| Title: | Loneliness and social isolation, mediating lifestyle factors, and incidence of COPD: A prospective cohort study |
| Journal: | Journal of Affective Disorders |
| Published: | 25 Apr 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40288454/ |
| DOI: | https://doi.org/10.1016/j.jad.2025.04.144 |
Publication 15755
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Abstract
BACKGROUND: Limited information exists regarding the associations and pathways of loneliness and social isolation with chronic obstructive pulmonary disease (COPD). Our goal was to investigate the associations of loneliness and social isolation with COPD, as well as to analyze how lifestyle factors may play a role in mediating these effects.</p>
METHODS: In the UK Biobank, 293,864 participants were included in this study. The study assessed five lifestyle factors: physical activity, eating habits, smoking, alcohol consumption, and body mass index (BMI). Incident COPD was detected through algorithms based on electronic health records. We used Cox proportional models to explore the association. Cause mediation analyses were applied to estimate the effect of various lifestyle factors.</p>
RESULTS: In the fully adjusted model, the lonely participants had a greater risk of developing COPD (HR: 1.31; 95 % CI: 1.20-1.43) compared with those participants without loneliness. Similarly, the HR of social isolation on incident COPD was 1.39 (95 % CI: 1.30-1.48) after adjusting for potential confounders. Current smokers (21.9 %), unhealthy dietary characteristics (4.8 %), BMI (4.0 %), unhealthy drinking habits (1.4 %), and physical activity (0.7 %) explained 32.8 % of the association between loneliness and COPD. Likewise, current smokers, physical activity, and unhealthy drinking habit mediated 46.1 %, 4.7 %, and 4.2 % of the effect of social isolation on incident COPD.</p>
LIMITATIONS: Despite extensive adjustment for potential confounders and several sensitivity analyses, residual confounding and reverse causality could not be ruled out.</p>
CONCLUSION: Individuals with loneliness or social isolation have a higher risk of COPD, partly mediated through lifestyle factors.</p>
17 Keywords
- Aged
- Alcohol Drinking
- Body Mass Index
- Exercise
- Female
- Humans
- Incidence
- Life Style
- Loneliness
- Male
- Middle Aged
- Prospective Studies
- Pulmonary Disease, Chronic Obstructive
- Risk Factors
- Smoking
- Social Isolation
- United Kingdom
3 Authors
- Zhen Liu
- Minzhi Xu
- Xiaoxv Yin
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