Abstract：
BACKGROUND: Social isolation (SI) was recently identified as a significant public health issue in the United States. Consequently, several studies on the association between SI and mental health were conducted. However, few studies have considered the duration and intensity of SI. In the present study, a longitudinal analysis was conducted to determine the effect of the intensity of persistent SI on the mental health status of late middle-aged and older Koreans.
METHODS: After excluding missing values, data on 6200 participants were analyzed using the group-based trajectory model (GBTM) from the first to fifth Korean Longitudinal Study of Ageing (KLoSA) to categorise the SI trajectory (SIT). The Chi-square test, t-test, analysis of variance, and time-lagged generalised estimation equations were utilised from the fifth to eighth KLoSA to determine the association between SIT and the incidence of cognitive decline (the group with a Korean version Mini-Mental State Examination score of 23 or lower), cognitive function score, and depression score.
RESULTS: Four SIT groups were identified in the GBTM analysis. These were the non-SIT (21.7%), mild (46.8%), moderate (21.1%), and severe SIT (10.4%) groups. Compared to the non-SIT group, the severe SIT group experienced a greater incidence of cognitive decline (odds ratio = 1.57, P < 0.0001) as well as poorer cognitive function scores (B = -0.63, P < 0.0001) and depression scores (B = 0.90, P < 0.0001). Furthermore, stratified analysis by sex and age showed that mental health status was inversely proportionate to the intensity of SIT, particularly in males and patients, aged 65 years and above.
CONCLUSIONS: A close association was observed between SIT and mental health. This finding highlighted the need for policies and institutional measures to reduce the incidence of mental health deterioration among vulnerable groups due to the intensity of SI.
METHODS: After excluding missing values, data on 6200 participants were analyzed using the group-based trajectory model (GBTM) from the first to fifth Korean Longitudinal Study of Ageing (KLoSA) to categorise the SI trajectory (SIT). The Chi-square test, t-test, analysis of variance, and time-lagged generalised estimation equations were utilised from the fifth to eighth KLoSA to determine the association between SIT and the incidence of cognitive decline (the group with a Korean version Mini-Mental State Examination score of 23 or lower), cognitive function score, and depression score.
RESULTS: Four SIT groups were identified in the GBTM analysis. These were the non-SIT (21.7%), mild (46.8%), moderate (21.1%), and severe SIT (10.4%) groups. Compared to the non-SIT group, the severe SIT group experienced a greater incidence of cognitive decline (odds ratio = 1.57, P < 0.0001) as well as poorer cognitive function scores (B = -0.63, P < 0.0001) and depression scores (B = 0.90, P < 0.0001). Furthermore, stratified analysis by sex and age showed that mental health status was inversely proportionate to the intensity of SIT, particularly in males and patients, aged 65 years and above.
CONCLUSIONS: A close association was observed between SIT and mental health. This finding highlighted the need for policies and institutional measures to reduce the incidence of mental health deterioration among vulnerable groups due to the intensity of SI.
摘要：
背景：社会隔离（SI）最近在美国被认为是一个重要的公共卫生问题。因此,我们对SI与心理健康之间的关联进行了多项研究.然而,很少有研究考虑SI的持续时间和强度。在本研究中,进行了纵向分析,以确定持续性SI强度对中老年韩国人心理健康状况的影响.
方法：排除缺失值后，我们使用基于群组的轨迹模型(GBTM)对来自第一至第五次韩国老龄化纵向研究(KLoSA)的6,200名参与者的数据进行了分析,以对SI轨迹(SIT)进行分类.卡方检验,t检验,方差分析，从第五到第八KLoSA，利用时滞广义估计方程来确定SIT与认知能力下降发生率之间的关联（韩国版Mini-精神状态检查评分为23分或更低的组），认知功能评分,和抑郁评分。
结果：在GBTM分析中确定了四个SIT组。这些是非SIT(21.7%)，轻度(46.8%)，中等(21.1%)，和严重SIT（10.4%）组。与非SIT组相比，重度SIT组的认知功能减退发生率较高(比值比=1.57,P<0.0001),认知功能评分(B=-0.63,P<0.0001)和抑郁评分(B=0.90,P<0.0001).此外，按性别和年龄进行的分层分析表明，心理健康状况与SIT的强度成反比，尤其是男性和患者，65岁及以上。
结论：观察到SIT与心理健康之间存在密切关联。这一发现强调了需要采取政策和体制措施，以减少由于SI的强度而导致弱势群体心理健康恶化的发生率。
方法：排除缺失值后，我们使用基于群组的轨迹模型(GBTM)对来自第一至第五次韩国老龄化纵向研究(KLoSA)的6,200名参与者的数据进行了分析,以对SI轨迹(SIT)进行分类.卡方检验,t检验,方差分析，从第五到第八KLoSA，利用时滞广义估计方程来确定SIT与认知能力下降发生率之间的关联（韩国版Mini-精神状态检查评分为23分或更低的组），认知功能评分,和抑郁评分。
结果：在GBTM分析中确定了四个SIT组。这些是非SIT(21.7%)，轻度(46.8%)，中等(21.1%)，和严重SIT（10.4%）组。与非SIT组相比，重度SIT组的认知功能减退发生率较高(比值比=1.57,P<0.0001),认知功能评分(B=-0.63,P<0.0001)和抑郁评分(B=0.90,P<0.0001).此外，按性别和年龄进行的分层分析表明，心理健康状况与SIT的强度成反比，尤其是男性和患者，65岁及以上。
结论：观察到SIT与心理健康之间存在密切关联。这一发现强调了需要采取政策和体制措施，以减少由于SI的强度而导致弱势群体心理健康恶化的发生率。
