TY - JOUR
T1 - Social Isolation and Incident Heart Failure Hospitalization in Older Women
T2 - Women’s Health Initiative Study Findings
AU - Cené, Crystal W.
AU - Leng, Xiaoyan Iris
AU - Faraz, Khushnood
AU - Allison, Matthew
AU - Breathett, Khadijah
AU - Bird, Chloe
AU - Coday, Mace
AU - Corbie-Smith, Giselle
AU - Foraker, Randi
AU - Ijioma, Nkechinyere N.
AU - Rosal, Milagros C.
AU - Sealy-Jefferson, Shawnita
AU - Shippee, Tetyana P.
AU - Kroenke, Candyce H.
N1 - Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - BACKGROUND: The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. METHODS AND RESULTS: This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women’s Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993– 1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08–1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07–1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. CONCLUSIONS: Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors.
AB - BACKGROUND: The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. METHODS AND RESULTS: This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women’s Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993– 1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08–1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07–1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. CONCLUSIONS: Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors.
KW - heart failure
KW - older adults
KW - social isolation
KW - women
UR - http://www.scopus.com/inward/record.url?scp=85125554483&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.022907
DO - 10.1161/JAHA.120.022907
M3 - Article
C2 - 35189692
AN - SCOPUS:85125554483
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 5
M1 - e022907
ER -