Associations of Loneliness and Social Isolation with Healthspan and Lifespan in the US Health and Retirement Study

Abstract

Background. Loneliness and social isolation are emerging public health challenges for aging populations. Methods. We followed N=11,305 US Health and Retirement Study (HRS) participants aged 50-95 from 2006-2014 to measure persistence of exposure to loneliness and social isolation. We tested associations of longitudinal loneliness and social-isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018. Results. During follow-up, 18% of older adults met criteria for loneliness and, for 6%, symptoms persisted across two or more follow-up assessments. For social isolation, these fractions were 21% and 8%. HRS participants who experienced loneliness and social isolation were at increased risk for disease, disability, and mortality. Older adults experiencing persistent loneliness were at a 59% increased hazard of mortality compared to those who were never lonely. For social isolation, the increase was 28%. Effect-sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and social isolation also exhibited physiological indications of advanced biological aging (Cohen's-d for persistent loneliness and social isolation=0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence of symptoms was associated with increased risk. Conclusion. Deficits in social connectedness prevalent in a national sample of older adults in the US were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connection to interrupt experiences of loneliness may promote healthy aging.

Loneliness and isolated living status in middle-aged and older adults in Taiwan: exploration on stress-related biomarkers, depressive symptoms, and disability

“…In our study, we did not find significant associations between different combinations of loneliness and isolated living status at baseline and mobility/IADL disability 6 years later after adjusting for baseline disabilities and covariates. The associations between isolated living status and physical disability in an aging population may be partly but not fully explained by correlated social and economic circumstances and social relationships [ 48 ].…”

COVID-19 pandemic partnership between medical students and isolated elders improves student understanding of older adults’ lived experience

“…3 Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada. 4 Toronto Western Family Health Team, University Health Network, Toronto, Canada. 5 Hospital for Sick Children, Toronto, Canada.…”

“…Loneliness is associated with increased risk of death, hospitalization, and emergency department visits for older adults with heart failure [1]. Social isolation is linked to an increased risk of premature mortality [3][4][5][6] and developing dementia [1]. This growing concern is coupled with research that suggests ageism amongst physicians-in-training is an issue that may impact social empathy and contribute to a lack of understanding older adults' care needs [7][8][9].…”