IntroductionLoneliness has social and health implications. The aim of this article is to evaluate the association of loneliness with all-cause mortality.MethodsPubmed, PsycINFO, CINAHL and Scopus databases were searched through June 2016 for published articles that measured loneliness and mortality. The main characteristics and the effect size values of each article were extracted. Moreover, an evaluation of the quality of the articles included was also carried out. A meta-analysis was performed firstly with all the included articles and secondly separating by gender, using a random effects model.ResultsA total of 35 articles involving 77220 participants were included in the systematic review. Loneliness is a risk factor for all-cause mortality [pooled HR = 1.22, 95% CI = (1.10, 1.35), p < 0.001] for both genders together, and for women [pooled HR = 1.26, 95% CI = (1.07, 1.48); p = 0.005] and men [pooled HR = 1.44; 95% CI = (1.19, 1.76); p < 0.001] separately.ConclusionsLoneliness shows a harmful effect for all-cause mortality and this effect is slightly stronger in men than in women. Moreover, the impact of loneliness was independent from the quality evaluation of each article and the effect of depression.

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Our results suggest that subjective well-being is associated with a decreased risk of mortality. Longitudinal studies examining changing levels of well-being and their relationship to longevity would be required to establish a cause-effect relationship. Establishing such a causal relationship would strengthen the case for policy interventions to improve the population subjective well-being to produce longevity gains combined with optimizing quality of life.

Objectives: The number of older adults is rapidly rising globally. Loneliness is a common problem that can deteriorate health. The aims of this work were to identify different types of loneliness (transient and chronic) and to assess their association with depression over time. Methods: A nationally representative sample from the Spanish population comprising 1190 individuals aged 50+ years was interviewed on three evaluations over a 7-year period. The UCLA Loneliness Scale was used to measure loneliness. While chronic loneliness was defined as the presence of loneliness across all three waves, transient loneliness expressed the presence of loneliness in one wave only. A 12-month major depressive episode was assessed at each interview. After confirming the crosssectional relationship, a multilevel mixed-effects model was used to examine the association between loneliness and depression. Results: Almost a quarter of individuals felt lonely and one out of 10 presented depression at baseline. Of the sample, 22.78% showed transient loneliness, while 6.72% presented the chronic type. People experiencing chronic loneliness were at a higher risk of presenting major depression (OR = 6.11; 95% CI = 2.62, 14.22) than those presenting transient loneliness (OR = 2.22; 95% CI = 1.19, 4.14). This association varied over time and was stronger at the first follow-up than at the second one. Conclusions: Focusing on loneliness prevention could reduce the risk of depression. Chronic loneliness is a public health problem that should be addressed through the full participation of the political, social, and medical sectors.

Objective: Loneliness is associated with worse health status outcomes. Yet, the present study is one of the first to identify how patterns of loneliness (transient and chronic), are associated with health over time.Design: A total of 2,390 individuals were interviewed in 2011-12 and 2014-15 in a follow-up study conducted over a nationally representative sample of Spain. After confirming a longitudinal relationship between loneliness and health status, a Growth curve Mixture Modeling (GMM) was used to examine health trajectories.Main outcome measures: The three-item UCLA Loneliness Scale was used to assess loneliness. Health status was measured with self-reported questions regarding ten domains (vision, mobility, and self-care, among others), and seven measured tests (including grip strength, walking speed and immediate and delayed verbal recall).Results: A quarter of participants were lonely at baseline. Both the group of transient and chronic loneliness showed a negative significant relationship with health status at follow-up, (β = -0.063 and β = -0.075 respectively, p < 0.001). Nevertheless, the health status did not change across time in any group. Conclusion: People experiencing chronic loneliness had the worst health status.Different patterns of loneliness could benefit from the appropriate interventions.

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