Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL)

Abstract

Background. Loneliness has a significant influence on both physical and mental health. Few studies have investigated the possible associations of loneliness with mortality risk, impact on men and women and whether this impact concerns the situation of being alone (social isolation), experiencing loneliness (feeling lonely) or both. The current study investigated whether social isolation and feelings of loneliness in older men and women were associated with increased mortality risk, controlling for depression and other potentially confounding factors.Method. In our prospective cohort study of 4004 older persons aged 65-84 years with a 10-year follow-up of mortality data a Cox proportional hazard regression analysis was used to test whether social isolation factors and feelings of loneliness predicted an increased risk of mortality, controlling for psychiatric disorders and medical conditions, cognitive functioning, functional status and sociodemographic factors.Results. At 10 years follow-up, significantly more men than women with feelings of loneliness at baseline had died. After adjustment for explanatory variables including social isolation, the mortality hazard ratio for feelings of loneliness was 1.30 [95 % confidence interval (CI) 1.04-1.63] in men and 1.04 (95 % CI 0.90-1.24) in women. No higher risk of mortality was found for social isolation.Conclusions. Feelings of loneliness rather than social isolation factors were found to be a major risk factor for increasing mortality in older men. Developing a better understanding of the nature of this association may help us to improve quality of life and longevity, especially in older men.

Assessment of health, functioning and disability of a population aged 60–70 in south-eastern Poland using the WHO Disability Assessment Schedule (WHODAS 2.0)

“…Similar results were obtained by Avalud who concluded that the risk of becoming disabled of a person suffering from 4 chonic diseases is increased 4-fold [46]. Chronic diseases are the leading cause of disability, and the dependence of the elderly, together with low incomes, are the main reason for the use of social welfare benefits [47].…”

Loneliness and Social Isolation: Risk Factors Long Overdue for Surveillance

“…In addition, depression (P = .04, HR = 1.81) and social isolation (P = .04, HR = 2.25) predicted mortality independent of demographics, clinical status, and treatment. 44 • When a prospective cohort study 45 of 4000 adults aged 65 to 84 years were followed for 10 years in the Netherlands, significantly more lonely men than women died. After controlling for other potentially explanatory variables (social isolation, psychiatric disorders, medical conditions, cognitive functioning, functional status, and sociodemographic factors), the mortality HR for loneliness was 1.30 (95% CI, 1.04-1.63) in men and 1.04 (95% CI, 0.90-1.24) in women.…”

“…The study authors concluded that loneliness but not social isolation was a major risk factor for higher mortality in older men. 45 • In contrast to the Dutch study, 45 a 2013 United Kingdom assessment of 6500 men and women 52 years and older over 7.25 years found that although loneliness and social isolation were both associated with increased mortality, after adjusting for other potentially influential variables, social isolation remained significantly associated with mortality (HR = 1.26; 95% CI, 1.08-1.48 for the most isolated), whereas loneliness did not (HR = 0.92; 95% CI, 0.78-1.09), indicating that social isolation was an independent factor raising mortality, but loneliness was not. 10 • To more closely examine the relationship between social isolation and mortality and to compare the predictive power of social isolation to that of traditional risk factors (elevated cholesterol, hypertension, smoking, obesity), California investigators used a nationally representative sample of 16 849 adults and found that socially isolated men and women had higher mortality than less socially isolated individuals and that social isolation predicted mortality for both genders, as did smoking and high blood pressure.…”

Problem-focused and emotion-focused coping options and loneliness: how are they related?

“…Loneliness is a negative experience (Dahlberg 2007;De Jong Gierveld 1998;Peplau and Perlman 1982) observed to be related to negative effects on well-being (De Jong Gierveld 1998) and physical and mental health (Hawkley and Cacioppo 2010;Heinrich and Gullone 2006;Holwerda et al 2012;Ó Luanaigh and Lawlor 2008;Routasalo and Pitkala 2003;Shankar et al 2013). We assume that due to its negative impact on people's lives, lonely people generally do not want to remain that way and try to overcome their loneliness.…”