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Joint Associations of Sarcopenia and Social Isolation with Mortality: Two Prospective Cohort Studies
Background: Sarcopenia and social isolation are both associated with adverse outcomes, but little is known about their combined impact on mortality.
Methods: The analysis included 14,363 Chinese adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and 385,910 European adults from the UK Biobank. Sarcopenia was diagnosed according to criteria from the European and Asian Working Groups on Sarcopenia. Social isolation was assessed using the standardized questionnaires including solitude, frequency of social activities and contact with others, and marital status (for CLHLS only). Cox proportional hazards regression models were used to compute the hazard ratios (HRs) and 95% confidence intervals (CIs).
Findings: During the follow-up period (median 3·0 years in CLHLS, and 13·1 years in UK Biobank), 8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank, with 5,285 due to CVD and 13,805 due to cancer. While no significant interaction was observed between sarcopenia and social isolation on all-cause mortality in the CLHLS, the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank (p-interaction = 0·03, relative risk due to interaction 0·23, 95% CI 0·06–0·41). Further joint analyses showed that participants with both sarcopenia and high levels of social isolation had the highest mortality risk (HR [95% CI]: 1·99 [1·74-2·28] in the CLHLS and 1·69 [1·55-1·85] in the UK Biobank) compared to those without either condition.
Interpretation: The combination of social isolation and sarcopenia synergistically elevated the risk of mortality in middle-aged and older adults. Early identification and intervention strategies targeting social isolation and sarcopenia simultaneously in seniors could substantially mitigate mortality risks.
Funding: The National Key Research and Development Program of China and the National Natural Science Foundation of China.
Declaration of Interest: No potential conflicts of interest relevant to this article were reported.
Ethical Approval: The CLHLS and UK Biobank were approved by the Biomedical Ethics Committee of Peking University (IRB00001052-13074) and the North West Multicenter Research Ethics Committee (REC reference numbers 11/NW/0382, 16/NW/0274, and 21/NW/0157). All participants or their legal representatives provided written informed consent.
Keywords: sarcopenia, social isolation, mortality, UK Biobank, CLHLS
Li, Juanjuan and Zhang, Zhe and Zhang, Jijuan and Wang, Yuxiang and Yu, Hancheng and Liu, Gang and Pan, An and Liao, Yunfei and Geng, Tingting, Joint Associations of Sarcopenia and Social Isolation with Mortality: Two Prospective Cohort Studies. Available at SSRN: https://ssrn.com/abstract=4964525 or http://dx.doi.org/10.2139/ssrn.4964525
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