scholarly journals Loneliness, social isolation, and chronic disease outcomes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Christiansen ◽  
R Lund ◽  
P Qualter ◽  
C M Andersen ◽  
S S Pedersen ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Social Isolation ◽  
Vulnerable Groups ◽  
Chronic Obstructive ◽  
Behavioral Factors ◽  
Multiple Mediation ◽  
Individual Level ◽  
Danish Patient

Abstract Background Research suggests that loneliness and social isolation are serious public health concerns. However, our knowledge of the associations of loneliness and social isolation with specific chronic diseases is limited. The present prospective cohort study investigated (a) the longitudinal associations of loneliness and social isolation with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and social isolation with chronic disease, and (c) baseline psychological and behavioral explanatory factors. Methods Self-reported data from the 2013 Danish “How are you?” survey (N = 24,607) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013-2018). Results Cox proportional hazard regression analyses showed that loneliness and social isolation were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or social isolation and COPD and cancer, respectively. Likewise, loneliness and social isolation did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and social isolation had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors. Conclusions Loneliness and social isolation were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and social isolation with CVD and T2D were fully explained by baseline psychological and behavioral factors. Key messages Individuals exposed to loneliness and social isolation constitute vulnerable groups in risk of chronic disease. Psychological and behavioural factors explain the associations with chronic disease.

Loneliness, Social Isolation, and Chronic Disease Outcomes

2020 ◽  
Author(s):  
Julie Christiansen ◽  
Rikke Lund ◽  
Pamela Qualter ◽  
Christina Maar Andersen ◽  
Susanne S Pedersen ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Social Isolation ◽  
Chronic Obstructive ◽  
Behavioral Factors ◽  
Multiple Mediation ◽  
Individual Level ◽  
Danish Patient ◽  
Reported Data

Abstract Background Research suggests that loneliness and social isolation (SI) are serious public health concerns. However, our knowledge of the associations of loneliness and SI with specific chronic diseases is limited. Purpose The present prospective cohort study investigated (a) the longitudinal associations of loneliness and SI with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and SI with chronic disease, and (c) baseline psychological and behavioral explanatory factors. Methods Self-reported data from the 2013 Danish “How are you?” survey (N = 24,687) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013–2018). Results Cox proportional hazard regression analyses showed that loneliness and SI were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or SI and COPD and cancer, respectively. Likewise, loneliness and SI did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and SI had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors. Conclusion Loneliness and SI were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and SI with CVD and T2D were fully explained by baseline psychological and behavioral factors.

The ‘loneliness pandemic’: implications for gerontological nursing

2021 ◽  
Vol 30 (11) ◽  
pp. 652-655
Author(s):  
Carlos Laranjeira
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
Chronic Diseases ◽  
Old Age ◽  
Social Isolation ◽  
Social Relationships ◽  
Vulnerable Groups ◽  
Negative Consequences ◽  
Gerontological Nursing

The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.

scholarly journals Smoking, drinking, diet and physical activity—modifiable lifestyle risk factors and their associations with age to first chronic disease

2019 ◽  
Vol 49 (1) ◽  
pp. 113-130 ◽  
Author(s):  
Ryan Ng ◽  
Rinku Sutradhar ◽  
Zhan Yao ◽  
Walter P Wodchis ◽  
Laura C Rosella
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Lifestyle Factors ◽  
Competing Risk ◽  
Chronic Obstructive ◽  
Common Disease ◽  
Heavy Smoking ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

AbstractBackgroundThis study examined the incidence of a person’s first diagnosis of a selected chronic disease, and the relationships between modifiable lifestyle risk factors and age to first of six chronic diseases.MethodsOntario respondents from 2001 to 2010 of the Canadian Community Health Survey were followed up with administrative data until 2014 for congestive heart failure, chronic obstructive respiratory disease, diabetes, lung cancer, myocardial infarction and stroke. By sex, the cumulative incidence function of age to first chronic disease was calculated for the six chronic diseases individually and compositely. The associations between modifiable lifestyle risk factors (alcohol, body mass index, smoking, diet, physical inactivity) and age to first chronic disease were estimated using cause-specific Cox proportional hazards models and Fine-Gray competing risk models.ResultsDiabetes was the most common disease. By age 70.5 years (2015 world life expectancy), 50.9% of females and 58.1% of males had at least one disease and few had a death free of the selected diseases (3.4% females; 5.4% males). Of the lifestyle factors, heavy smoking had the strongest association with the risk of experiencing at least one chronic disease (cause-specific hazard ratio = 3.86; 95% confidence interval = 3.46, 4.31). The lifestyle factors were modelled for each disease separately, and the associations varied by chronic disease and sex.ConclusionsWe found that most individuals will have at least one of the six chronic diseases before dying. This study provides a novel approach using competing risk methods to examine the incidence of chronic diseases relative to the life course and how their incidences are associated with lifestyle behaviours.

