Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders: a population-based cohort study

L M Laustsen; M Lasgaard; N C Momen; D Chen; J L Gradus; M S Grønkjær; M M Jensen; O Plana-Ripoll

doi:10.1017/S2045796024000829

Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders: a population-based cohort study

L M Laustsen, M Lasgaard, N C Momen, D Chen, J L Gradus, M S Grønkjær, M M Jensen, O Plana-Ripoll

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

AIMS: Individuals with diminished social connections are at higher risk of mental disorders, dementia, circulatory conditions and musculoskeletal conditions. However, evidence is limited by a disease-specific focus and no systematic examination of sex differences or the role of pre-existing mental disorders.

METHODS: We conducted a cohort study using data on social disconnectedness (loneliness, social isolation, low social support and a composite measure) from the 2013 and 2017 Danish National Health Survey linked with register data on 11 broad categories of medical conditions through 2021. Poisson regression was applied to estimate incidence rate ratios (IRRs), incidence rate differences (IRDs), and explore sex differences and interaction with pre-existing mental disorders.

RESULTS: Among 162,497 survey participants, 7.6%, 3.5% and 14.8% were classified as lonely, socially isolated and with low social support, respectively. Individuals who were lonely and with low social support had a higher incidence rate in all 11 categories of medical conditions (interquartile range [IQR] of IRRs, respectively 1.26-1.49 and 1.10-1.14), whereas this was the case in nine categories among individuals who were socially isolated (IQR of IRRs, 1.01-1.31). Applying the composite measure, the highest IRR was 2.63 for a mental disorder (95% confidence interval [CI], 2.38-2.91), corresponding to an IRD of 54 (95% CI, 47-61) cases per 10,000 person-years. We found sex and age differences in some relative and absolute estimates, but no substantial deviations from additive interaction with pre-existing mental disorders.

CONCLUSIONS: This study advances our knowledge of the risk of medical conditions faced by individuals who are socially disconnected. In addition to the existing evidence, we found higher incidence rates for a broad range of medical condition categories. Contrary to previous evidence, our findings suggest that loneliness is a stronger determinant for subsequent medical conditions than social isolation and low social support.A preregistered analysis plan and statistical code are available at Open Science Framework (https://osf.io/pycrq).

Original language	English
Article number	e81
Journal	Epidemiology and Psychiatric Sciences
Volume	33
ISSN	2045-7960
DOIs	https://doi.org/10.1017/S2045796024000829
Publication status	Published - 23 Dec 2024

Keywords

Adult
Aged
Cohort Studies
Denmark/epidemiology
Female
Health Surveys
Humans
Incidence
Loneliness/psychology
Male
Mental Disorders/epidemiology
Middle Aged
Risk Factors
Sex Factors
Social Isolation/psychology
Social Support
risk factors
mental health
chronic conditions
social network
epidemiology

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10.1017/S2045796024000829

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@article{28379ac87e3b4834853495324303c934,

title = "Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders: a population-based cohort study",

abstract = "AIMS: Individuals with diminished social connections are at higher risk of mental disorders, dementia, circulatory conditions and musculoskeletal conditions. However, evidence is limited by a disease-specific focus and no systematic examination of sex differences or the role of pre-existing mental disorders.METHODS: We conducted a cohort study using data on social disconnectedness (loneliness, social isolation, low social support and a composite measure) from the 2013 and 2017 Danish National Health Survey linked with register data on 11 broad categories of medical conditions through 2021. Poisson regression was applied to estimate incidence rate ratios (IRRs), incidence rate differences (IRDs), and explore sex differences and interaction with pre-existing mental disorders.RESULTS: Among 162,497 survey participants, 7.6%, 3.5% and 14.8% were classified as lonely, socially isolated and with low social support, respectively. Individuals who were lonely and with low social support had a higher incidence rate in all 11 categories of medical conditions (interquartile range [IQR] of IRRs, respectively 1.26-1.49 and 1.10-1.14), whereas this was the case in nine categories among individuals who were socially isolated (IQR of IRRs, 1.01-1.31). Applying the composite measure, the highest IRR was 2.63 for a mental disorder (95% confidence interval [CI], 2.38-2.91), corresponding to an IRD of 54 (95% CI, 47-61) cases per 10,000 person-years. We found sex and age differences in some relative and absolute estimates, but no substantial deviations from additive interaction with pre-existing mental disorders.CONCLUSIONS: This study advances our knowledge of the risk of medical conditions faced by individuals who are socially disconnected. In addition to the existing evidence, we found higher incidence rates for a broad range of medical condition categories. Contrary to previous evidence, our findings suggest that loneliness is a stronger determinant for subsequent medical conditions than social isolation and low social support.A preregistered analysis plan and statistical code are available at Open Science Framework (https://osf.io/pycrq).",

keywords = "Adult, Aged, Cohort Studies, Denmark/epidemiology, Female, Health Surveys, Humans, Incidence, Loneliness/psychology, Male, Mental Disorders/epidemiology, Middle Aged, Risk Factors, Sex Factors, Social Isolation/psychology, Social Support, risk factors, mental health, chronic conditions, social network, epidemiology",

author = "Laustsen, {L M} and M Lasgaard and Momen, {N C} and D Chen and Gradus, {J L} and Gr{\o}nkj{\ae}r, {M S} and Jensen, {M M} and O Plana-Ripoll",

year = "2024",

month = dec,

day = "23",

doi = "10.1017/S2045796024000829",

language = "English",

volume = "33",

journal = "Epidemiology and Psychiatric Sciences",

issn = "2045-7960",

publisher = "Cambridge University Press",

}

Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders: a population-based cohort study. / Laustsen, L M ; Lasgaard, M ; Momen, N C et al.
In: Epidemiology and Psychiatric Sciences, Vol. 33, e81, 23.12.2024.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders

