Cardiovascular
Gender-specific population attributable fractions for cardiovascular disease and all-cause mortality associated with living arrangement in community-dwelling older people Rosanne Freak-Poli* Rosanne Freak-Poli Achamyeleh Birhanu Teshale Htet Lin Htun Alice J. Owen James R. Baker Irja Isaksen
Background: Living alone poses significant social and health risks. No studies have yet examined the population attributable fraction (PAF) for cardiovascular disease (CVD) and all-cause mortality associated with living alone.
Aim: To assess the PAF for CVD and all-cause mortality related to living alone, and not living with a partner/spouse.
Methods: This study used longitudinal data from the Aspirin in Reducing Events in the Elderly (ASPREE) trial and its sub-study, the ASPREE Longitudinal Study of Older Persons (ALSOP), which included 5,853 men and 6,998 women followed for up to 12 years. The participants were community-dwelling healthy older adults aged >70 years without CVD, dementia, or significant physical disability. Adjusting for social determinants and clinical risk factors, the gender-specific PAFs of CVD and all-cause mortality attributable were determined. Not living with a partner/spouse was defined as living alone or with someone other than a partner/spouse.
Results: Living alone was more prevalent among women (41%) than men (17%, p<0.001). Among men, the PAFs for CVD and all-cause mortality attributable to living alone were very low and not statistically significant (only 2.9% of CVD events and 3.6% of all-cause mortality rates, Figure). In contrast, for women, these PAFs were higher and statistically significant, 13.5% of CVD events and 9.8% of all-cause mortalities were attributed to living alone. Patterns were similar for PAFs associated with not living with a partner/spouse but slightly greater in magnitude and reached statistical significance for all-cause mortality for men (6.0%).
Conclusion: Our findings demonstrate that living alone contributes to the population CVD risk and all-cause mortality. Our findings demonstrate that older women are more likely to live alone and their risk is greater, when compared to men. These findings have critical implications for “Ageing in Place” policies.
