关于社会隔离的脆弱性和影响是否因人群而异的数据有限。旨在探讨社会隔离与全因死亡率、心血管疾病（CVD）和恶性肿瘤之间的关联，重点关注社会人口因素的异质性。这项队列研究使用 2010 年和 2011 年日本老年学评估研究的基线数据，采用主持人范围的方法来检查社会隔离与全因死亡率、心血管疾病死亡率和恶性肿瘤死亡率之间的异质性。合格的参与者是 65 岁或以上的成年人在日本 12 个城市中没有心脏病、中风、癌症或日常生活活动受损。随访持续至 2017 年 12 月 31 日，确定了 6 年全因死亡率、心血管疾病 (CVD) 死亡率和恶性肿瘤死亡率。逻辑回归评估了年龄、性别、教育、收入、人口密度、婚姻状况和就业对死亡率关联的影响。数据分析于2023年9月13日至2024年3月17日进行。社会隔离，由3项量表确定（2或3分表示隔离）是主要暴露变量。六年全因、CVD、本研究纳入了 37604 名老年人，平均 (SD) 年龄为 73.5 (5.9) 岁（21073 名女性 [56.0%]）。共有 10094 名参与者 (26.8%) 被归类为经历社会孤立。社会隔离与全因死亡率（比值比 [OR]，1.20 [95% CI，1.09-1.32]）、CVD（OR，1.22 [95% CI，0.98-1.52]）和恶性肿瘤死亡率（OR）增加相关，1.14 [95% CI，1.01-1.28]）。分层分析显示，高收入人群的社会隔离与全因死亡率和恶性肿瘤死亡率存在关联（最高三分位全因死亡率：OR，1.27 [95% CI，1.06-1.53​​]；恶性肿瘤：OR，1.27 [95% CI， 1.02-1.60]），生活在人口密度高的地区（所有原因最高三分位数：OR，1.47 [95% CI，1.26-1.72]；恶性肿瘤：OR，1.38 [95% CI，1.11-1.70]），不已婚（所有原因：OR，1.33 [95% CI，1.15-1.53​​]；恶性肿瘤：OR，1.25 [95% CI，1.02-1.52]）和退休人员（所有原因：OR，1.27 [95% CI，1.14] -1.43]；恶性肿瘤：OR，1.27 [95% CI，1.10-1.48]）。对影响修正的正式测试表明，人口密度和就业对全因死亡率以及家庭收入和就业对肿瘤死亡率的影响有所改变。社会隔离与全因死亡率、心血管疾病死亡率和恶性肿瘤死亡率的风险增加相关，且相关性因人而异。人口。这项研究填补了社会孤立研究的一个重要空白，强调了社会孤立在人口和社会经济群体中的不同关联。

There are limited data on whether the vulnerabilities and impacts of social isolation vary across populations.To explore the association between social isolation and mortality due to all causes, cardiovascular diseases (CVD), and malignant neoplasms focusing on heterogeneity by sociodemographic factors.This cohort study used a moderator-wide approach to examine the heterogeneity in the association of social isolation with all-cause, CVD, and malignant neoplasm mortality using baseline data from the Japan Gerontological Evaluation Study in 2010 and 2011. Eligible participants were adults aged 65 years or older without heart disease, stroke, cancer, or impaired activity of daily living across 12 Japanese municipalities. Follow-up continued until December 31, 2017, identifying 6-year all-cause, cardiovascular disease (CVD), and malignant neoplasm mortality. Logistic regression assessed effect modification by age, gender, education, income, population density, marital status, and employment on mortality associations. Data analysis was performed from September 13, 2023, to March 17, 2024.Social isolation, determined by a 3-item scale (scores of 2 or 3 indicating isolation) was the primary exposure variable.Six-year all-cause, CVD, and malignant neoplasms mortality.This study included 37 604 older adults, with a mean (SD) age of 73.5 (5.9) years (21 073 women [56.0%]). A total of 10 094 participants (26.8%) were classified as experiencing social isolation. Social isolation was associated with increased all-cause (odds ratio [OR], 1.20 [95% CI, 1.09-1.32]), CVD (OR, 1.22 [95% CI, 0.98-1.52]), and malignant neoplasm mortality (OR, 1.14 [95% CI, 1.01-1.28]). Stratified analysis showed associations of social isolation with all-cause and malignant neoplasm mortality among people with high income (highest tertile all cause: OR, 1.27 [95% CI, 1.06-1.53]; malignant neoplasm: OR, 1.27 [95% CI, 1.02-1.60]), living in areas with high population density (highest tertile all cause: OR, 1.47 [95% CI, 1.26-1.72]; malignant neoplasm: OR, 1.38 [95% CI, 1.11-1.70]), not married (all cause: OR, 1.33 [95% CI, 1.15-1.53]; malignant neoplasm: OR, 1.25 [95% CI, 1.02-1.52]), and retirees (all cause: OR, 1.27 [95% CI, 1.14-1.43]; malignant neoplasm: OR, 1.27 [95% CI, 1.10-1.48]). Formal testing for effect modification indicated modification by population density and employment for all-cause mortality and by household income and employment for neoplasm mortality.Social isolation was associated with increased risks of all-cause, CVD, and malignant neoplasm mortality, with associations varying across populations. This study fills an important gap in research on social isolation, emphasizing its varied associations across demographic and socioeconomic groups.