scholarly journals Loneliness, social isolation and healthcare utilisation in the general population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Christiansen ◽  
S S Pedersen ◽  
C M Andersen ◽  
P Qualter ◽  
R Lund ◽  
...  
Keyword(s):  
Risk Factor ◽  
Chronic Disease ◽  
General Population ◽  
Synergistic Effect ◽  
Hospital Admission ◽  
Social Isolation ◽  
Negative Binomial ◽  
Healthcare Utilisation ◽  
Negative Binomial Regression

Abstract Background The present prospective cohort study investigated the association of loneliness and social isolation with healthcare utilisation in the general population over time. We also investigated the synergistic effect of loneliness and social isolation on healthcare utilisation. Methods Data from the 2013 Danish “How are you?' survey (n = 29,472) were combined with individual-level register data from the National Danish Patient Registry and the Danish National Health Service Registry in a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics, chronic disease, and healthcare utilisation during the follow-up period. Results Loneliness was significantly associated with number of GP visits (incident-rate ratio (IRR) = 1.06, 95% confidence interval (CI) [1.01, 1.13]), emergency admissions (IRR = 1.19, 95% CI [1.03, 1.37]) and number of hospital admission days (IRR = 1.32, 95% CI [1.08, 1.62]). No significant associations were found between social isolation and healthcare utilisation with one minor exception, in which social isolation was associated with less planned admissions (IRR = .88, 95% CI [.78, .99]). Finally, loneliness and social isolation demonstrated a synergistic effect on number of visits to the GP (IRR = .87, 95% CI [.78, .98]) and number of hospital admission days (IRR = .67, 95% CI [.45, .98]). Conclusions Our findings suggest that loneliness is a risk factor for primary and secondary healthcare utilisation, independently of social isolation, baseline demographics, chronic disease, and healthcare utilisation during the follow-up period. Key messages Loneliness is an independent risk factor for healthcare utilisation in the general population. Social isolation is not associated with healthcare utilisation in the general population.

scholarly journals Use of heated tobacco products by people with chronic diseases: The 2019 JASTIS study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260154
Author(s):  
Chikako Nakama ◽  
Takahiro Tabuchi
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Internet Survey ◽  
Chronic Obstructive ◽  
Dual Use ◽  
Tobacco Products ◽  
Obstructive Pulmonary Disease ◽  
Quit Smoking ◽  
Quitting Smoking ◽  
Internet Study

Heated tobacco products (HTPs) have become popular recently. People with chronic disease, such as diabetes, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD) and cancer, should quit smoking for treatment and recurrence of tobacco-related diseases. However, they have difficulty in quitting smoking, and they may start HTPs use to quit smoking. The purpose of this study is to examine the use of HTPs in people with chronic disease. We used data from an internet study, the Japan Society and New Tobacco Internet Survey (JASTIS). We analyzed 9,008 respondents aged 15–73 years in 2019 using logistic regression. Current use of tobacco products was defined as use within the previous 30 days. Prevalence of current HTP use including dual use and dual use with cigarettes was 9.0% and 6.1% respectively in total. By disease: hypertension 10.2% and 7.4%, diabetes 15.9% and 12.3%, CVD 19.2% and 15.7%, COPD 40.5% and 33.3%, and cancer 17.5% and 11.9%. Diabetes, CVD, COPD, and cancer were positively associated with current use of HTPs (odds ratios (ORs) and 95% confidence intervals (CIs): 1.48 (1.06, 2.07), 2.29 (1.38, 3.80), 3.97(1.73, 9.11), and 3.58(1.99, 6.44), respectively) and dual use of cigarettes and HTPs (ORs and 95% CIs: 2.23 (1.61, 3.09), 3.58 (2.29, 5.60), 7.46 (3.76, 14.80), and 2.57 (1.46, 4.55), respectively) after adjusting for confounders. People with chronic disease were more likely to use HTPs and HTPs together with cigarettes. Further research on the smoking situation of HTPs in patients with chronic diseases is necessary.

scholarly journals Digital Recruitment and Acceptance of a Stepwise Model to Prevent Chronic Disease in the Danish Primary Care Sector: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Lars Bruun Larsen ◽  
Jens Sondergaard ◽  
Janus Laust Thomsen ◽  
Anders Halling ◽  
Anders Larrabee Sønderlund ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Low Cost ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Cross Sectional ◽  
Interaction Detection ◽  
Health Checks

