Sex-specific associations of social isolation and loneliness with residual life expectancy at age 45 years among middle-aged and older adults in China

作者：Meng Zhao, Xiaoyang Huo, Haihong Zhang, Chen Wu, Sijing Peng, Zuyun Liu, Sha Sha, Ming Li, Kefang Wang · 发表于：BMC Public Health · 年份：2025 · DOI：10.1186/s12889-025-23708-x · 被引用次数：3 · 研究领域：Health disparities and outcomes、Chronic Disease Management Strategies、Health and Well-being Studies

BACKGROUND: Globally, one-third of older adults experience social isolation or loneliness, making them critical public health priorities. However, the impact of social isolation and loneliness on life expectancy remains underexplored. This study investigated the separate and joint associations of social isolation and loneliness with residual life expectancy at age 45 years, alongside the sex-specific variations in these associations with the aim of informing targeted strategies for mitigating social health disparities in rapidly ageing populations. METHODS: This prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study. A total of 11,315 community dwellers (5,274 men; 6,041 women) aged 45 years and above included. After the baseline 2011 assessment year, participants from the 2013, 2015, 2018, and 2020 waves were followed up. The measurements included the following: social isolation, assessed on the basis of social network usage, activities, and engagements; loneliness, evaluated on the basis of the subjective feeling of loneliness; and a flexible parametric Royston-Parmar model to estimate hazard ratios (HR) for all-cause mortality and to predict residual life expectancy differences. RESULTS: In men, socially isolated and lonely individuals had the greatest reduction in residual life expectancy at age 45 years, losing 4.61 years (95% CI: 1.49-7.74) compared to those with neither experience. Social isolation alone (3.82 years lo...