ASSOCIATION OF SOCIAL ISOLATION AND LONELINESS WITH MORTALITY IN INDIVIDUALS WITH OSTEOARTHRITIS: AN ANALYSIS OF THE UK BIOBANK COHORT

Background: Both social isolation and loneliness were associated with an increased risk of all-cause mortality in general population. However, there is still limited evidence elucidating the relationship between social isolation, loneliness, and all-cause mortality in osteoarthritis patients. Objectives: To investigate the prospective associations of social isolation and loneliness with risk of all-cause mortality in osteoarthritis patients and to compare the relative importance of social isolation and loneliness with traditional risk factors. Methods: A total of 55, 497 participants diagnosed with osteoarthritis from the UK Biobank were included. A two-item scale and a three-item scale were used to assess loneliness and isolation levels, respectively. The information of all-cause mortality was obtained through linkage to registries. Cox proportional hazard model was used to elucidate the relationship between isolation or loneliness and mortality in osteoarthritis participants. The relative importance of risk factors was measured by the R and concordance of the models. Population attributable fractions (PAFs) for all-cause mortality and isolation/ loneliness were estimated. Results: During a median follow-up of 12.57 years, 6, 186 all-cause deaths occurred. Compared to participants with the least social isolation score, those with a higher social isolation score were associated with a higher risk of all-cause mortality among individuals with osteoarthritis (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.10-1.23 for moderately isolation; HR 1.39, 95%CI 1.29-1.50 for most isolation; p for trend < 0.001). Stronger effect sizes were observed among female, younger individuals and non-obese individuals (all p for additive interaction < 0.1). Loneliness was significantly associated with a higher risk of all-cause mortality (HR 1.15, 95%CI 1.04-1.26). Social isolation ranked higher in relative strength for predicting all-cause mortality than loneliness, and common lifestyle risk factors (except for smoking) among individuals with osteoarthritis. In the PAFs analyses, 0.93% (95% CI 0.31%, 1.55%), 6.36% (95% CI 3.82%, 8.91%), and 8.57% (95% CI 6.54%, 10.59%) of deaths were attributable to loneliness, moderately isolation, and most isolation, respectively. Conclusion: Among individuals diagnosed with osteoarthritis, social isolation and loneliness were significantly associated with an increased risk of all-cause mortality, where isolation was a stronger predictor and exhibited a higher PAF for all-cause mortality than loneliness and common lifestyle risk factors except for smoking. These findings highlight the importance of social support, which could reduce premature mortality in individuals with osteoarthritis. REFERENCES: [1] Wang F, Gao Y, Han Z, et.al. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav. 2023 Aug;7(8):1307-1319. doi: 10.1038/s41562-023-01617-6. [2] Wang X, Ma H, Li X, et.al. Joint association of loneliness and traditional risk factor control and incident cardiovascular disease in diabetes patients. Eur Heart J. 2023 Jul 21;44(28):2583-2591. doi: 10.1093/eurheartj/ehad306. Acknowledgements: This study makes use of data from UK Biobank (Project ID: 67654) and we thank the UK Biobank participants and the UK Biobank team for generating an important research resource. Disclosure of Interests: None declared. DOI: 10.1136/annrheumdis-2024-eular.3707 Keywords: Epidemiology, Observational studies/ registry, Lifestyles Citation: , volume 83, supplement 1, year 2024, page 664Session: Osteoarthritis and other mechanical musculoskeletal problems (Poster View)

Epidemiology, Observational studies/ registry, Lifestyles