. 张焱, 刘方, 徐瑞, 等. 养老机构老年人社会隔离、抑郁与衰弱的关系. 护理研究, 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. 季红莉, 路孝琴. 养老机构老年人健康状况与卫生服务需求调查. 中华全科医学, 2012, 10(11): 1763-1764.
57. 张河川, 岑晓钰, 郭良骥. 养老机构老年人健康状况及服务需求调查. 中国公共卫生, 2010, 26(4): 411-412.

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