T2 - a population-based cohort study

AU - Laustsen, L M

AU - Lasgaard, M

AU - Momen, N C

AU - Chen, D

AU - Gradus, J L

AU - Grønkjær, M S

AU - Jensen, M M

AU - Plana-Ripoll, O

PY - 2024/12/23

Y1 - 2024/12/23

N2 - AIMS: Individuals with diminished social connections are at higher risk of mental disorders, dementia, circulatory conditions and musculoskeletal conditions. However, evidence is limited by a disease-specific focus and no systematic examination of sex differences or the role of pre-existing mental disorders.METHODS: We conducted a cohort study using data on social disconnectedness (loneliness, social isolation, low social support and a composite measure) from the 2013 and 2017 Danish National Health Survey linked with register data on 11 broad categories of medical conditions through 2021. Poisson regression was applied to estimate incidence rate ratios (IRRs), incidence rate differences (IRDs), and explore sex differences and interaction with pre-existing mental disorders.RESULTS: Among 162,497 survey participants, 7.6%, 3.5% and 14.8% were classified as lonely, socially isolated and with low social support, respectively. Individuals who were lonely and with low social support had a higher incidence rate in all 11 categories of medical conditions (interquartile range [IQR] of IRRs, respectively 1.26-1.49 and 1.10-1.14), whereas this was the case in nine categories among individuals who were socially isolated (IQR of IRRs, 1.01-1.31). Applying the composite measure, the highest IRR was 2.63 for a mental disorder (95% confidence interval [CI], 2.38-2.91), corresponding to an IRD of 54 (95% CI, 47-61) cases per 10,000 person-years. We found sex and age differences in some relative and absolute estimates, but no substantial deviations from additive interaction with pre-existing mental disorders.CONCLUSIONS: This study advances our knowledge of the risk of medical conditions faced by individuals who are socially disconnected. In addition to the existing evidence, we found higher incidence rates for a broad range of medical condition categories. Contrary to previous evidence, our findings suggest that loneliness is a stronger determinant for subsequent medical conditions than social isolation and low social support.A preregistered analysis plan and statistical code are available at Open Science Framework (https://osf.io/pycrq).

AB - AIMS: Individuals with diminished social connections are at higher risk of mental disorders, dementia, circulatory conditions and musculoskeletal conditions. However, evidence is limited by a disease-specific focus and no systematic examination of sex differences or the role of pre-existing mental disorders.METHODS: We conducted a cohort study using data on social disconnectedness (loneliness, social isolation, low social support and a composite measure) from the 2013 and 2017 Danish National Health Survey linked with register data on 11 broad categories of medical conditions through 2021. Poisson regression was applied to estimate incidence rate ratios (IRRs), incidence rate differences (IRDs), and explore sex differences and interaction with pre-existing mental disorders.RESULTS: Among 162,497 survey participants, 7.6%, 3.5% and 14.8% were classified as lonely, socially isolated and with low social support, respectively. Individuals who were lonely and with low social support had a higher incidence rate in all 11 categories of medical conditions (interquartile range [IQR] of IRRs, respectively 1.26-1.49 and 1.10-1.14), whereas this was the case in nine categories among individuals who were socially isolated (IQR of IRRs, 1.01-1.31). Applying the composite measure, the highest IRR was 2.63 for a mental disorder (95% confidence interval [CI], 2.38-2.91), corresponding to an IRD of 54 (95% CI, 47-61) cases per 10,000 person-years. We found sex and age differences in some relative and absolute estimates, but no substantial deviations from additive interaction with pre-existing mental disorders.CONCLUSIONS: This study advances our knowledge of the risk of medical conditions faced by individuals who are socially disconnected. In addition to the existing evidence, we found higher incidence rates for a broad range of medical condition categories. Contrary to previous evidence, our findings suggest that loneliness is a stronger determinant for subsequent medical conditions than social isolation and low social support.A preregistered analysis plan and statistical code are available at Open Science Framework (https://osf.io/pycrq).

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Female

KW - Health Surveys

KW - Humans

KW - Incidence

KW - Loneliness/psychology

KW - Male

KW - Mental Disorders/epidemiology

KW - Middle Aged

KW - Risk Factors

KW - Sex Factors

KW - Social Isolation/psychology

KW - Social Support

KW - risk factors

KW - mental health

KW - chronic conditions

KW - social network

KW - epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85213982250&partnerID=8YFLogxK

U2 - 10.1017/S2045796024000829

DO - 10.1017/S2045796024000829

M3 - Journal article

C2 - 39711018

SN - 2045-7960

VL - 33

JO - Epidemiology and Psychiatric Sciences

JF - Epidemiology and Psychiatric Sciences

M1 - e81

ER -

Social disconnectedness, subsequent medical conditions, and, the role of pre-existing mental disorders: a population-based cohort study

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Keywords

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