Background Social isolation is a well-known risk factor for poor health outcomes, including incident dementia, yet its associations with outcomes among persons living with dementia is understudied. We examined the association between social isolation and hospitalization among a nationally representative sample of older adults with and without dementia. Methods This observational cohort study included 5,533 community-dwelling Medicare beneficiaries from the 2015 and 2016 National Health and Aging Trends Study (NHATS). Using multivariable logistic regression analyses, we examined associations between social isolation and hospitalization in the following year, examining differences by dementia status. Social isolation was measured using a 4-item typology. Dementia was identified using a pre-specified classification in NHATS. Results 20.7% of older adults were socially isolated. Social isolation was more prevalent among persons with dementia (35.4%) than among those without dementia (19.0%) (p < .001). Among persons with dementia, social isolation was associated with 1.68 greater odds of hospitalization (CI: 1.23‒2.28), translating into a 9% average increase in the predicted probability of hospitalization for persons with dementia who were socially isolated compared to those who were not (p = 0.001). In the combined sample that included persons with and without dementia, there was a significant moderation effect of dementia on the association between social isolation and hospitalization (OR: 1.70; CI: 1.19‒2.43). Conclusions For persons with dementia, social isolation is prevalent and associated with greater odds of subsequent hospitalization. Efforts to reduce acute healthcare utilization should explore ways to bolster social connection to improve health outcomes among persons with dementia.

中文翻译：

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按痴呆状态划分的社区老年人的社会孤立和住院


背景 社会孤立是众所周知的不良健康结果（包括痴呆症）的风险因素，但其与痴呆患者结果的相关性研究不足。我们检查了具有全国代表性的患有和不患有痴呆的老年人样本中的社会孤立与住院之间的关联。方法 这项观察性队列研究包括来自 5,533 年和 2015 年全国健康和老龄化趋势研究 （NHATS） 的 2016 名社区居住的 Medicare 受益人。使用多变量 logistic 回归分析，我们检查了社会孤立与次年住院之间的关联，检查了痴呆状态的差异。使用 4 项类型学来衡量社会孤立。使用 NHATS 中预先指定的分类确定痴呆。结果 20.7% 的老年人在社会上被孤立。社会孤立在痴呆患者 （35.4%） 中比在非痴呆患者 （19.0%） 中更普遍 （p < .001）。在痴呆患者中，社会孤立与住院几率高出 1.68 相关 （CI： 1.23\u20122.28），转化为与非社会隔离的痴呆患者相比，预测住院概率平均增加 9%（p = 0.001）。在包括痴呆症患者和无痴呆症患者的组合样本中，痴呆对社会孤立与住院之间的关联存在显着的调节作用（OR：1.70;CI：1.19\u20122.43）。结论 对于痴呆患者，社会孤立很普遍，并且与随后住院的几率更大有关。 减少急性医疗保健利用的努力应探索加强社会联系的方法，以改善痴呆患者的健康状况。