Abstract
BACKGROUND: To explore the potential classes of social isolation in older patients with chronic obstructive pulmonary disease (COPD), analyze the influencing factors of these classes, and investigate the relationship between different classes and cognitive function. METHODS: From April to December 2024, a convenience sampling method was used to survey older COPD patients at a tertiary hospital in Shanxi Province. The general information questionnaire, Social Network Scale Brief, Hamilton Depression Scale, Social Support Rating Scale, and Montreal Cognitive Assessment Scale were employed. Latent profile analysis was conducted to categorize social isolation in older COPD patients. Uni-variate and multivariate analyses were used to explore the influencing factors of different social isolation classes, and a mixed-effects regression model was applied to analyze the relationship between these classes and cognitive function. RESULTS: A total of 245 older COPD patients were included, with 33.5% experiencing social isolation. Social isolation in older COPD patients could be divided into three classes, named "High Social Isolation-Interaction Deficiency Group", "Moderate Social Isolation-Moderate Interaction Group", and "Low Social Isolation-Coordinated Relationship Development Group", accounting for 27.4%, 43.9%, and 28.7% of the sample, respectively. The unordered multinomial results indicated that older age, living alone, annual household income per capital below 7000-Yuan, acute exacerbation history within the last month, and high levels of depression were more likely to be associated with the "High Social Isolation-Interaction Deficiency Group". Patients with low education levels and annual household income per capital between 7000 and 15,000 Yuan were more likely to belong to the "Moderate Social Isolation-Moderate Interaction Group". Patients with moderate airflow limitation, long disease duration, and high levels of social support were more likely to belong to the "Low Social Isolation-Coordinated Relationship Development Group". The mixed-effects regression model analysis showed that patients in the "High Social Isolation-Interaction Deficiency Group" were at a higher risk of cognitive impairment compared to the other two groups. CONCLUSION: The findings reveal a significant association between social isolation patterns and cognitive dysfunction risk in older COPD patients. Nurses and healthcare providers should prioritize screening for cognitive impairment in the "High Social Isolation-Interaction Deficiency Group", as this subgroup exhibits the highest prevalence of cognitive deficits. Future interventions may consider tailoring strategies to address distinct social isolation profiles, pending validation through longitudinal or experimental studies to establish causal pathways.