Associations between inflammatory bowel disease, social isolation, and mortality: evidence from a longitudinal cohort study

Abstract

Background: Social well-being of patients with inflammatory bowel disease (IBD) is garnering increased attention; however, the impact of social isolation remained poorly understood. Objectives: We investigated the joint association of social isolation and IBD with premature deaths to articulate the profound impact of social isolation in IBD prognosis. Design: Longitudinal cohort study. Methods: We leveraged data of 486,014 participants from UK Biobank (including 5791 with IBD), the mean follow-up was 11.84 years. Diagnoses of IBD and its subtypes of Crohn’s disease (CD) and ulcerative colitis were confirmed with the combination of self-reporting, primary care, and hospital admission data. Social isolation was measured by the frequency of meeting family/friends, leisure and social activity, and communal/solitary living. Mortality was ascertained through data linkage with national death registries. Multivariable Cox regression models were conducted to estimate hazard ratio (HR) and 95% confidence interval (CI). Results: Comparing non-isolated non-IBD population, the HRs of mortality in patients with IBD who were socially isolated or not were 2.06 (95% CI: 1.69, 2.51) and 1.33 (95% CI: 1.21, 1.45), respectively. The excess risk of death was observed in socially isolated patients with IBD (HR = 1.69, 95% CI: 1.36, 2.11), particularly among patients with CD (HR = 2.06, 95% CI: 1.48, 2.87) than their non-isolated counterparts. Data from subgroup and sensitivity analyses were consistent with those from the primary analysis. Conclusion: Socially isolated patients with IBD especially CD increases the risk of premature death. Preventing social isolation might be a promising approach to improve IBD prognosis. Plain language summary Social isolation as a risk factor to excess mortality in patients with IBD: findings from a longitudinal cohort study Social isolation is prevalent in individuals with inflammatory bowel disease (IBD); however, its potential health impact on IBD prognosis has not been quantitatively well examined. In this study, we explored the association between social isolation and subsequent death, with the focus on patients with IBD. We leveraged data of 486,014 participants (including 5791 with IBD) from UK Biobank. We measured social isolation by the frequency of meeting family/friends, leisure and social activity, and communal/solitary living. We ascertained patients with IBD and mortality by self-report data and data linkage with primary care, hospital, and national death registry. Participants were followed up for a mean of 11.84 years. Comparing non-isolated non-IBD population, we found that patients with IBD who were deemed as socially isolated or not were associated with a 2.06-fold (1.69–2.51) and 1.33-fold (1.21–1.45) risk of death, respectively. Furthermore, we revealed that socially isolated patients with IBD and subtype Crohn’s disease (CD) had 69% (36–111%) and 106% (48–187%) increased risk of premature death compared with their non-isolated counterparts, respectively. Social isolation merits attention in IBD care and management. Patients with IBD, especially CD, are more likely to be affected when socially isolated. Targeted social support strategies ought to be devised to improve IBD prognosis.

Effects of Continuous Nursing on the Disease Uncertainty, Coping Strategies and Quality of Sleep and Life of Patients with Inflammatory Bowel Disease

“…Another important phenomenon in the incidence of IBD is its genetic tendency; it is not only a polygenic disease but also a genetically heterogeneous disease (caused by different genes in different people). 18 Therefore, patients with IBD often feel sorry for themselves and lack confidence. The results of this study showed that, in the control group, the face, avoidance and yield scores were 19.10 ± 3.16, 16.69 ± 2.03 and 9.83 ± 3.04, respectively.…”

Crohn’s disease and breast cancer: a literature review of the mechanisms and treatment

“…Patients with IBD have been reported to be at high risk for social isolation due to the stress associated with the disease, negative patient perception of social support systems and social stigma resulting from lack of public awareness. In one study with a mean follow-up period of 11.84 years, Cox proportional risk assessment showed that IBD patients who were socially isolated had a 69% increased risk of premature death compared with IBD/CD/ulcerative colitis (UC) patients who were not socially isolated, and this risk was more strongly associated with the CD subtype [ 47 ]. In the meta-IVW analysis, gene-predicted IBD was associated with depression [ 48 ].…”