BACKGROUND During recent years, stepwise approaches to health checks have been advanced as an alternative to general health checks. In 2013, we set up the Early Detection and Prevention project (Tidlig Opsporing og Forebyggelse, TOF) to develop a stepwise approach aimed at patients at high or moderate risk of a chronic disease. A novel feature was the use of a personal digital mailbox for recruiting participants. A personal digital mailbox is a secure digital mailbox provided by the Danish public authorities. Apart from being both safe and secure, it is a low-cost, quick, and easy way to reach Danish residents. OBJECTIVE In this study we analyze the association between the rates of acceptance of 2 digital invitations sent to a personal digital mailbox and the sociodemographic determinants, medical treatment, and health care usage in a stepwise primary care model for the prevention of chronic diseases. METHODS We conducted a cross-sectional analysis of the rates of acceptance of 2 digital invitations sent to randomly selected residents born between 1957 and 1986 and residing in 2 Danish municipalities. The outcome was acceptance of the 2 digital invitations. Statistical associations were determined by Poisson regression. Data-driven chi-square automatic interaction detection method was used to generate a decision tree analysis, predicting acceptance of the digital invitations. RESULTS A total of 8814 patients received an invitation in their digital mailbox from 47 general practitioners. A total of 40.22% (3545/8814) accepted the first digital invitation, and 30.19 % (2661/8814) accepted both digital invitations. The rates of acceptance of both digital invitations were higher among women, older patients, patients of higher socioeconomic status, and patients not diagnosed with or being treated for diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular disease. CONCLUSIONS To our knowledge, this is the first study to report on the rates of acceptance of digital invitations to participate in a stepwise model for prevention of chronic diseases. More studies of digital invitations are needed to determine if the acceptance rates seen in this study should be expected from future studies as well. Similarly, more research is needed to determine whether a multimodal recruitment approach, including digital invitations to personal digital mailboxes will reach hard-to-reach subpopulations more effectively than digital invitations only.

scholarly journals Anxiety and depressive features in chronic disease patients in Cambodia, Myanmar and Vietnam

2016 ◽  
Vol 22 (1) ◽  
pp. 4 ◽  
Author(s):  
Karl Peltzer ◽  
Supa Pengpid
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Chronic Diseases ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Cross Sectional Survey

<p><strong>Objective:</strong> The aim of this study was to estimate the prevalence and relationship of anxiety and depressive features among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam).<br /><strong>Methods:</strong> A cross-sectional survey was conducted in 2014 among 4803 adult patients with chronic diseases who were recruited cross-sectionally from health facilities. Anxiety and depression were assessed with the <em>Hospital Anxiety and Depression Scale</em>.<br /><strong>Results:</strong> Overall, 17.0% of patients screened positive for anxiety disorder and 39.1% for depressive disorder. Patients with cancer (47.8%) had the highest rate of anxiety features, and those with chronic obstructive pulmonary disease (COPD) (62.1%), kidney disease (55.5%), Parkinson’s disease (53.7%) and cardiovascular disorders (CVDs) (52.6%) the highest prevalence of depressive features. Stomach and intestinal diseases, CVDs, migraine or frequent <br />headaches and kidney disease were positively associated with anxiety and depression after adjusting for sociodemographics and illness duration. In addition, cancer and Parkinson’s disease were positively associated with anxiety, and arthritis, diabetes, and COPD were positively associated with depression. In multivariate logistic regression, having two or more chronic conditions and poor quality of life was associated with anxiety and depression.<br /><strong>Conclusion:</strong> Considering the high rate of anxiety and depression among these patients with chronic disease, more efforts should directed to on the psychosocial management of these patients.</p>

scholarly journals Systematic review and meta analysis of differential attrition between active and control arms in randomized controlled trials of lifestyle interventions in chronic disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bevens W ◽  
Shoushtari A ◽  
Jelinek P ◽  
Jelinek GA ◽  
Weiland TJ
Keyword(s):  
Systematic Review ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Lifestyle Intervention ◽  
Meta Analysis ◽  
Research Question ◽  
Lifestyle Interventions ◽  
And Control

