TY - JOUR
T1 - Impact of social isolation on subsequent peptic ulcer recurrence in older adults with mild cognitive impairment
T2 - The role of change in severity of depression
AU - Fang, Boye
AU - Liu, Huiying
AU - Yang, Shuyan
AU - Xu, Ruirui
AU - Chen, Gengzhen
N1 - Funding Information:
Source of Funding and Conflicts of Interest: The study received financial support from the Medical Research Foundation of Guangdong Province (B2015047). The sponsors hold no role in study design, data collection, data analyses, interpretation of study results, manuscript submission, or article publication. The authors declare no conflicts of interest.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objective: This study aimed to examine the association between social isolation, change in severity of depression, and subsequent recurrence of peptic ulcer disease (PUD) in older adults with mild cognitive impairment. Methods: Older adults (≥55 years) with mild cognitive impairment and Helicobacter pylori–infected PUD (N = 2208) were recruited between 2010 and 2014 from 12 hospitals in the People’s Republic of China. H. pylori was eradicated and PUD was cleared in 2015 participants by the end of 2014; 1900 of these were followed up for up to 36 months. The Kaplan-Meier method was used to assess how PUD recurrence varied with social engagement levels and changes in depression severity. Multivariate Cox proportional hazard models were used to examine associations between social isolation, changes in depression severity, and PUD recurrence. Results: PUD recurrence was more prevalent in socially isolated (10.8%) than in socially engaged participants (5.5%). However, the rates of PUD were lower in socially isolated individuals without (absence of) depression (7.2%) and those with decreased depression (8.2%), whereas socially isolated individuals with unchanged and increased depression had substantially higher rates of PUD (16.3% and 17.8%, respectively; the social isolation by depression group for PUD recurrence was significant (p < .001). Specifically, although social isolation was associated with PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 2.665 [1.602–4.518]), it did not increase PUD recurrence risk in participants without depression or with reduced depression. However, in participants with unchanged or increased depression, PUD recurrence was more likely to occur in socially isolated (HR = 1.587 [1.125–2.588]; HR = 1.886 [1.012, 3.522] respectively) than in socially engaged participants. Conclusions: Social isolation is associated with a greater risk of PUD recurrence; however, the absence of or decreased severity of depression may alter this relationship.
AB - Objective: This study aimed to examine the association between social isolation, change in severity of depression, and subsequent recurrence of peptic ulcer disease (PUD) in older adults with mild cognitive impairment. Methods: Older adults (≥55 years) with mild cognitive impairment and Helicobacter pylori–infected PUD (N = 2208) were recruited between 2010 and 2014 from 12 hospitals in the People’s Republic of China. H. pylori was eradicated and PUD was cleared in 2015 participants by the end of 2014; 1900 of these were followed up for up to 36 months. The Kaplan-Meier method was used to assess how PUD recurrence varied with social engagement levels and changes in depression severity. Multivariate Cox proportional hazard models were used to examine associations between social isolation, changes in depression severity, and PUD recurrence. Results: PUD recurrence was more prevalent in socially isolated (10.8%) than in socially engaged participants (5.5%). However, the rates of PUD were lower in socially isolated individuals without (absence of) depression (7.2%) and those with decreased depression (8.2%), whereas socially isolated individuals with unchanged and increased depression had substantially higher rates of PUD (16.3% and 17.8%, respectively; the social isolation by depression group for PUD recurrence was significant (p < .001). Specifically, although social isolation was associated with PUD recurrence during the 36-month follow-up period (hazard ratio [HR] = 2.665 [1.602–4.518]), it did not increase PUD recurrence risk in participants without depression or with reduced depression. However, in participants with unchanged or increased depression, PUD recurrence was more likely to occur in socially isolated (HR = 1.587 [1.125–2.588]; HR = 1.886 [1.012, 3.522] respectively) than in socially engaged participants. Conclusions: Social isolation is associated with a greater risk of PUD recurrence; however, the absence of or decreased severity of depression may alter this relationship.
KW - Change in the severity of depression
KW - Mild cognitive impairment
KW - Older adults
KW - Peptic ulcer disease recurrence
KW - Social isolation
UR - http://www.scopus.com/inward/record.url?scp=85079090636&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000000772
DO - 10.1097/PSY.0000000000000772
M3 - Journal article
C2 - 31794441
AN - SCOPUS:85079090636
SN - 0033-3174
VL - 82
SP - 197
EP - 207
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
IS - 2
ER -
