TY - JOUR
T1 - Association Between Social Isolation With Age-Gap Determined by Artificial Intelligence-Enabled Electrocardiography
AU - Rajai, Nazanin
AU - Medina-Inojosa, Jose R.
AU - Lewis, Bradley R.
AU - Sheffeh, Mohammad Ali
AU - Baez-Suarez, Abraham
AU - Nyman, Mark
AU - Attia, Zachi I.
AU - Lerman, Lilach O.
AU - Medina-Inojosa, Betsy J.
AU - Friedman, Paul Andrew
AU - Lopez-Jimenez, Francisco
AU - Lerman, Amir
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024
Y1 - 2024
N2 - Background: Loneliness and social isolation are associated with poor health outcomes such as an increased risk of cardiovascular diseases. Objectives: The authors aimed to explore the association between social isolation with biological aging which was determined by artificial intelligence-enabled electrocardiography (AI-ECG) as well as the risk of all-cause mortality. Methods: The study included adults aged ≥18 years seen at Mayo Clinic from 2019 to 2022 who respond to a survey for social isolation assessment and had a 12-lead ECG within 1 year of completing the questionnaire. Biological age was determined from ECGs using a previously developed and validated convolutional neural network (AI-ECG age). Age-Gap was defined as AI-ECG age minus chronological age, where positive values reflect an older-than-expected age. The status of social isolation was measured by the previously validated multiple-choice questions based on Social Network Index (SNI) with score ranges between 0 (most isolated) and 4 (least isolated). Results: A total of 280,324 subjects were included (chronological age 59.8 ± 16.4 years, 50.9% female). The mean Age-Gap was −0.2 ± 9.16 years. A higher SNI was associated with a lower Age-Gap (β of SNI = 4 was −0.11; 95% CI: −0.22 to −0.01; P < 0.001, adjusted to covariates). Cox proportional hazard analysis revealed the association between social connection and all-cause mortality (HR for SNI = 4, 0.47; 95% CI: 0.43-0.5; P < 0.001). Conclusions: Social isolation is associated with accelerating biological aging and all-cause mortality independent of conventional cardiovascular risk factors. This observation underscores the need to address social connection as a health care determinant.
AB - Background: Loneliness and social isolation are associated with poor health outcomes such as an increased risk of cardiovascular diseases. Objectives: The authors aimed to explore the association between social isolation with biological aging which was determined by artificial intelligence-enabled electrocardiography (AI-ECG) as well as the risk of all-cause mortality. Methods: The study included adults aged ≥18 years seen at Mayo Clinic from 2019 to 2022 who respond to a survey for social isolation assessment and had a 12-lead ECG within 1 year of completing the questionnaire. Biological age was determined from ECGs using a previously developed and validated convolutional neural network (AI-ECG age). Age-Gap was defined as AI-ECG age minus chronological age, where positive values reflect an older-than-expected age. The status of social isolation was measured by the previously validated multiple-choice questions based on Social Network Index (SNI) with score ranges between 0 (most isolated) and 4 (least isolated). Results: A total of 280,324 subjects were included (chronological age 59.8 ± 16.4 years, 50.9% female). The mean Age-Gap was −0.2 ± 9.16 years. A higher SNI was associated with a lower Age-Gap (β of SNI = 4 was −0.11; 95% CI: −0.22 to −0.01; P < 0.001, adjusted to covariates). Cox proportional hazard analysis revealed the association between social connection and all-cause mortality (HR for SNI = 4, 0.47; 95% CI: 0.43-0.5; P < 0.001). Conclusions: Social isolation is associated with accelerating biological aging and all-cause mortality independent of conventional cardiovascular risk factors. This observation underscores the need to address social connection as a health care determinant.
KW - artificial intelligence
KW - biological aging
KW - cardiovascular disease
KW - social connection
KW - social isolation
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U2 - 10.1016/j.jacadv.2024.100890
DO - 10.1016/j.jacadv.2024.100890
M3 - Article
AN - SCOPUS:85188068526
SN - 2772-963X
JO - JACC: Advances
JF - JACC: Advances
M1 - 100890
ER -