Loneliness and All-Cause, Cardiovascular, and Noncardiovascular Mortality in Older Men: The Zutphen Elderly Study

Julsing, Jolien E.; Kromhout, Daan; Geleijnse, Johanna M.; Giltay, Erik J.

doi:10.1016/j.jagp.2016.01.136

Cited by 29 publications

(22 citation statements)

References 35 publications

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“…A previous Dutch study with multiple measures of loneliness had not reported clear evidence of an association between feeling lonely and cardiovascular mortality in older men (hazard ratio associated with being severely lonely 1.18, 95% CI 0.58–2.39). 28 The absence of a statistically significant effect is likely to have stemmed from the study's relatively small sample size: 719 men in total, only 23 of whom were classed as being ‘severely lonely’. Our study relied on a sample of over 5000 individuals, surveyed every 2 years rather than every 5 years in the Zutphen Elderly Study.…”

Section: Discussionmentioning

confidence: 99%

Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing

Valtorta

Kanaan

Gilbody

et al. 2018

Eur J Prev Cardiolog

207

146

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Background There is increasing evidence of an association between social relationships and morbidity in general, and cardiovascular disease in particular. However, recent syntheses of the evidence raise two important questions: is it the perceived quality or the more objective quantity of relationships that matters most; and what are the implications of changes in relationships over time? In this study, we investigate the cumulative effects of loneliness and social isolation on incident cardiovascular disease. Design A secondary analysis of prospective follow-up data from the English Longitudinal Study of Ageing (ELSA). Methods To assess the association between social isolation or loneliness and incident cardiovascular disease, lagged values of exposure to loneliness and isolation were treated as time-varying variables in discrete time survival models controlling for potential confounders and established cardiovascular disease risk factors. Results A total of 5397 men and women aged over 50 years were followed up for new fatal and non-fatal diagnoses of heart disease and stroke between 2004 and 2010. Over a mean follow-up period of 5.4 years, 571 new cardiovascular events were recorded. We found that loneliness was associated with an increased risk of cardiovascular disease (odds ratio 1.27, 95% confidence interval 1.01-1.57). Social isolation, meanwhile, was not associated with disease incidence. There was no evidence of a cumulative effect over time of social relationships on cardiovascular disease risk. Conclusions Loneliness is associated with an increased risk of developing coronary heart disease and stroke, independently of traditional cardiovascular disease risk factors. Our findings suggest that primary prevention strategies targeting loneliness could help to prevent cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing

Valtorta

Kanaan

Gilbody

et al. 2018

Eur J Prev Cardiolog

207

146

View full text Add to dashboard Cite

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“…Loneliness was measured using either a single item question, or one of two well established scales. Eight studies used the De Jong Gierveld scale [49,50,54,56,62,68,73], and all but one study [70] employed the longer 11-point version. The UCLA loneliness measure was used in five studies [7,65,66,68,72].…”

Section: Measurement Of Lonelinessmentioning

confidence: 99%

Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis

et al. 2021

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Background and objective Loneliness is associated with increased rates of morbidity and mortality, and is a growing public health concern in later life. This study aimed to produce an evidence-based estimate of the prevalence of loneliness amongst older people (aged 60 years and above). Study design and setting Systematic review and random-effects meta-analysis of observational studies from high income countries 2008 to 2020, identified from searches of five electronic databases (Medline, EMBASE, PsychINFO, CINAHL, Proquest Social Sciences Premium Collection). Studies were included if they measured loneliness in an unselected population. Results Thirty-nine studies reported data on 120,000 older people from 29 countries. Thirty-one studies were suitable for meta-analysis. The pooled prevalence estimate of loneliness was 28.5% (95%CI: 23.9% - 33.2%). In twenty-nine studies reporting loneliness severity, the pooled prevalence was 25.9% (95%CI: 21.6% - 30.3%) for moderate loneliness and 7.9% (95%CI: 4.8% - 11.6%) for severe loneliness (z = -6.1, p < 0.001). Similar pooled prevalence estimates were observed for people aged 65–75 years (27.6%, 95%CI: 22.6% - 33.0%) and over 75 years (31.3%, 95%CI: 21.0% - 42.7%, z = 0.64, p = 0.52). Lower levels of loneliness were reported in studies from Northern Europe compared to South and Eastern Europe. Conclusions Loneliness is common amongst older adults affecting approximately one in four in high income countries. There is no evidence of an increase in the prevalence of loneliness with age in the older population. The burden of loneliness is an important public health and social problem, despite severe loneliness being uncommon. PROSPERO registration CRD42017060472.

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“…Julsing et al. [ 12 ] found no association between loneliness and all-cause, cardiovascular and non-cardiovascular deaths among Dutch men, whereas research from the US Health and Retirement Study [ 13 ] and elsewhere [ 14 ] found that loneliness did predict early mortality. On the other hand, research from the English Longitudinal Study of Ageing found that although both loneliness and social isolation were associated with premature mortality, social isolation was the more important factor [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…The correlation between loneliness and social isolation tends to be weak [ 2 , 3 , 10 , 15 ] and the level of agreement or discordance between the two may be important, particularly as loneliness and social isolation relate differently to health outcomes, including mortality [ 6 , 10 , 12 , 14 ]. There may also be important discordance between loneliness and social isolation whereby individuals may report high levels of loneliness despite being objectively socially integrated and vice versa [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Mortality risk associated with combinations of loneliness and social isolation. Findings from The Irish Longitudinal Study on Ageing (TILDA)

et al. 2021

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Background Social distancing and similar measures in response to the coronavirus disease 2019 pandemic have greatly increased loneliness and social isolation among older adults. Understanding the association between loneliness and mortality is therefore critically important. We examined whether combinations of loneliness and social isolation, using a metric named social asymmetry, was associated with increased mortality risk. Methods The sample was derived from participants in The Irish Longitudinal Study on Ageing, a nationally representative sample of community-dwelling older adults aged ≥50. Survey data were linked to official death registration records. Cox proportional hazards regressions and competing risk survival analyses were used to examine the association between social asymmetry and all-cause and cause-specific mortality. Results Of four social asymmetry groups, concordant low lonely (low loneliness, low isolation) included 35.5% of participants; 26.4% were concordant high lonely (high loneliness, high isolation); 19.2% were discordant robust (low loneliness, high isolation) and 18.9% discordant susceptible (high loneliness, low isolation). The concordant high lonely (hazard ratio [HR] = 1.43, 95% confidence interval [CI]: 1.09–1.87) and discordant robust (HR = 1.37, 95% CI: 1.04–1.81) groups had an increased mortality risk compared to those in the concordant low lonely group. The concordant high lonely group had an increased risk of mortality due to diseases of the circulatory system (sub-distribution hazard ratio = 1.52, 95% CI: 1.03–2.25). Conclusion We found that social asymmetry predicted mortality over a 7-year follow-up period. Our results confirm that a mismatch between subjective loneliness and objective social isolation, as well as the combination of loneliness and social isolation, were associated with an increased all-cause mortality risk.

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Loneliness and All-Cause, Cardiovascular, and Noncardiovascular Mortality in Older Men: The Zutphen Elderly Study

Cited by 29 publications

References 35 publications

Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing

Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing

Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis

Mortality risk associated with combinations of loneliness and social isolation. Findings from The Irish Longitudinal Study on Ageing (TILDA)

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