Abstract Background Attrition is a major obstacle for lifestyle interventions sustained for the medium-to-long term and can have significant consequences on the internal validity of a trial. When the degree of attrition differs between active and control arms this is termed differential attrition and is an important consideration during initial stages of trial planning. Objectives The primary research question of this study was: what is the differential attrition between treatment arms in lifestyle interventions for prevalent chronic diseases? Methods We performed a systematic review and meta-analysis of 23 studies involving a lifestyle intervention component in cohorts with chronic diseases. The search accessed three databases: Scopus, Medline Ovid and Web of Science. Attrition between treatment arms was analysed using a random-effects model and examined the relationship between the relative attrition and potential moderators, such as time to final follow-up, time to first follow-up, type of disease, type of control, type of intervention and length of treatment. Results The pooled risk ratio was 1.00 (95% CI 0.97 – 1.03) and only one study fell outside this range. A univariable association was described between the pooled risk ration and length (years) to final follow-up, which did not remain in the multivariable model. Conclusions Ultimately, we found no evidence of differential attrition in medium-to-long term lifestyle intervention studies for chronic disease, increasing confidence in conducting such studies with minimal potential of attrition bias. Trial registration PROSPERO registration number CRD42018084495.

scholarly journals Vaccination Coverage with the Pneumococcal and Influenza Vaccine Among Persons with Chronic Diseases in Shanghai, China, 2017

2020 ◽  
Author(s):  
Yuheng Wang ◽  
Minna Cheng ◽  
Siyuan Wang ◽  
Fei Wu ◽  
Qinghua Yan ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Influenza Vaccination ◽  
Chronic Diseases ◽  
Vaccination Coverage ◽  
Rural Areas ◽  
Urban Areas ◽  
Chronic Disease Management ◽  
Pneumococcal Vaccination ◽  
Chronic Obstructive

Abstract Background: Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai.Methods: The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson’s chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables.Results: In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70-79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination.Conclusions: We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake – like younger adults, and individuals who have not yet retired.

scholarly journals Using a Constraint-Based Method to Identify Chronic Disease Patients Who Are Apt to Obtain Care Mostly Within a Given Health Care System: Retrospective Cohort Study

10.2196/26314 ◽  
2021 ◽  
Vol 5 (10) ◽  
pp. e26314
Author(s):  
Yao Tong ◽  
Zachary C Liao ◽  
Peter Tarczy-Hornoch ◽  
Gang Luo
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Chronic Diseases ◽  
Care Management ◽  
Adult Patients ◽  
Chronic Obstructive ◽  
University Of Washington ◽  
Obstructive Pulmonary Disease ◽  
The University

Background For several major chronic diseases including asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes, a state-of-the-art method to avert poor outcomes is to use predictive models to identify future high-cost patients for preemptive care management interventions. Frequently, an American patient obtains care from multiple health care systems, each managed by a distinct institution. As the patient’s medical data are spread across these health care systems, none has complete medical data for the patient. The task of building models to predict an individual patient’s cost is currently thought to be impractical with incomplete data, which limits the use of care management to improve outcomes. Recently, we developed a constraint-based method to identify patients who are apt to obtain care mostly within a given health care system. Our method was shown to work well for the cohort of all adult patients at the University of Washington Medicine for a 6-month follow-up period. It is unknown how well our method works for patients with various chronic diseases and over follow-up periods of different lengths, and subsequently, whether it is reasonable to perform this predictive modeling task on the subset of patients pinpointed by our method. Objective To understand our method’s potential to enable this predictive modeling task on incomplete medical data, this study assesses our method’s performance at the University of Washington Medicine on 5 subgroups of adult patients with major chronic diseases and over follow-up periods of 2 different lengths. Methods We used University of Washington Medicine data for all adult patients who obtained care at the University of Washington Medicine in 2018 and PreManage data containing usage information from all hospitals in Washington state in 2019. We evaluated our method’s performance over the follow-up periods of 6 months and 12 months on 5 patient subgroups separately—asthma, chronic kidney disease, type 1 diabetes, type 2 diabetes, and chronic obstructive pulmonary disease. Results Our method identified 21.81% (3194/14,644) of University of Washington Medicine adult patients with asthma. Around 66.75% (797/1194) and 67.13% (1997/2975) of their emergency department visits and inpatient stays took place within the University of Washington Medicine system in the subsequent 6 months and in the subsequent 12 months, respectively, approximately double the corresponding percentage for all University of Washington Medicine adult patients with asthma. The performance for adult patients with chronic kidney disease, adult patients with chronic obstructive pulmonary disease, adult patients with type 1 diabetes, and adult patients with type 2 diabetes was reasonably similar to that for adult patients with asthma. Conclusions For each of the 5 chronic diseases most relevant to care management, our method can pinpoint a reasonably large subset of patients who are apt to obtain care mostly within the University of Washington Medicine system. This opens the door to building models to predict an individual patient’s cost on incomplete data, which was formerly deemed impractical. International Registered Report Identifier (IRRID) RR2-10.2196/13783

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