Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women

Abstract

Background: This study examined whether loneliness predicts cardiovascular-and all-cause mortality in older men and women. Methods: Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n = 524). Mortality data were analyzed until 2012 through Swedish national registers. Results: Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78-2.96; all-cause HR 1.32, 95% CI 0.77-2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14-4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04-5.65). Conclusions: Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular-or allcause mortality in men.

Living arrangement modifies the associations of loneliness with adverse health outcomes in older adults: evidence from the CLHLS

“…In addition to the modifying effect of living arrangement, age and gender could also modify the associations of loneliness with prevalent cognitive impairment and mortality: older adults ≥80 years, older males and older females had higher risk of prevalent cognitive impairment; older adults < 80 years and older females were especially more likely to die at the 3-year follow-up. These results were consistent with previous studies [ 7 , 9 , 23 ], but further demonstrated the role of age in modifying the associations of loneliness with cognitive impairment and mortality. Our findings concluded that when managing the impacts of loneliness on different adverse health outcomes, not only living arrangement but age and gender should be considered when formulating individualized strategies.…”

“…Loneliness is a major source of suffering among older adults [ 6 ]. It has been found that loneliness increased the risk of developing dementia among older adults especially in men [ 7 ], and was associated with mental disorders such as depression, physical decline and increased risk of death [ 4 , 8 , 9 ].…”

Loneliness and its predictors among older adults prior to and during the COVID-19 pandemic: cross-sectional and longitudinal survey findings from participants of the Atherosclerosis Risk in Communities (ARIC) Study cohort in the USA

“…The overall more favourable health profile of those who responded to the Psychosocial Wellbeing Questionnaire, compared with the non-respondents likely biased our estimates of the prevalence of loneliness towards the null, as worse physical health has been found to be associated with increased prevalence of loneliness. [37][38][39][40][41][42][43] In our assessment of participants' perceived loneliness, we used the short three-item UCLA Loneliness Scale. This was dictated by the need for a short telephone, rather than in-person, assessment.…”

“…However, the strength of this study lies in the ascertainment of change in perceived loneliness from before to during the COVID-19 pandemic, as well as availability of validated repeated measures on risk factors, morbidity, and lifestyle and behavioural characteristics. The overall more favourable health profile of those who responded to the Psychosocial Wellbeing Questionnaire, compared with the non-respondents likely biased our estimates of the prevalence of loneliness towards the null, as worse physical health has been found to be associated with increased prevalence of loneliness 37–43…”

Loneliness and Risk for Cardiovascular Disease: Mechanisms and Future Directions

“…For example, there have been some differential findings for men and women with respect to loneliness. Using data from the Swedish Gothenburg H70 Birth Cohort Studies, loneliness was a predictor of cardiovascular mortality in women (HR = 2.42; 95% CI = 1.04–5.65), but not in men (HR = 1.52; 95% CI = 0.78–2.96) independent of living alone [ 26 ]. Additionally, in a prospective study of population-based Finnish men (ages 42–61) who were followed for an average of 23 years, loneliness but not social isolation predicted CVD mortality (HR = 1.12; 95% CI = 1.01 to 1.24), even whilst adjusting for depressive symptoms and other confounding variables [ 27 ].…”