A unified approach to loneliness

Fried, Linda P.; Prohaska, Thomas R.; Burholt, Vanessa; Burns, Annette; Golden, Jeannette; Hawkley, Louise C.; Lawlor, Brian A.; Leavey, Gerard; Lubben, James E.; O’Sullivan, Roger; Perissinotto, Carla; Tilburg, T.G. van; Tully, Mark A.; Chapot, Victor

doi:10.1016/s0140-6736(19)32533-4

Cited by 84 publications

(87 citation statements)

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“…This is not to say that the correlation between loneliness and cognition or the health factors that mediate the correlation are not interesting; indeed, they are. But such small effects must be contextualized, as many older adults do not feel lonely [76]. The present study further suggests that older adults who report feeling lonely may not be as beset with worse physical and psychological health as is assumed sometimes nor at increased risk for cognitive decline and impairment.…”

Section: Importance Of Health Factors In the Temporal Correlation Of mentioning

confidence: 50%

Health Factors as Potential Mediators of the Longitudinal Effect of Loneliness on General Cognitive Ability

Kim

Beam

Greenberg

et al. 2020

The American Journal of Geriatric Psychiatry

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OBJECTIVE: Higher levels of loneliness in older adulthood predict cognitive decline, but research on mediating mechanisms is sparse. We examine multisystemic physiological risk, functional ability, self-rated health, depressive symptoms, and social participation as mediating processes for the association between loneliness and general cognitive ability over a 10-year follow-up in an older adult sample. METHODS: Three waves of data from 3,005 individuals (mean intake age: 69.30 (SD: 7.85) years; female = 51.61%) recruited during Wave 1 of the National Social Life, Health, and Aging Project were used to test whether hypothesized mediators collected at the 5-year follow-up explained effects of baseline loneliness on 10-year general cognitive ability. RESULTS: The relationship between baseline loneliness and 10-year general cognitive ability was not mediated by multisystemic physiological risk. Functional ability (β =-0.24, SE = 0.05, p < .001), self-rated health (β=-0.08, SE = 0.02, p < .001), depressive symptoms (β=-0.20, SE = 0.05, p < .001), and social participation (β =-0.03, SE = 0.01, p = .016) significantly mediated effects. Indirect effects remained significant after adjusting for demographic covariates and 5year general cognitive ability, except social participation. DISCUSSION: Loneliness may influence cognitive ability indirectly, signaling waning physical and psychiatric health more proximally correlated with cognitive ability. These mechanisms may serve as targets of intervention for cognitive maintenance in lonely older adults. (217/250)

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Section: Importance Of Health Factors In the Temporal Correlation Of mentioning

confidence: 50%

Health Factors as Potential Mediators of the Longitudinal Effect of Loneliness on General Cognitive Ability

Kim

Beam

Greenberg

et al. 2020

The American Journal of Geriatric Psychiatry

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“…The inclusion of the five-item UCLA in TILDA also meant that we were able to look at loneliness based on data beyond the widely used three-item UCLA, using the direct item measure provided by item 5, and a total score, including this, as well as item 4, a reverse-scored positively worded item. In the context of a current lack of consensus on a validated UCLA cut-off (Fried et al 2020), this approach allowed us to look across these indicators for consistent patterns relating to HCU while also providing data comparable to other recent longitudinal analyses on loneliness and HCU (Gerst-Emerson and Jayawardhana 2015; Lim and Chan 2017).…”

Section: Strengthsmentioning

confidence: 85%

The impact of loneliness on healthcare use in older people: evidence from a nationally representative cohort

Burns

Leavey²,

Ward

et al. 2020

J Public Health (Berl.)

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Aim Concerns around loneliness leading to increased healthcare use persist in spite of a mixed evidence base and lack of adjustment for key potential confounders. We investigated the associations among loneliness, health and healthcare use in older adults including stratification to investigate whether these associations differ by gender. Subject and methods Secondary analysis of a nationally representative sample of 8175 community-dwelling adults aged 50 years and over from The Irish Longitudinal Study on Ageing (TILDA). Primary outcomes were self-reported general practitioner (GP) and emergency department (ED) visits in the past 12 months. Negative binomial and logistic regression analysis was used to investigate associations between loneliness and healthcare use, later adjusting for potential mediators (health and health behaviours). Results Loneliness was consistently positively associated with number of GP visits according to both cross-sectional and longitudinal analyses, with incidence rate ratios (IRRs) ranging from 1.08 to 1.33 in the sample overall. Associations with ED visits were less consistent. After adjusting for health and health behaviours, male loneliness does not appear to influence ED or GP visits. However, women who reported loneliness had an elevated risk of an ED visit at wave 1 (W1; odds ratio (OR) 1.08 [1.01-1.16]), as well as increased GP visits at both waves (IRRs ranging from 1.

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“…10 Loneliness is a subjective negative experience that results from inadequate meaningful connections, where ‘inadequate’ refers to the discrepancy or unmet need between an individual’s preferred and actual experience. 3 21 Loneliness has been described in a range of different domains and experienced as a sense of inadequate social connection to:…”

Section: Definitionsmentioning

confidence: 99%

Consensus statement: loneliness in older adults, the 21st century social determinant of health?

et al. 2020

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ObjectiveThe purpose of this consensus statement is to determine the state of the field of loneliness among older people, highlighting key issues for researchers, policymakers and those designing services and interventions.MethodsIn December 2018, an international meeting on loneliness was held in Belfast with leaders from across the USA and Europe. A summary of the conclusions reached at this event is presented following a consensus-building exercise conducted both during this event after each presentation as well as after the event through the drafting, reviewing and agreement of this statement by all authors for over 6 months.ResultsThis meeting resulted in an agreement to produce a consensus statement on key issues including definitions of loneliness, measurement, antecedents, consequences and interventions.DiscussionThere has been an exponential growth in research on loneliness among older adults. However, differing measurements and definitions of loneliness mean the incidence and prevalence, associated risk factors and health consequences are often conflicting or confusing especially for those developing policy and services.

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A unified approach to loneliness

Cited by 84 publications

References 1 publication

Health Factors as Potential Mediators of the Longitudinal Effect of Loneliness on General Cognitive Ability

Health Factors as Potential Mediators of the Longitudinal Effect of Loneliness on General Cognitive Ability

The impact of loneliness on healthcare use in older people: evidence from a nationally representative cohort

Consensus statement: loneliness in older adults, the 21st century social determinant of health?

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