OBJECTIVES: To compare levels of social isolation in aging veterans with and without the human immunodeficiency virus (HIV) and determine associations with hospital admission and mortality. DESIGN: Longitudinal data analysis. SETTING: The Veterans Aging Cohort Study (VACS), at eight VA Medical Centers nationally. PARTICIPANTS: Veterans aged 55 and older enrolled in VACS from 2002 to 2008 (N = 1,836). MEASUREMENTS: A Social Isolation Score (SIS) was created using baseline survey responses about relationship status; number of friends and family and frequency of visits; and involvement in volunteer work, religious or self-help groups, and other community activities. Scores were compared according to age and HIV status, and multivariable regression was used to assess effects of SIS on hospital admission and all-cause mortality. RESULTS: Mean SIS was higher for HIV-positive (HIV+) individuals, with increasing difference according to age (P = .01 for trend). Social isolation was also more prevalent for HIV+ (59%) than uninfected participants (51%, P < .001). In multivariable regression analysis of HIV+ and uninfected groups combined, adjusted for demographic and clinical features, isolation was independently associated with greater risk of incident hospitalization (hazard rate (HR) = 1.25, 95% confidence interval (CI) = 1.09-1.42) and risk of all-cause mortality (HR=1.28, 95% CI = 1.06-1.54). Risk estimates calculated for HIV+ and uninfected groups separately were not significantly different. CONCLUSION: Social isolation is associated with greater risk of hospitalization and death in HIV+ and uninfected older veterans. Despite similar effects in both groups, the population-level effect of social isolation may be greater in those who are HIV+ because of the higher prevalence of social isolation, particularly in the oldest individuals.
OBJECTIVES: To compare levels of social isolation in aging veterans with and without the human immunodeficiency virus (HIV) and determine associations with hospital admission and mortality. DESIGN: Longitudinal data analysis. SETTING: The Veterans Aging Cohort Study (VACS), at eight VA Medical Centers nationally. PARTICIPANTS: Veterans aged 55 and older enrolled in VACS from 2002 to 2008 (N = 1,836). MEASUREMENTS: A Social Isolation Score (SIS) was created using baseline survey responses about relationship status; number of friends and family and frequency of visits; and involvement in volunteer work, religious or self-help groups, and other community activities. Scores were compared according to age and HIV status, and multivariable regression was used to assess effects of SIS on hospital admission and all-cause mortality. RESULTS: Mean SIS was higher for HIV-positive (HIV+) individuals, with increasing difference according to age (P = .01 for trend). Social isolation was also more prevalent for HIV+ (59%) than uninfected participants (51%, P < .001). In multivariable regression analysis of HIV+ and uninfected groups combined, adjusted for demographic and clinical features, isolation was independently associated with greater risk of incident hospitalization (hazard rate (HR) = 1.25, 95% confidence interval (CI) = 1.09-1.42) and risk of all-cause mortality (HR=1.28, 95% CI = 1.06-1.54). Risk estimates calculated for HIV+ and uninfected groups separately were not significantly different. CONCLUSION: Social isolation is associated with greater risk of hospitalization and death in HIV+ and uninfected older veterans. Despite similar effects in both groups, the population-level effect of social isolation may be greater in those who are HIV+ because of the higher prevalence of social isolation, particularly in the oldest individuals.
Authors: P A Selwyn; J L Goulet; S Molde; J Constantino; K P Fennie; P Wetherill; D M Gaughan; H Brett-Smith; C Kennedy Journal: J Urban Health Date: 2000-06 Impact factor: 3.671
Authors: Amy C Justice; Elizabeth Dombrowski; Joseph Conigliaro; Shawn L Fultz; Deborah Gibson; Tamra Madenwald; Joseph Goulet; Michael Simberkoff; Adeel A Butt; David Rimland; Maria C Rodriguez-Barradas; Cynthia L Gibert; Kris Ann K Oursler; Sheldon Brown; David A Leaf; Matthew B Goetz; Kendall Bryant Journal: Med Care Date: 2006-08 Impact factor: 2.983
Authors: Margaret A Chesney; Donald B Chambers; Jonelle M Taylor; Lisa M Johnson Journal: J Acquir Immune Defic Syndr Date: 2003-06-01 Impact factor: 3.731
Authors: Silvia Stringhini; Lisa Berkman; Aline Dugravot; Jane E Ferrie; Michael Marmot; Mika Kivimaki; Archana Singh-Manoux Journal: Am J Epidemiol Date: 2012-04-24 Impact factor: 4.897
Authors: Amanda A Allshouse; Sam MaWhinney; Catherine M Jankowski; Wendy M Kohrt; Thomas B Campbell; Kristine M Erlandson Journal: J Acquir Immune Defic Syndr Date: 2015-06-01 Impact factor: 3.731
Authors: Krupa Shah; James M McMahon; Nicole Trabold; Angela A Aidala; Michael Chen; Enrique R Pouget; Janie Simmons; Keith Klostermann Journal: AIDS Care Date: 2015-03-27
Authors: Latesha Elopre; Andrew O Westfall; Michael J Mugavero; Anne Zinski; Greer Burkholder; Edward W Hook; Nicholas Van Wagoner Journal: AIDS Behav Date: 2016-01
Authors: Tasneem Khambaty; Jesse C Stewart; Samir K Gupta; Chung-Chou H Chang; Roger J Bedimo; Matthew J Budoff; Adeel A Butt; Heidi Crane; Cynthia L Gibert; David A Leaf; David Rimland; Hilary A Tindle; Kaku A So-Armah; Amy C Justice; Matthew S Freiberg Journal: JAMA Cardiol Date: 2016-11-01 Impact factor: 14.676
Authors: S Duke Han; Oluwatoyin Adeyemi; Robert S Wilson; Sue Leurgans; Antonio Jimenez; Lawrence Oullet; Raj Shah; Alan Landay; David A Bennett; Lisa L Barnes Journal: Gerontology Date: 2017-01-27 Impact factor: 5.140